SB 244-NO DISCRIMINATION AGAINST ACUPUNCTURIST  CHAIR FRED DYSON announced SB 244 to be up for consideration. 1:49:56 PM AMY SEITZ, Staff to Senator Wagoner, said that SB 244 adds acupuncturists to the list of licensed providers in the Unfair Discrimination Statute. This would prohibit insurance companies that offer group policies from unfairly discriminating against them. She added that the sponsor introduced the bill after reviewing the results of several studies that demonstrate the positive affects of acupuncture. She referenced a 1993 Swedish study on a group of recovering stroke patients that were treated with acupuncture. According to the study, the treatment of these patients cost $26,000 less than patients without acupuncture and required half the normal time for recovery. She referenced another study on knee surgery patients who underwent acupuncture therapy before surgery. According to the study, the treatment of these patients cost $9,000 less per patient than for patients without acupuncture. A Boston University researcher recently claimed that acupuncture treatment for stroke and Carpel Tunnel Syndrome could reduce the nation's medical bill by 11 million. She said, in addition to positive health benefits, acupuncture has an extremely low rate of malpractice associated with acupuncture. A bill was recently introduced at the federal level to include acupuncturists into the Federal Insurance Act. She continued to say that several insurance companies have volunteered to cover acupuncturists. 1:53:12 PM SENATOR OLSON asked how long the results of acupuncture treatment lasted for patients in the stroke study. MS. SEITZ believed that they were long-term results. SENATOR OLSON asked how often acupuncture treatment causes a major bleeding event. MS. SEITZ said all the information she has read shows that it happens very infrequently. SENATOR OLSON asked the amount of education required for a person to legally practice acupuncture. MS. SEITZ replied that it requires a three-year graduate degree. 1:56:50 PM MELANIE MILLHORN, Director, Division of Retirement and Benefits (DRB), Department of Administration (DOA), provided information on the state's health plans and discussed how SB 244 would affect them. She said the Division administers two health plans, one for the active population and one for the retired population. She said that the commissioner of The Department of Administration has the authority to make changes to the health plans. FREDA MILLER, Health Benefits Manager, DRB, DOA, reported that the health plans only cover acupuncture if a physician performs it in lieu of anesthetic during surgery. She said that passage of SB 244 would allow acupuncturists to bill for office visits related to the evaluation and management of a condition. Since SB 244 only expands coverage options, the bill is cost neutral. She remarked that acupuncture therapy itself would remain an uncovered benefit unless there is a signed plan change authorized by the commissioner of The Department of Administration. SENATOR ELTON asked if SB 244 would allow coverage for visits to an acupuncturist that are related to evaluation and management, but not to therapy. MS. MILLER replied that SB 244 confers recognized provider status upon acupuncturists thereby allowing them to bill for visits related to evaluation and management. She added that SB 244 would not change any existing coverage for therapy since that is determined by one's particular health plan. SENATOR OLSON asked whether SB 244 would change the impatient/outpatient status of acupuncture treatment. MS. MILLER replied it would not do so. SENATOR WILKEN asked whether the bill would open up a new level of service for plan members and create additional costs for the system. MS. MILLER replied that it only allows members to see an acupuncturist instead of a physician to evaluate and manage a condition. She stressed that it does not increase the level of coverage to which members are already entitled for evaluation and management. SENATOR WILKEN remarked that he would like Ms. Millhorn's reassurance that the legislation would indeed be cost-neutral. MS. MILLHORN said that according to Delloit Consulting, it costs less to visit an acupuncturist than a physician, and consequently, the cost-neutral designation is conservative. SENATOR WILKEN said he was concerned that the bill would generate additional costs because it would create coverage for the alternative treatment of conditions for which some would not otherwise see a physician. SENATOR OLSON said he was concerned about the possibility of additional costs from lawsuits arising from the inability of acupuncturists to evaluate and manage certain conditions. CHAIR DYSON asked Ms. DeLaune to explain how the bill would benefit the people of Alaska. VALERIE DeLAUNE, licensed acupuncturist, testified that she has personally saved the state and its residents a lot of money by providing an effective alternative to some conventional procedures. She remarked that coverage for acupuncture is the number one requested benefit among insurance consumers. She added that many insurance companies voluntarily cover acupuncture and suggested that they would not do so if it did not save them money. CHAIR DYSON said that he is struck by the fact that an acupuncturist can mitigate the pain of surgery, but cannot seek reimbursement for evaluating a condition. MS. DeLAUNE said, with regard to Senator Olson's concern about malpractice, that the incidence of malpractice among acupuncturists is very low. 2:21:03 PM SENATOR OLSON asked the number of licensed and unlicensed acupuncturists practice in the state. MS. DeLAUNE replied that about 65 acupuncturists are licensed in the state. MS. MILLER added it is illegal to practice acupuncture without a license in the state. SENATOR ELTON asked whether an acupuncture license could be revoked in the case of malpractice. MS. DeLAUNE replied that is correct, but the state has yet to revoke an acupuncture license. SENATOR OLSON asked how an acupuncturist is licensed. MS. DeLAUNE replied the state requires at least three years of graduate level education for licensure. SENATOR OLSON asked whether the state requires a written exam for licensure. MS. DeLAUNE replied the state requires that a prospective licensee take certain courses on AIDS, CPR, pass a written and practical exam, and complete 15 hours of continuing education every two years. SENATOR OLSON asked how this bill compares to similar bills in other states. MS. DeLAUNE replied the State of Washington has similar legislation. MS. SEITZ said that as of 1991, ten states covered acupuncture. SENATOR WILKEN asked whether acupuncture treatment would be covered for small businesses under this bill. MS. SEITZ replied that it would. SENATOR WILKEN asked if the legislation would require managers of private insurance plans to cover acupuncture treatments that they do not cover at the present time. MS. SEITZ replied that the bill does not affect the coverage plans of any insurance provider; it only allows members to choose acupuncture for services already provided under their plans. 2:39:25 PM SENATOR WILKEN asked if private plan managers would have to make a plan modification before covering acupuncturists for evaluation and management and therapy services. MS. MILLER answered that adding acupuncturists to the recognized provider list allows them to submit charges for evaluation and management for any plan that covers it. The managers would have to decide whether or not to cover acupuncture therapy in their benefit plans. SENATOR WILKEN cited Alaska Sales and Service as an example of a small private company and asked whether its plan covers acupuncturists for providing evaluation and management services. MS. DeLAUNE did not know. SENATOR WILKEN asked if the state and private providers would be able to decide whether or not to cover acupuncture therapy and evaluation and management services if the bill is passed. MS. MILLER replied that is the case and added it is important to remember that typically the evaluation and management services are already covered in all insurance plans. SENATOR WILKEN asked if conferring recognized provider status upon acupuncturists would allow them to receive coverage under the state plan since it currently covers evaluation and management services. MS. MILLER replied that is correct. SENATOR WILKEN asked if acupuncture therapy would not be covered under the state plan until the commissioner of administration amends the design of the benefit plan. MS. MILLER replied that is correct. SENATOR WILKEN asked if the commissioner or private plan managers could decide to cover acupuncture therapy without the passage of SB 244. MS. SEITZ replied that they could do so. SENATOR WILKEN asked why the bill is needed. MS. MILLER replied the bill would ensure that insurance companies could not refuse plan managers who decide to cover acupuncture. SENATOR ELTON said it is important to note that the bill only prevents insurance companies from discriminating against acupuncturists; it does not preclude them from charging for the added service. CHAIR DYSON remarked it is not a pro-choice bill, but an anti- discrimination bill for a profession that is widely recognized. SENATOR WILKEN expressed concern over costs that the bill would generate for both the state and private insurance companies. CHAIR DYSON asked Ms. Seitz if she heard anything from the insurance industry when the bill was heard in the Labor and Commerce Committee. MS. SEITZ said she has not heard any opposition from the insurance industry. She remarked that many insurance companies already voluntarily cover acupuncture. CHAIR DYSON asked whether insurance companies have been notified about the bill. MS. SEITZ said she has been trying to solicit comments from the insurance companies, but it doesn't seem to be a big issue for them. SENATOR WILKEN remarked that while no one wants to discriminate, the bill might be less benign than it seems. MS. SEITZ remarked that it might actually save money. Acupuncture is the only licensed profession in the state that is not on the recognized providers list. SENATOR ELTON said it would be important to determine whether the amount of money saved by visits to acupuncturists instead of physicians would offset the cost of visits to acupuncturists by people who would not otherwise see a physician. SENATOR OLSON said a study done five years ago showed that people saved money when they underwent effective acupuncture therapy as opposed to drug therapy because there are no side effects associated with acupuncture. 2:54:46 PM CHAIR DYSON held SB 244 in committee.