Legislature(2021 - 2022)BUTROVICH 205

04/13/2021 01:30 PM Senate HEALTH & SOCIAL SERVICES

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Audio Topic
02:01:50 PM Start
02:02:20 PM SB93
02:42:11 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to a Call of the Chair (Approx.2PM) --
+= SB 93 HEALTH INS. ALL-PAYER CLAIMS DATABASE TELECONFERENCED
Moved CSSB 93(HSS) Out of Committee
+ Bills Previously Heard/Scheduled TELECONFERENCED
                    ALASKA STATE LEGISLATURE                                                                                  
      SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE                                                                    
                         April 13, 2021                                                                                         
                           2:01 p.m.                                                                                            
                                                                                                                                
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator David Wilson, Chair                                                                                                     
Senator Shelley Hughes, Vice Chair                                                                                              
Senator Mia Costello                                                                                                            
Senator Lora Reinbold                                                                                                           
Senator Tom Begich                                                                                                              
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
SENATE BILL NO. 93                                                                                                              
"An Act relating to the establishment of an all-payer health                                                                    
claims database; and providing for an effective date."                                                                          
                                                                                                                                
      - MOVED CSSB 93(HSS) OUT OF COMMITTEE                                                                                     
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: SB  93                                                                                                                  
SHORT TITLE: HEALTH INS. ALL-PAYER CLAIMS DATABASE                                                                              
SPONSOR(s): RULES BY REQUEST OF THE GOVERNOR                                                                                    
                                                                                                                                
02/24/21       (S)       READ THE FIRST TIME - REFERRALS                                                                        
02/24/21       (S)       HSS, L&C, FIN                                                                                          
03/11/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/11/21       (S)       <Bill Hearing Rescheduled to 3/16/21>                                                                  
03/16/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/16/21       (S)       <Bill Hearing Canceled>                                                                                
03/23/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
03/23/21       (S)       Heard & Held                                                                                           
03/23/21       (S)       MINUTE(HSS)                                                                                            
04/07/21       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
04/07/21       (S)       Scheduled but Not Heard                                                                                
04/13/21       (S)       HSS AT 1:30 PM BUTROVICH 205                                                                           
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
LORI WING-HEIER, Director                                                                                                       
Division of Insurance                                                                                                           
Department  of  Commerce,   Community  and  Economic  Development                                                               
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Answered question on SB 93.                                                                               
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
2:01:50 PM                                                                                                                    
CHAIR DAVID WILSON  called the Senate Health  and Social Services                                                             
Standing Committee meeting  to order at 2:01 p.m.  Present at the                                                               
call to  order were Senators Begich,  Hughes, Costello, Reinbold,                                                               
and Chair Wilson.                                                                                                               
                                                                                                                                
          SB  93-HEALTH INS. ALL-PAYER CLAIMS DATABASE                                                                      
                                                                                                                                
2:02:20 PM                                                                                                                    
CHAIR WILSON announced the consideration of SENATE BILL NO. 93                                                                  
"An  Act relating  to the  establishment of  an all-payer  health                                                               
claims database; and providing for an effective date."                                                                          
                                                                                                                                
2:02:56 PM                                                                                                                    
LORI WING-HEIER,  Director, Division of Insurance,  Department of                                                               
Commerce,  Community and  Economic  Development (DCCED),  Juneau,                                                               
Alaska, stated that she is available to answer questions.                                                                       
                                                                                                                                
CHAIR WILSON stated his office received five amendments.                                                                        
                                                                                                                                
2:03:28 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
2:04:02 PM                                                                                                                    
CHAIR  WILSON reconvened  the  meeting for  discussion  on SB  93                                                               
Amendment 1.                                                                                                                    
                                                                                                                                
SENATOR REINBOLD moved Amendment 1.                                                                                             
                                                                                                                                
                          AMENDMENT 1                                                                                       
                                                                                                                                
                                                 32-GS1530\A.1                                                                  
                                                         Marx                                                                   
                                                      3/24/21                                                                   
                                                                                                                                
    OFFERED IN THE SENATE               BY SENATOR REINBOLD                                                                     
     TO: SB 93                                                                                                                  
                                                                                                                                
     Page 3, line 11:                                                                                                           
          Delete "may"                                                                                                          
          Insert "shall"                                                                                                        
                                                                                                                                
                                                                                                                                
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
SENATOR  REINBOLD  stated that  the  amendment  changes the  word                                                               
"may" to "shall" on page 3 line 11 of the bill.                                                                                 
                                                                                                                                
SENATOR COSTELLO asked  if members know why the  bill was drafted                                                               
using the  word "may",  which would  not require  the competitive                                                               
bid process to  be used. She asked if the  recovery from COVID-19                                                               
would have an impact.                                                                                                           
                                                                                                                                
MS.  WING-HEIRER stated  that  the  drafter of  the  bill had  no                                                               
concerns changing  the word  to "shall".  "May" was  carried over                                                               
from the federal bill.                                                                                                          
                                                                                                                                
2:05:24 PM                                                                                                                    
CHAIR  WILSON  withdrew his  objection.  There  being no  further                                                               
objection, Amendment 1 passed.                                                                                                  
                                                                                                                                
2:05:34 PM                                                                                                                    
CHAIR WILSON moved Amendment 2.                                                                                                 
                                                                                                                                
                          AMENDMENT 2                                                                                       
                                                                                                                                
                                                 32-GS1530\A.2                                                                  
                                                         Marx                                                                   
                                                      3/31/21                                                                   
                                                                                                                                
     OFFERED IN THE SENATE                 BY SENATOR WILSON                                                                    
     TO: SB 93                                                                                                                  
                                                                                                                                
     Page 4, following line 14:                                                                                                 
     Insert a new section to read:                                                                                              
          "Sec. 21.92.040. Eligibility for state grants.                                                                      
     (a) A  health care insurer  that is required  to submit                                                                    
     health  care data  to  the  statewide all-payer  health                                                                    
     claims database  may not receive  a state  grant unless                                                                    
     the  insurer  submits  the  data  as  required  by  the                                                                    
     director under AS 21.92.010.                                                                                               
          (b)  A health care payer that agrees to                                                                               
     voluntarily report  health care  data to  the statewide                                                                    
     all-payer  health claims  database  may  not receive  a                                                                    
     state grant  unless the payer  reports the data  to the                                                                    
     database as required by the payer's agreement."                                                                            
                                                                                                                                
     Page 4, line 15:                                                                                                           
     Delete "Sec. 21.92.040"                                                                                                  
     Insert "Sec. 21.92.050"                                                                                                  
                                                                                                                                
2:05:41 PM                                                                                                                    
SENATOR BEGICH objected for purposes of discussion.                                                                             
                                                                                                                                
2:05:45 PM                                                                                                                    
At ease.                                                                                                                        
                                                                                                                                
2:06:11 PM                                                                                                                    
CHAIR WILSON reconvened  the meeting and stated  that Amendment 2                                                               
is  on page  4 line  14. Amendment  2 is  incentive language  for                                                               
healthcare facilities  that enter  data in  the database  and are                                                               
eligible to receive grants. He  stated facilities must enter data                                                               
into the database to continue receiving state grants.                                                                           
                                                                                                                                
SENATOR REINBOLD  stated that she  disagrees with Amendment  2 as                                                               
it  appears to  be quid  pro  quo. Putting  information into  the                                                               
database should not be required in order to get a grant.                                                                        
                                                                                                                                
SENATOR COSTELLO  asked if grant  recipients in other  fields are                                                               
required to  submit information  and if it  is a  problem getting                                                               
them to submit it.                                                                                                              
                                                                                                                                
CHAIR  WILSON answered  that there  are entities  that must  give                                                               
reports  in  order   to  be  eligible  for   state  grants.  Some                                                               
healthcare  services  must  be  Medicaid  eligible  in  order  to                                                               
receive  grants.   Some  areas  of  behavioral   health  must  be                                                               
inclusive of all  providers, for example IHS  beneficiaries. If a                                                               
state grant  in behavioral health  is received, all  members must                                                               
be seen, not subsets of populations.                                                                                            
                                                                                                                                
SENATOR HUGHES stated  that she is for the  amendment because its                                                               
purpose  is to  control costs  in the  state. Recipients  benefit                                                               
from   state  grants.   Requiring   they  provide   de-identified                                                               
information at  the onset of  receiving a  grant should not  be a                                                               
problem.                                                                                                                        
                                                                                                                                
2:09:02 PM                                                                                                                    
SENATOR  BEGICH withdrew  his objection  and thanked  members for                                                               
the description of change that Amendment 2 creates.                                                                             
                                                                                                                                
2:09:11 PM                                                                                                                    
SENATOR  REINBOLD  contended  that Amendment  2  was  outlandish.                                                               
Insurers should  not have  to provide  confidential data  that is                                                               
protected by the Health  Insurance Portability and Accountability                                                               
Act  (HIPPA).   Awarding  grants  should  not   be  dependent  on                                                               
providing  confidential data.  She  offered her  belief that  the                                                               
bill is unconstitutional.                                                                                                       
                                                                                                                                
SENATOR HUGHES  asked Ms.  Wing-Heier to  speak to  the assertion                                                               
that   the  amendment   will  violate   HIPPA  laws   and  reveal                                                               
confidential information.                                                                                                       
                                                                                                                                
MS. WING-HEIER LORI WING-HEIER, Director, Division of Insurance                                                                 
Department  of  Commerce,   Community  and  Economic  Development                                                               
Anchorage,  Alaska  replied  that  the  bill  already  asks  that                                                               
healthcare insurers submit  data and there are  penalties if they                                                               
do not.  Amendment 2 states  that if  insurers do not  submit the                                                               
data, they  will not  be eligible for  state grants.  Amendment 2                                                               
does not change the type of  data to be submitted therefore HIPPA                                                               
laws have no relevance to the amendment.                                                                                        
                                                                                                                                
SENATOR HUGHES  asked if there is  any data in the  database that                                                               
breaks patient confidentiality.                                                                                                 
                                                                                                                                
MS. WING-HEIER answered no. The data must be de-identified.                                                                     
                                                                                                                                
SENATOR  REINBOLD  questioned  if  any  of  the  healthcare  data                                                               
submitted  to  the  claims database  regard  the  patient,  their                                                               
diagnosis or medication.                                                                                                        
                                                                                                                                
MS. WING-HEIER  clarified that the  database will not  identify a                                                               
patient,  but  information   on  pharmaceuticals,  medicines  and                                                               
procedures  will  be  collected.  That   is  the  intent  of  the                                                               
database.                                                                                                                       
                                                                                                                                
2:11:09 PM                                                                                                                    
SENATOR  REINBOLD  asked how  the  state  rates in  keeping  data                                                               
secure.                                                                                                                         
                                                                                                                                
MS. WING-HEIER replied she cannot answer the question.                                                                          
                                                                                                                                
SENATOR REINBOLD  stated that the  bill is dangerous, and  she is                                                               
against the amendment.                                                                                                          
                                                                                                                                
SENATOR HUGHES asked if it is  correct that a patient's name will                                                               
not be attached to submitted data.                                                                                              
                                                                                                                                
MS.  WING-HEIER replied  yes. Information  is de-identified,  and                                                               
data cannot be tied back to an individual.                                                                                      
                                                                                                                                
SENATOR COSTELLO asked  what the procedure would be  if a grantee                                                               
did  not  submit the  information  but  had begun  utilizing  the                                                               
grant. She asked if it would  increase the state costs to retract                                                               
and reissue grants.                                                                                                             
                                                                                                                                
                                                                                                                                
MS. WING-HEIER  offered her belief  that the grant would  be held                                                               
up until amends were made.  It would not automatically cancel any                                                               
grant.                                                                                                                          
                                                                                                                                
                                                                                                                                
CHAIR WILSON noted the objection and asked for a roll call.                                                                     
                                                                                                                                
2:12:24 PM                                                                                                                    
A roll  call vote was  taken. Senators Hughes,  Costello, Begich,                                                               
and Wilson  voted in  favor of Amendment  2 and  Senator Reinbold                                                               
voted against it. Therefore, Amendment 2 passed by a 4:1 vote.                                                                  
                                                                                                                                
2:13:13 PM                                                                                                                    
SENATOR BEGICH moved Amendment 3.                                                                                               
                                                                                                                                
                          AMENDMENT 3                                                                                       
                                                                                                                                
                                                 32-GS1530\A.3                                                                  
                                                         Marx                                                                   
                                                       4/9/21                                                                   
                                                                                                                                
    OFFERED IN THE SENATE                 BY SENATOR BEGICH                                                                     
     TO: SB 93                                                                                                                  
                                                                                                                                
     Page 3, line 7:                                                                                                            
          Delete the second occurrence of "and"                                                                                 
                                                                                                                                
     Page 3, following line 7:                                                                                                  
     Insert a new paragraph to read:                                                                                            
               "(5)  establish by regulation a schedule of                                                                      
     reasonable  fees   to  be  charged  to   an  authorized                                                                    
     requester that  is a  business entity  for the  use and                                                                    
     distribution of data from the  database to the business                                                                    
     entity; and"                                                                                                               
                                                                                                                                
     Renumber the following paragraph accordingly.                                                                              
                                                                                                                                
2:13:18 PM                                                                                                                    
SENATOR COSTELLO objected for purposes of discussion.                                                                           
                                                                                                                                
2:13:22 PM                                                                                                                    
SENATOR BEGICH  stated that Amendment 3  provides the opportunity                                                               
for the  director to establish,  by regulation, a  reasonable fee                                                               
schedule  for   enterprises  that  request  more   than  publicly                                                               
available data. It  is preceded in the bill by  a "ma   clause. A                                                               
director  is not  required to  set  fees for  enterprises but  is                                                               
provided an opportunity  should there be a need  to recoup costs.                                                               
The database would be free to the public.                                                                                       
                                                                                                                                
2:14:20 PM                                                                                                                    
SENATOR COSTELLO removed her objection.                                                                                         
                                                                                                                                
2:14:33 PM                                                                                                                    
SENATOR HUGHES asked if reasonable fees are defined.                                                                            
                                                                                                                                
SENATOR BEGICH  replied that the  language came  from Legislative                                                               
Legal Services, and they could answer the question.                                                                             
                                                                                                                                
CHAIR  WILSON stated  legal  services is  not  in attendance  and                                                               
suggested others who might answer.                                                                                              
                                                                                                                                
MS.  WING-HEIER stated  that reasonable  fees for  the regulation                                                               
project  would be  established by  collecting  data from  similar                                                               
databases and  determining the median. Public  comment would also                                                               
be taken. The federal bill states  who must be charged to use the                                                               
database,  such   as  universities,  researchers   and  insurance                                                               
companies.                                                                                                                      
                                                                                                                                
SENATOR  HUGHES  asked if  the  division  charging  a fee  is  to                                                               
recover data collection costs rather than making a profit.                                                                      
                                                                                                                                
SENATOR BEGICH replied  yes; producing data has a  cost and other                                                               
states have instituted  fees for similar data sets.  The fees are                                                               
to cover costs, not to be onerous.                                                                                              
                                                                                                                                
SENATOR  REINBOLD  stated  her  objection to  the  bill  and  the                                                               
database. She  offered her  belief that the  state should  not be                                                               
collecting data  on diagnoses, pharmaceuticals and  other private                                                               
data. She  does not trust the  government to protect the  data it                                                               
collects. She does not want  database information to be available                                                               
for individuals and enterprises to delve into.                                                                                  
                                                                                                                                
CHAIR WILSON asked for a roll call.                                                                                             
                                                                                                                                
2:18:12 PM                                                                                                                    
A roll  call vote was  taken. Senators Costello,  Begich, Hughes,                                                               
and Wilson  voted in  favor of Amendment  3 and  Senator Reinbold                                                               
voted against it. Therefore, Amendment 3 passed by a 4:1 vote.                                                                  
                                                                                                                                
2:18:48 PM                                                                                                                    
SENATOR BEGICH moved Amendment 4.                                                                                               
                                                                                                                                
                          AMENDMENT 4                                                                                       
                                                                                                                              
                                                 32-GS1530\A.4                                                                  
                                                         Marx                                                                   
                                                       4/9/21                                                                   
                                                                                                                                
    OFFERED IN THE SENATE                 BY SENATOR BEGICH                                                                     
     TO: SB 93                                                                                                                  
                                                                                                                                
     Page 3, following line 26:                                                                                                 
     Insert a new paragraph to read:                                                                                            
               "(6)         engage    consumer    protection                                                                    
     stakeholders   and  the   community   in  the   process                                                                    
     described in  (5) of this  subsection to  ensure claims                                                                    
     and other  data from  the database  are available  in a                                                                    
     format accessible to all authorized requesters;"                                                                           
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
2:19:00 PM                                                                                                                    
SENATOR BEGICH stated  Amendment 4 came from a  desire to involve                                                               
community  groups  in  the  process   so  that  the  database  is                                                               
accessible to all  Alaskans. This amendment asks  the division to                                                               
work with  community groups and consumer  protection stakeholders                                                               
to  ensure the  database is  available and  easy to  use for  all                                                               
Alaskan citizens.                                                                                                               
                                                                                                                                
2:19:31 PM                                                                                                                    
CHAIR WILSON asked Ms. Wing-Heier  how engagement of stakeholders                                                               
and the community would work in terms of accessing the data.                                                                    
                                                                                                                                
MS. WING-HEIER  replied outreach to  various groups, such  as the                                                               
Alaska  Native  Tribal  Health   Consortium,  would  be  done  to                                                               
determine interest.  If a group expresses  interest, the division                                                               
will  strive to  put a  translatable feature  on the  database to                                                               
meet  that  group's  need. The  division  will  prioritize  those                                                               
groups who express interest in using the database.                                                                              
                                                                                                                                
CHAIR WILSON asked Senator Begich to clarify user accessibility.                                                                
                                                                                                                                
SENATOR  BEGICH  replied the  data  from  the database  would  be                                                               
available in  a format accessible  to all  authorized requesters.                                                               
This  means the  data must  be  understood by  requesters and  it                                                               
means that  data must be  accessible. Consumers would  be engaged                                                               
in determining what barriers there  are to accessing information.                                                               
Ways  would  then  be  identified to  make  the  data  available.                                                               
Amendment  5  is  relevant  to  this  point,  as  it  provides  a                                                               
continual means of  keeping the database current.  Amendment 4 is                                                               
about format,  but it is also  about making sure the  database is                                                               
accessible to users by virtue of language or other matters.                                                                     
                                                                                                                                
2:21:44 PM                                                                                                                    
SENATOR  HUGHES asked  if Alaska  Native Tribal  Health providers                                                               
will contribute to the database.                                                                                                
                                                                                                                                
MS. WING-HEIER replied yes. Providers  that are insured plans and                                                               
Medicaid will contribute to the database.                                                                                       
                                                                                                                                
SENATOR  HUGHES commented  that de-identified  information is  an                                                               
advantage  of the  database since  information  will be  publicly                                                               
accessible. She  appreciates that  the information  will be  in a                                                               
format  that makes  ascertaining  identity  impossible, even  for                                                               
small  communities. She  asked  if another  fiscal  note will  be                                                               
necessary.                                                                                                                      
                                                                                                                                
MS.  WING-HEIER  replied  she  did   not  know.  Based  on  other                                                               
projects, programs come with  translation capability. Language is                                                               
a  small  portion of  the  programs;  mostly programs  are  about                                                               
numbers, which don't need translation.                                                                                          
                                                                                                                                
SENATOR  HUGHES asked  if  an  increment will  be  added at  this                                                               
point.                                                                                                                          
                                                                                                                                
MS. WING-HEIER answered no.                                                                                                     
                                                                                                                                
SENATOR REINBOLD  asked if anyone  in the state is  excluded from                                                               
the database.                                                                                                                   
                                                                                                                                
MS. WING-HEIER replied the division is not excluding anyone.                                                                    
                                                                                                                                
SENATOR REINBOLD asked  if everybody in the state  of Alaska will                                                               
be in the database.                                                                                                             
                                                                                                                                
MS.  WING-HEIER  replied that  insured  plans,  Alaska Care,  and                                                               
Medicaid are expected  to contribute to the  database. There will                                                               
be  people who  are not  included. The  bill specifically  states                                                               
insurance companies and everyone else is voluntary.                                                                             
                                                                                                                                
SENATOR  REINBOLD asked  if there  is any  tribal health  that is                                                               
excluded from the data.                                                                                                         
                                                                                                                                
MS. WING-HEIER responded no.                                                                                                    
                                                                                                                                
SENATOR REINBOLD sought confirmation  that people associated with                                                               
tribal  health are  not excluded  but  they may  not be  included                                                               
either.                                                                                                                         
                                                                                                                                
MS. WING-HEIER answered correct.                                                                                                
                                                                                                                                
SENATOR  REINBOLD  stated  that  she  objects  to  the  amendment                                                               
because if it was really  about healthcare, it would be promoting                                                               
healthy  lifestyle  instead  of  being a  massive  database  that                                                               
everyone has access to.                                                                                                         
                                                                                                                                
2:25:22 PM                                                                                                                    
CHAIR WILSON removed  his objection and asked for a  roll call. A                                                               
roll call vote was taken.                                                                                                       
                                                                                                                                
2:25:32 PM                                                                                                                    
Senators Begich, Hughes,  and Wilson voted in  favor of Amendment                                                               
4  and   Senators  Costello  and   Reinbold  voted   against  it.                                                               
Therefore, Amendment 4 passed by a 3:2 vote.                                                                                    
                                                                                                                                
2:25:57 PM                                                                                                                    
SENATOR BEGICH moved Amendment 5.                                                                                               
                                                                                                                                
                          AMENDMENT 5                                                                                       
                                                                                                                                
                                                 32-GS1530\A.5                                                                  
                                                         Marx                                                                   
                                                       4/9/21                                                                   
                                                                                                                                
    OFFERED IN THE SENATE                 BY SENATOR BEGICH                                                                     
     TO: SB 93                                                                                                                  
                                                                                                                                
     Page 3, following line 20:                                                                                                 
     Insert a new paragraph to read:                                                                                            
               "(4)  engage stakeholders in the development                                                                     
     and maintenance of the database;"                                                                                          
                                                                                                                                
     Renumber the following paragraphs accordingly.                                                                             
                                                                                                                                
2:26:02 PM                                                                                                                    
CHAIR WILSON objected for purposes of discussion.                                                                               
                                                                                                                                
SENATOR BEGICH stated  that Amendment 5 asks  for stakeholders to                                                               
be engaged  in the development  and maintenance of  the database.                                                               
Currently the  director could design  the database  without input                                                               
from stakeholders.                                                                                                              
                                                                                                                                
CHAIR WILSON asked Ms. Wing-Heier if  she had any issues with the                                                               
amendment.                                                                                                                      
                                                                                                                                
MS.  WING-HEIER stated  the  department does  not  object to  the                                                               
amendment. Stakeholder engagement  is encouraged. The regulations                                                               
of  the database  will be  an  open and  transparent process  and                                                               
involve stakeholders.  She suggested that hearings  could be held                                                               
once or twice a year to take public comment.                                                                                    
                                                                                                                                
2:27:37 PM                                                                                                                    
SENATOR HUGHES  noted the prior amendment  mentioned stakeholders                                                               
as being consumer protection stakeholders.  She asked the Senator                                                               
Begich if Amendment 5  includes consumer protection stakeholders.                                                               
She  opined  that  doing  so  would  ensure  information  is  de-                                                               
identified and  the database  is used  to lower  healthcare costs                                                               
for the state.                                                                                                                  
                                                                                                                                
SENATOR BEGICH replied that is the intent of the amendment.                                                                     
                                                                                                                                
SENATOR  HUGHES   stated  that  sometimes  only   people  in  the                                                               
healthcare   industry  are   considered.  She   appreciates  that                                                               
consumer  protection   stakeholders  will  be  included   in  the                                                               
amendment.                                                                                                                      
                                                                                                                                
SENATOR  REINBOLD asked  for the  stakeholders  mentioned in  the                                                               
amendment to be identified.                                                                                                     
                                                                                                                                
SENATOR  BEGICH stated  that the  stakeholders would  be consumer                                                               
stakeholders,  those who  deposit information  into the  database                                                               
and consumers of the data, which  could be members of the public,                                                               
businesses and researchers.                                                                                                     
                                                                                                                                
2:29:44 PM                                                                                                                    
SENATOR REINBOLD stated objection to Amendment 5.                                                                               
                                                                                                                                
SENATOR HUGHES stated  she was in favor of  the amendment because                                                               
it is an important safeguard.                                                                                                   
                                                                                                                                
CHAIR WILSON removed his objection.                                                                                             
                                                                                                                                
SENATOR  REINBOLD stated  that the  database  is unnecessary.  It                                                               
chases  federal   dollars  to   data  mine   Alaskan's  sensitive                                                               
information. She offered her belief  that it will not be censored                                                               
or achieve its objective.                                                                                                       
                                                                                                                                
2:30:34 PM                                                                                                                    
CHAIR WILSON called for a roll call.                                                                                            
                                                                                                                                
2:30:57 PM                                                                                                                    
A  roll call  vote was  taken  on Amendment  5. Senators  Begich,                                                               
Hughes, Costello,  and Wilson voted  in favor of Amendment  5 and                                                               
Senator Reinbold voted against it.  Therefore, Amendment 5 passed                                                               
by a 4:1 vote.                                                                                                                  
                                                                                                                                
2:31:30 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
2:31:51 PM                                                                                                                    
CHAIR  WILSON  reconvened  the  meeting  and  asked  for  closing                                                               
comments on SB 93.                                                                                                              
                                                                                                                                
SENATOR  REINBOLD  asked  if  the  database  will  show  doctors'                                                               
charges or define what the insurance companies paid.                                                                            
                                                                                                                                
MS.  WING-HEIER   stated  that   showing  doctor   and  insurance                                                               
information is  intended. The grant requires  that the department                                                               
of labor's  formatting be used.  She cannot say  what information                                                               
will be contained  in the database until the  Department of Labor                                                               
and  Workforce Development  (DOLWD) provides  formatting. If  her                                                               
department  was doing  the formatting,  the  database would  have                                                               
both.                                                                                                                           
                                                                                                                                
2:33:01 PM                                                                                                                    
SENATOR  REINBOLD stated  she will  be voting  no on  SB 93.  She                                                               
opined that  it is the second  worst bill in committee.  The bill                                                               
is not  necessary. It chases  federal dollars, while  the federal                                                               
government is trillions  of dollars in debt. She  stated that the                                                               
Alaska State  Constitution Article 1 Section  22 provides privacy                                                               
rights.  She   is  concerned  the   bill  violates   HIPPA  laws.                                                               
Legislators should  uphold the  oath of office  and not  pass the                                                               
bill.  It  is  ridiculous  to require  patients'  information  be                                                               
divulged  in order  to  be eligible  for  grants. She  referenced                                                               
Legislative Budget  and Audit reports that  recommended increased                                                               
security for  two state  databases. She  offered her  belief that                                                               
the bill could lead to a universal payer system.                                                                                
                                                                                                                                
SENATOR  HUGHES  commented  that  the database  will  not  be  in                                                               
violation of  HIPPA laws, and  it will not infringe  on Alaskan's                                                               
privacy.  She offered  her belief  that it  is not  leading to  a                                                               
 universal one  payer system.  Alaska has  the highest healthcare                                                               
costs  in  the entire  world.  The  database  is a  step  towards                                                               
figuring out  how to  bring healthcare costs  down. If  this bill                                                               
allowed for  identifying information  to be  in the  database she                                                               
would be against it.                                                                                                            
                                                                                                                                
SENATOR  COSTELLO  stated  that   for  too  long  Alaskan's  have                                                               
struggled  with healthcare  costs.  The  healthcare industry  has                                                               
been shrouded  in secrecy. Revealing  information on  what people                                                               
pay  begins  the process  of  transparency,  which will  lead  to                                                               
consumers having more choice in healthcare.                                                                                     
                                                                                                                                
2:38:32 PM                                                                                                                    
SENATOR BEGICH  stated that the  bill now requires  a competitive                                                               
bid,  which means  the director  will  be writing  a request  for                                                               
proposal (RFP). Concerns  brought up by the committee  can be met                                                               
in the RFP.                                                                                                                     
                                                                                                                                
SENATOR REINBOLD opined that people should think for themselves.                                                                
                                                                                                                                
2:39:24 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
2:40:26 PM                                                                                                                    
CHAIR WILSON reconvened the meeting.                                                                                            
                                                                                                                                
2:40:26 PM                                                                                                                    
SENATOR   REINBOLD   offered   her  belief   that   de-identified                                                               
information  can  be reidentified  and  databases  do not  reduce                                                               
healthcare costs.                                                                                                               
                                                                                                                                
2:41:17 PM                                                                                                                    
CHAIR WILSON solicited a motion to move the bill from committee.                                                                
                                                                                                                                
2:41:21 PM                                                                                                                    
SENATOR HUGHES moved to report SB  93, version A as amended, from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
note(s).                                                                                                                        
                                                                                                                                
2:41:25 PM                                                                                                                    
SENATOR REINBOLD objected.                                                                                                      
                                                                                                                                
CHAIR WILSON asked for a roll call                                                                                              
                                                                                                                                
2:41:30 PM                                                                                                                    
A roll  call vote was  taken. Senators Hughes,  Costello, Begich,                                                               
and Wilson  voted in  favor of  reporting SB  93 as  amended from                                                               
committee and Senator Reinbold voted against it. Therefore, the                                                                 
motion passed by a 4:1 vote.                                                                                                    
Chair Wilson stated CSSB 93 (HSS) was moved from the Senate                                                                     
Health and Social Services Standing Committee.                                                                                  
                                                                                                                                
2:42:11 PM                                                                                                                    
There being no further business to come before the committee,                                                                   
Chair Wilson adjourned the Senate Health and Social Services                                                                    
Standing Committee meeting at 2:42 p.m.                                                                                         

Document Name Date/Time Subjects
SB 93 Cliff Groh Letter of Support (3.25.21).pdf SHSS 4/13/2021 1:30:00 PM
SB 93
SB 93 AHTP Letter of Support.pdf SHSS 4/13/2021 1:30:00 PM
SB 93
SB 93 Hope Letter of Support.PDF SHSS 4/13/2021 1:30:00 PM
SB 93
SB 93 Providence Letter of Support.PDF SHSS 4/13/2021 1:30:00 PM
SB 93
SB 93 ACEP Letter of Support.pdf SHSS 4/13/2021 1:30:00 PM
SB 93
SB 93 Adopted Amendments 4.13.21 SHSS.pdf SHSS 4/13/2021 1:30:00 PM
SB 93