Legislature(1997 - 1998)
05/08/1997 03:07 PM House HES
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* first hearing in first committee of referral
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= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
HOUSE HEALTH, EDUCATION AND SOCIAL
SERVICES STANDING COMMITTEE
May 8, 1997
3:07 p.m.
MEMBERS PRESENT
Representative Con Bunde, Chairman
Representative Joe Green, Vice Chairman
Representative Al Vezey
Representative Brian Porter
Representative Fred Dyson
Representative J. Allen Kemplen
Representative Tom Brice
MEMBERS ABSENT
Representative Al Vezey
COMMITTEE CALENDAR
*HOUSE BILL NO. 219
"An Act relating to chiropractic health care services provided by
a health maintenance organization."
- HEARD AND HELD
(* First public hearing)
PREVIOUS ACTION
BILL: HB 219
SHORT TITLE: CHIROPRACTIC CARE BY HMO
SPONSOR(S): REPRESENTATIVE(S) KOTT
JRN-DATE JRN-DATE ACTION
04/01/97 897 (H) READ THE FIRST TIME - REFERRAL(S)
04/01/97 897 (H) HES
05/08/97 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
NICOLE POIRRIER, Student Intern
for Representative Kott
Alaska State Legislature
Capitol Building, Room 204
Juneau, Alaska 99801
Telephone: (907) 465-3777
POSITION STATEMENT: Provide sponsor statement for HB 219
MITCHELL D. GRAVO, Lobbyist
Alaska Chiropractic Society
170 Botanical Circle
Anchorage, Alaska 99515
Telephone: (907) 244-2884
POSITION STATEMENT: Testified in support of HB 219
ACTION NARRATIVE
TAPE 97-44, SIDE A
Number 0000
CHAIRMAN CON BUNDE called the House Health, Education and Social
Services Standing Committee meeting to order at 3:07 p.m. Members
present at the call to order were Representatives Bunde, Green,
Porter and Dyson. Representatives Brice and Kemplen arrived at
3:11 p.m. and 3:13 p.m., respectively. Representative Vezey was
absent.
HB 219 - CHIROPRACTIC CARE BY HMO
Number 0014
CHAIRMAN BUNDE announced that committee would hear HB 219, "An Act
relating to chiropractic health care services provided by a health
maintenance organization."
Number 0053
NICOLE POIRRIER, Student Intern for Representative Kott, said that
HB 219 will allow Alaskans to choose chiropractic services
notwithstanding the positions of their health maintenance
organizations or gatekeepers. This bill will give Alaskans the
right to choose their own initial treatment for their health
services. Health Maintenance Organizations (HMO's) attempt to
control the cost of health care by requiring all participants to
initially go through a gatekeeper. A gatekeeper is usually a
medical doctor or a registered nurse who listens to the health
complaint and refers the enrollee to the appropriate health care
provider. There has been a long-standing animosity between
traditional Western medicine and the chiropractic profession. This
animosity has improved in recent years, but a prejudice still
exists. Many times a gatekeeper will not refer a patient to a
chiropractor even if the HMO plan covers chiropractic services and
even if such a referral would be the most effective means of
solving the health complaint.
MS. POIRRIER stated that the bill addresses the issue of fairness.
It would require that an HMO allow their clients to self-refer to
a chiropractor, thus guaranteeing a patient's right to choose these
types of services. It also contains language stipulating that an
HMO cannot limit a health care provider from disclosure of
information to a patient regarding their condition or treatment
options. At this time, there are no HMO's operating in Alaska, but
this bill is being introduced in order to assure fairness and
access in the future.
Number 0177
CHAIRMAN BUNDE clarified that there are no HMO's in the state of
Alaska and that this bill would be considered pre-emptive
legislation. He asked if there are other fields of treatment that
would also prefer not to go through a gatekeeper. He questioned
whether or not the legislature would be setting up a special
privilege for chiropractors.
Number 0234
MITCHELL D. GRAVO, Lobbyist, Alaska Chiropractic Society, answered
that the chiropractic profession has been tracking their experience
within the HMO system. He mentioned that chiropractors fall into
a category of practitioners who would experience the same type of
prejudice. He thought that instead of waiting until there is a
problem in Alaska with HMO's not referring chiropractors, it was
better to have legislation such as HB 219 to address the problem
now, when there would be little opposition.
Number 0368
REPRESENTATIVE JOE GREEN repeated the question of whether this type
of legislation would lead to the exemption of other types of
treatment from having to go through a gatekeeper.
Number 0414
MR. GRAVO answered no, unless HB 219 was amended to include the
other types of treatment.
REPRESENTATIVE GREEN suggested that other types of practitioners
might use this type of legislation to allow them to avoid the HMO
gatekeeper.
Number 0414
MR. GRAVE stated that if he was representing those other interests,
he would use that argument, the self-referral argument. The person
who is going to receive the treatment should make the decision
about what kind of health care it is, not some large organization.
Number 0441
CHAIRMAN BUNDE commented that HMO's put side boards on treatment to
save money. The state can decide to allow those type of side
boards or can choose not to allow HMO's to come into the state.
Number 0475
REPRESENTATIVE BRIAN PORTER felt that HB 219 was a balanced
approach. It allows 30 days of treatment and if the treatment
period extends past that, then there is a check and balance by the
organization.
Number 0490
CHAIRMAN BUNDE announced that this is the first time HB 219 has
been heard and it would be held for further discussion. He took a
brief at ease at 3:14 p.m. which reconvened at 3:16 p.m. He said
the committee might work on the foundation formula over the summer
and suggested that the committee take HB 215 and HB 216 back to
their district.
Number 0571
REPRESENTATIVE DYSON stated that he would be working on Fetal
Alcohol Syndrome issues this summer and that he would keep the
chair apprised of his work.
Number 0590
ADJOURNMENT
There being no further business to conduct, CHAIRMAN BUNDE
adjourned the meeting of the House Health, Education and Social
Services Standing Committee at 3:18 p.m.
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