HB 187-PRIOR AUTH EXEMPT FOR HEALTH PROVIDERS  3:50:35 PM CHAIR SUMNER announced that the next order of business would be HOUSE BILL NO. 187, "An Act relating to utilization review entities; exempting certain health care providers from making preauthorization requests for certain services; and providing for an effective date." 3:51:01 PM SARENA HACKENMILLER, Staff, Representative Jesse Sumner, Alaska State Legislature, on behalf of Representative Sumner, prime sponsor, gave the sponsor statement for HB 187 [included in the committee packet], which read as follows [original punctuation provided]: HB 187 aims to reduce the wait time for certain health care services by exempting health care providers from making preauthorization requests for said services. Currently, Alaskans who need certain health care services must wait days and even weeks at a time to get pre-authorized to receive health care services because of the processing time between the health care provider and insurance companies. This bill would help Alaskans receive health care services immediately, especially health care services that could save their lives. This bill would create a utilization review entity that may evaluate whether a health care provider continues to qualify for an exemption if during the most recent 12-month period, the utilization review entity has approved or would approve at least 80% of the prior authorization requests submitted by the health care provider for that health care service. The Health Care provider is not required to request an exemption to qualify for an exemption. A utilization review may not deny or reduce payment for a health care service that is exempted. Other states with prior authorization exemptions have seen increased frequency of patients who receive the health care services they need expediently. This bill will help Alaskans receive fast, efficient, and quality healthcare when they need it without waiting for a preauthorization process that could cause their health to decline even more. 3:53:18 PM JEFF DAVIS, Former President, Premera Blue Cross Blue Shield of Alaska, began invited testimony by giving his history of working in Alaska's health insurance industry and sharing what problems he thinks might be solved by HB 187. He said that currently patients are bearing the cost of unnecessary prior authorization in the form of delays in care. He said the original goals of prior authorization were well meaning but because of unchecked expansion have grown ineffective. He said the issue is the fact that there are a huge number of prior authorization requests that are denied initially by the payer. He shared his belief that HB 187 would restore the balance between patients, physicians, and health insurance providers. 4:00:38 PM PAM VENTGEN, Executive Director, Alaska State Medical Association, began her invited testimony on HB 187 by explaining that when a prior authorization request is denied it must be appealed, which can delay adequate and timely care to a patient. She said that in the case of a denial, either a nurse or a physician assistant may request the prior authorization appeal, both of whom must educate the prior authorization request reviewer on new technologies that affect the appeal which further takes time away from care to the patient. 4:03:31 PM JOHN KELLY, Chief Executive Officer, Alaska Air Group, began invited testimony on HB 187 by giving an example of someone who was diagnosed with a disease and was affected by the complexities of insurance and delays in their prior authorization request. He said that prior authorization has gone awry and emphasized that the time used in the review and appeals process is harmful to patients in the form of delayed and lost time. 4:11:19 PM JARED KOSIN, President/CEO, Alaska Hospital & Healthcare Association (AHHA), began invited testimony by noting that AHHA is in strong support of HB 187. He said that currently, prior authorization is causing major delays with patient care that is at times detrimental to their quality of life, and HB 187 would help to alleviate some of the downfalls of the current prior authorization process. 4:13:56 PM CHAIR SUMNER announced that HB 187 was held over.