HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS  4:24:56 PM CHAIR WILSON reconvened the meeting and announced the consideration of HOUSE BILL NO. 57 "An Act relating to review organizations and permitting an emergency medical services provider to establish a review organization; and relating to patient records." 4:25:23 PM REPRESENTATIVE STANLEY WRIGHT, District 22, Alaska State Legislature, Juneau, Alaska, sponsor of HB 57 provided the following recap: House Bill 57 introduces legal protections for confidential EMS peer reviews and quality assurance discussions, fostering an environment of continuous learning and safety. It shields EMS providers and medical directors from legal repercussions, ensuring that they focus on improving patient care without fear. 4:26:16 PM CHAIR WILSON moved to adopt Amendment 1, work order 33- LS0334\A.3, to HB 57. 33-LS0335\A.3 Bergerud 4/3/24 AMENDMENT 1 OFFERED IN THE SENATE BY SENATOR WILSON TO HB 57 Page 1, line 2: Delete "and" Following "records": Insert "; and relating to disclosure and  reporting of health care services, prices, and fee  information" Page 3, following line 22: Insert a new bill section to read: "* Sec. 4. AS 18.23.400(n)(3) is amended to read: (3) "health care facility municipal, or state hospital, psychiatric hospital, emergency department, independent diagnostic testing facility, residential psychiatric treatment center as defined in AS 47.32.900, kidney disease treatment center (including freestanding hemodialysis units), office of a private physician or dentist whether in individual or group practice, ambulatory surgical center as defined in AS 47.32.900, freestanding birth center as defined in AS 47.32.900, and rural health clinic as defined in AS 47.32.900; "health care facility" does not include " means a private, (A) the Alaska Pioneers' Home and the Alaska Veterans' Home administered by the department under AS 47.55; (B) an assisted living home as defined in AS 47.33.990; (C) a nursing facility licensed by the department to provide long-term care; (D) a facility operated by an Alaska tribal health organization; [AND] (E) a hospital operated by the United States Department of Veterans Affairs or the United States Department of Defense, or any other federally operated hospital or institution; or (F) a hospital subject to 45 C.F.R. 180 as  that section read on the effective date of this  Act or any other federal price transparency  requirements that are reasonably similar to or  exceed the requirements in this section;" 4:26:23 PM SENATOR KAUFMAN objected for purposes of discussion. 4:26:30 PM At ease 4:26:45 PM CHAIR WILSON reconvened the meeting and explained that Amendment 1 addresses price transparency and disclosure of healthcare cost information for providers. Alaska updated its laws in 2018, but since that time, federal laws have been updated twicefirst with the Affordable Care Act (ACA) and then with the No Surprises Act (NSA), which are more rigorous than our state laws. Amendment 1 provides statutory clarity upon those laws and, if passed, would require hospitals to comply with federal requirements under 45 CFR 180, in addition to state standards found in AS 18.23.400, if 45 CFR 180 or similar federal hospital transparency regulations are repealed. This ensures hospitals remain subject to state reporting requirements, maintaining price transparency without duplicative reporting obligations. Federal requirements are currently more stringent than state requirements. Members have been provided with four relevant items from the Alaska Hospital and Healthcare Association, Alaska Regional Hospital, and Fairbanks Memorial Hospital. He stated representatives from these organizations were available to answer questions. 4:29:08 PM SENATOR GIESSEL acknowledged the efficacy of the amendment but expressed difficulty understanding its connection to Emergency Medical Services (EMS) reviews, noting that it feels like an entirely new topic, perhaps suited for a separate bill. She requested clarification. CHAIR WILSON clarified that it is not a separate bill but rather an amendment to similar sections of law and statutes addressed by the current bill. SENATOR GIESSEL replied she understood and noted it. CHAIR WILSON responded that the premise is to do a legislative fix to statute. He noted that a title change resolution was also prepared. 4:30:01 PM SENATOR GIESSEL stated that she would be interested in hearing the sponsor's response to this significant amendment. 4:30:11 PM REPRESENTATIVE WRIGHT stated that he had reviewed the amendment and is open to taking more if it creates positive changes in similar legislation. 4:30:39 PM SENATOR DUNBAR noted for the record, and with appreciation to the Chair, that Amendment 1 as he reads it provides a "backstop." He stated the purpose of the amendment is to ensure hospitals adhere to the higher federal standard under 45 CFR 180, or any similar federal price transparency requirement, in case of future changes. He explained that if federal law were fully repealed, the amendment would default to the state standard, serving as a fallback. He emphasized that this is his interpretation of the amendment and expressed hope that future readers understand it similarly, commending the Chair's work in crafting the language. 4:32:27 PM CHAIR WILSON asked Mr. Kosin to provide comment and background on the impetus for Amendment 1, as well as some of the challenges Alaskan hospitals encounter with dueling federal and state statutes. 4:32:54 PM JARED KOSIN, President, Alaska Hospital and Healthcare Association, Anchorage, Alaska, pointed out that Alaska's requirements require manual data entry into a PDF, while federal standards are automated and on a much broader scale. Aligning with federal standards would save both hospitals and the state considerable time and resources, as it would eliminate redundant data entry. He expressed appreciation for the amendment, emphasizing that if federal standards ever fall below Alaska's current requirements, hospitals will automatically revert to the state standards. He also highlighted the federal focus on shoppable services and episodes of care, which provide practical, consumer-friendly information that state requirements currently lack. 4:36:51 PM CHAIR WILSON asked if objection was maintained. 4:36:59 PM SENATOR KAUFMAN removed his objection. 4:37:00 PM CHAIR WILSON found no further objection and solicited a motion. 4:37:29 PM SENATOR KAUFMAN moved to report HB 57, work order 33-LS0335\A, as amended, from committee with individual recommendations and attached fiscal note(s). 4:37:42 PM CHAIR WILSON asked if there was objection. 4:37:48 PM SENATOR DUNBAR objected for purposes of discussion. SENATOR DUNBAR stated there was mention of a title change. CHAIR WILSON explained that Legislative Legal Services would provide a title change resolution that will be read across the floor and then go to the Senate Secretaries office until HB 57 is taken up. 4:38:09 PM SENATOR DUNBAR removed his objection. 4:38:12 PM CHAIR WILSON found no further objection and SCS HB 57 (HSS) was reported from the Senate Health and Social Services Standing Committee.