SB 83-TELEHEALTH REIMBURSEMENT RATES  3:32:14 PM CHAIR DUNBAR announced the consideration of SENATE BILL NO. 83 "An Act relating to health care insurance; relating to insurance reimbursement for health care services provided through telehealth; and providing for an effective date." 3:33:43 PM CHAIR DUNBAR solicited a motion. 3:33:46 PM SENATOR GIESSEL moved to adopt the committee substitute (CS) for SB 83, work order 34-LS0413\O, as the working document. 3:33:56 PM CHAIR DUNBAR objected for purposes of discussion. 3:34:17 PM ARIELLE WIGGIN, Staff, Senator Forrest Dunbar, Alaska State Legislature, Juneau, Alaska, offered the summary of changes for SB 83 version I to version O. She paraphrased the following: [Original punctuation provided.] SUMMARY OF CHANGES  CSSB 83: TELEHEALTH REIMBURSEMENT RATES  Version I to Version O  Title Changes:  - removes "relating to health care insurance  reimbursement rates" on account of removed  language in prior Section 3.  - Expanded to include "providing for an effective  date by repealing the effective date of secs. 9  and 10, ch. 38, SLA 2022;"    Prior version Section 3 removed: required health care  insurers to equally apply reimbursement rates for each  health care provider; renumbers following sections.  Page 1 Line 10 following "services" Inserts "including behavioral health services," Page 5 Lines 3-4  Repeals Sections 9, 10, 13, and 14 of chapter 38 of the Session Laws of Alaska 2022. These are sections within House Bill 265, passed into law in 2022. Sections 9 and 10 would be negated by this legislation. Sections 13 and 14 have to do with the effective date of the legislation, and repealing these sections deletes the sunset date of June 30, 2030. Page 5, Line 5  Creates an effective date of January 1st, 2026. 3:35:45 PM SENATOR HUGHES noted that telehealth was originally intended to reduce health care costs. She asked whether any cost projections have been completed on how removing the telehealth sunset would affect the Medicaid budget. 3:36:10 PM SENATOR CLAMAN speaking as sponsor of SB 83 stated the question is for Ms. Wing-Heier. CHAIR DUNBAR asked to confirm that the projection extends to 2030 and that the next five years should already be incorporated into the cost estimates. SENATOR CLAMAN replied correct. 3:36:58 PM LORI WING-HEIER, Director, Division of Insurance, Department of Commerce, Community and Economic Development (DCCED), Juneau, Alaska, answered questions regarding SB 83. She answered that the Division of Insurance does not handle Medicaid and that the Department of Health would need to provide that information. 3:37:14 PM SENATOR HUGHES expressed concern that establishing payment parity between in-person care and telehealth may not help control health care costs and affects only a small segment of the market. She asked whether this approach could unfairly burden that group. 3:37:59 PM MS. WING-HEIER replied that that insurers reported they already pay at parity. She said the Division of Insurance relayed that information to the sponsor, who still wanted it codified to ensure consistency. She noted that insurers have not opposed the bill and do not view parity as a health care cost concern. 3:38:28 PM SENATOR HUGHES stated that private insurers do not mirror Center for Medicare and Medicaid Services (CMS) or Medicaid rates exactly but often use them as a reference. She asked whether insurers realized that removing Medicaid's telehealth sunset under SB 83 would make payment parity permanent, eliminating the possibility of future rate divergence and effectively locking insurers into parity going forward. 3:39:37 PM MS. WING-HEIER replied that she was unsure whether insurers are aware, but insurers have had the same opportunity to review the Committee Substitute for SB 83 and did not raise concerns or submit opposition. She said the division assumes insurers are aware and have no objections. 3:40:01 PM SENATOR HUGHES said she sent a letter to a national association for insurance carriers asking whether they would support permanently locking in telehealth rates at in-person levels. They replied no. She noted that she plans to follow up and share that information with the sponsor and others. 3:40:57 PM CHAIR DUNBAR removed his objection. He found no further objection and CSSB 83 was adopted as the working document. 3:41:07 PM CHAIR DUNBAR asked the sponsor of the bill for closing remarks. 3:41:20 PM SENATOR CLAMAN explained that the committee substitute (CS) reflects extensive discussions with stakeholders, including insurance representatives. Some provisions were removed, the sunset was revised, and the updated CS was carefully reviewed with those who had engaged with their office. It is his belief that SB 83 has broad support from both insurers and providers. 3:41:55 PM SENATOR HUGHES asked why the provision requiring clinicians, PAs, advanced nurse practitioners, and physicians to be paid at the same rate was removed from SB 83. SENATOR CLAMAN replied that the provision originated as an amendment requested by Senator Giessel, but both the hospital association and insurers raised concerns. After discussing it with Senator Giessel, who has other legislation addressing similar issues, she agreed to remove the provision, and it was taken out of SB 83. 3:42:45 PM SENATOR GIESSEL clarified that it was not truly an agreement. The proposal would have codified unequal pay based on provider licensure, which they found unacceptable; therefore, they preferred removing the provision rather than adopting the alternative. 3:43:24 PM SENATOR HUGHES noted that although they previously supported equal pay for the same service, they reconsidered because providers have differing levels of training and expertise. She concluded that equalizing rates could discourage medical education and said they are relieved the provision was removed from SB 83. 3:43:57 PM SENATOR CLAMAN clarified that Senator Giessel recalled that the alternative options were even less acceptable to her, and her comments accurately reflect those discussions. 3:44:22 PM CHAIR DUNBAR solicited the will of the committee. 3:44:22 PM SENATOR GIESSEL moved to report CSSB 83, work order 34-LS0413\O, from committee with individual recommendations and attached fiscal note(s). 3:44:38 PM CHAIR DUNBAR found no objection and CSSB 83(HSS) was reported from the Senate Health and Social Services Standing Committee.