02/22/2007 03:00 PM House HEALTH, EDUCATION & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| SCR2 | |
| HB100 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HB 100 | TELECONFERENCED | |
| + | SCR 2 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE
February 22, 2007
3:04 p.m.
MEMBERS PRESENT
Representative Peggy Wilson, Chair
Representative Bob Roses, Vice Chair
Representative Mark Neuman
Representative Paul Seaton
Representative Sharon Cissna
Representative Berta Gardner
MEMBERS ABSENT
Representative Anna Fairclough
COMMITTEE CALENDAR
SENATE CONCURRENT RESOLUTION NO. 2
Relating to establishing March 2007 as brain injury awareness
month.
- MOVED SCR 2 OUT OF COMMITTEE
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 100
"An Act relating to exempting certain air ambulance services
from insurance regulation and requiring certain air ambulance
services to provide services."
- CANCELLED, HEARD TESTIMONY
PREVIOUS COMMITTEE ACTION
BILL: SCR 2
SHORT TITLE: BRAIN INJURY AWARENESS MONTH: MARCH 2007
SPONSOR(s): SENATOR(s) MCGUIRE
01/24/07 (S) READ THE FIRST TIME - REFERRALS
01/24/07 (S) HES
02/14/07 (S) HES AT 1:30 PM BUTROVICH 205
02/14/07 (S) Moved SCR 2 Out of Committee
02/14/07 (S) MINUTE(HES)
02/16/07 (S) HES RPT 5DP
02/16/07 (S) DP: DAVIS, ELTON, THOMAS, COWDERY,
DYSON
02/19/07 (S) BEFORE THE SENATE IN FINAL PASSAGE
02/19/07 (S) TRANSMITTED TO (H)
02/19/07 (S) VERSION: SCR 2
02/21/07 (H) READ THE FIRST TIME - REFERRALS
02/21/07 (H) HES
02/22/07 (H) HES AT 3:00 PM CAPITOL 106
BILL: HB 100
SHORT TITLE: AIR AMBULANCE SERVICES
SPONSOR(s): REPRESENTATIVE(s) COGHILL
01/16/07 (H) READ THE FIRST TIME - REFERRALS
01/16/07 (H) HES, L&C
02/15/07 (H) SPONSOR SUBSTITUTE INTRODUCED
02/15/07 (H) READ THE FIRST TIME - REFERRALS
02/15/07 (H) HES, L&C
02/22/07 (H) HES AT 3:00 PM CAPITOL 106
WITNESS REGISTER
MARIT CARLSON-VAN DORT, Staff
to Senator Lesil McGuire
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: Presented SCR 2 on behalf of Senator
McGuire, sponsor.
ART WARBELOW, President & Owner
Warbelow Air Ventures, Inc.
Fairbanks, Alaska
POSITION STATEMENT: Testified in opposition to SSHB 100.
ACTION NARRATIVE
CHAIR PEGGY WILSON called the House Health, Education and Social
Services Standing Committee meeting to order at 3:04:15 PM.
Representatives Wilson, Neuman, Seaton, Cissna, Roses, and
Gardner were present at the call to order.
SCR 2-BRAIN INJURY AWARENESS MONTH: MARCH 2007
3:04:41 PM
CHAIR WILSON announced that the first order of business would be
SENATE CONCURRENT RESOLUTION NO. 2, Relating to establishing
March 2007 as brain injury awareness month.
[A brief discussion regarding SSHB 100 testimony ensued.]
3:07:13 PM
MARIT CARLSON-VAN DORT, Staff to Senator Lesil McGuire, Alaska
State Legislature, sponsor, explained that this resolution is
intended to draw awareness to traumatic brain injuries, in
addition to supporting those who have suffered from such an
injury, their families, and care providers. Traumatic brain
injuries are one of the leading causes of death among young
people in Alaska. She pointed out that Alaska has the highest
number of traumatic brain injuries per capita. An estimated
12,000 Alaskans have suffered from this type of injury. She
then gave examples of events that can lead to a traumatic brain
injury. Many victims of these injuries live with permanent
disability. "The tragedy of traumatic brain injury is
exacerbated by the fact that it's preventable," she said. She
went on to say that this type of injury is often life-altering,
and can place a tremendous strain on everyone involved. March
is recognized [as brain injury awareness month] by the Brain
Injury Awareness Association of America.
3:08:50 PM
REPRESENTATIVE NEUMAN inquired as to whether March is currently
recognized as an "awareness month."
MS. CARLSON-VAN DORT replied that she is unable to answer this.
REPRESENTATIVE SEATON moved to report SCR 2 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, SCR 2 was reported from the
House Health, Education and Social Services Standing Committee.
HB 100-AIR AMBULANCE SERVICES
CHAIR WILSON announced that the final order of business would be
SPONSOR SUBSTITUTE FOR HOUSE BILL NO. 100, "An Act relating to
exempting certain air ambulance services from insurance
regulation and requiring certain air ambulance services to
provide services."
CHAIR WILSON explained that the bill hearing was cancelled,
therefore SSHB 100 would not be discussed. However, the
committee would hear specific testimony.
3:10:27 PM
REPRESENTATIVE GARDNER stated her appreciation that the
committee is able to accommodate the aforementioned testimony.
CHAIR WILSON shared her understanding of the intent behind SSHB
100.
3:11:44 PM
ART WARBELOW, President & Owner, Warbelow Air Ventures, Inc,
("Warbelow") began by giving a brief history of the company. He
stated that Warbelow is a critical care air ambulance provider,
and is opposed to SSHB 100. He opined that memberships reduce
the efficiency of air ambulances, and will force air ambulance
providers to field sales organizations in order to sell
memberships. This would take money away from necessary support
services. Memberships would also limit patient choices and
increase wait times. He stated that this is an insurance
product, and expressed concern regarding operators that sell
"lifetime memberships." He also stressed the importance of
requiring that providers show fiscal responsibility. In regard
to deductibles and copays, he stated that consumers may be led
to believe that this insurance would protect against high
deductibles and copays; however, this only applies to the air
ambulance portion. He opined that patients should be aware that
this insurance does not protect against hospital deductibles and
copays.
3:15:27 PM
MR. WARBELOW went on to say that air ambulance services are
available regardless of whether insurance is available. Air
ambulance providers are restricted from inquiring as to whether
a patient has the ability to pay. He said "We write off
probably about 25 percent of our air ambulance charges, because
the people that we transported don't have insurance, and don't
have any way to pay." People will not be denied service if SSHB
100 does not pass. He then explained that this type of
insurance has been sold by a single carrier for many years.
Warbelow contacted the Division of Insurance to find out whether
the sale of this type of insurance was legal, and was informed
that it was not. The Division of insurance was investigating
this. He opined that the current legislation is evidence that
sale of this insurance is illegal. If this legislation were to
pass, other carriers would be at a competitive disadvantage, as
the aforementioned carrier has built up a base of memberships.
Therefore, he requested that any carriers that have violated
this law be required to cancel and refund the memberships, in
addition to "standing down" for a period of one year. This
would create a level playing field for other providers. He
opined that it is inappropriate to reward carriers that have
disregarded the current regulations and statutes, while
penalizing those that have complied.
3:19:40 PM
REPRESENTATIVE CISSNA requested details regarding the services
offered, and related costs.
3:20:08 PM
MR. WARBELOW described the aircraft used for the air ambulance
service. The air ambulance may carry two paramedics, or one
paramedic and one nurse, in addition to medical equipment. He
explained that state law requires that certain equipment be
onboard to be certified as a critical care air ambulance
provider. The air ambulance crew and equipment is on call 24
hours, seven days a week, and has a rotating crew. Prices are
driven from Medicare and Medicaid reimbursement levels, and are
generally in the $5-$10 thousand range. In response to
additional questions, he explained that the air ambulance can go
anywhere in the state; however, most business is in the Tanana
Chiefs region. Typically, the flights are 100-300 miles.
Warbelow currently has a contract with Tanana Chiefs Conference
(TCC).
3:22:34 PM
MR. WARBELOW, in response to a question from Representative
Neuman regarding federal compensation, explained that the only
sources of compensation are Medicare, Medicaid, third party
insurance, or payment from the contract holder. In response to
an additional question, he explained that an air ambulance is
restricted from flying if weather minimums are not met.
3:23:53 PM
REPRESENTATIVE SEATON inquired as to whether all air ambulance
services receive the same reimbursement from Medicare and
Medicaid.
MR. WARBELOW replied yes. He explained that the rates are
established. The company may bill any amount; however, Medicare
and Medicaid reimburses based on these rates.
REPRESENTATIVE SEATON posed a scenario in which a village
covered by a contract signed up for insurance with a different
carrier, and inquired as to how this would work.
MR. WARBELOW replied that this has been a "complicated
situation." He shared his experience of local competitors
attempting to solicit business from areas covered by a contract
with Warbelow. He explained that if enough Medicaid and
Medicare reimbursements are received, the contract business can
be done "for free." He shared his understanding that this is
illegal.
CHAIR WILSON shared her experience with using this type of
insurance program to cover air ambulance services.
3:27:17 PM
REPRESENTATIVE ROSES requested additional information regarding
the legality of current policies.
MR. WARBELOW explained that when Warbelow contacted the Division
of Insurance to inquire as to whether it might sell this
insurance, the Division stated that this would be contrary to
current regulations. He added that the Division was
investigating the company that was selling the insurance. In
response to a question, he stated that this occurred about five
years ago.
3:28:18 PM
REPRESENTATIVE SEATON clarified that SSHB 100 does not exempt
air ambulance services from carrying insurance.
MR. WARBELOW stated that while he may not be available for the
next hearing of SSHB 100, he will be available for questions
after March 1, 2007.
3:29:56 PM
CHAIR WILSON closed testimony, and stated that her intention is
to hear and hold SSHB 100 at the March 1, 2007, meeting of the
House Health, Education and Social Services Standing Committee.
3:30:31 PM
ADJOURNMENT
There being no further business before the committee, the House
Health, Education and Social Services Standing Committee meeting
was adjourned at 3:30.
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