HB 300 - ALASKA PATIENTS' BILL OF RIGHTS Number 0075 CHAIRMAN ROKEBERG announced the committee's next order of business was HB 300, "An Act relating to health insurance; and providing for an effective date." He stated there was a proposed committee substitute, Version M, labeled 0-LS1248\M, Ford, dated 4/30/98, and he explained the changes which had been made. Chairman Rokeberg indicated on page 1, line 1, the word "care" had been placed in the title so the language read, "health care insurance". The chairman noted the same addition had been made on page 1, line 2, also in the bill title. The next changes had been made in Section 3 of Version M, "AS 21 is amended by adding a new chapter to read: Chapter 07. Regulation of Health Care Insurance Plans.". On page 2, line 28, Sec. 21.07.010(5)(E) had been modified to read, "(E) current, usual, customary, and reasonable reimbursement schedules, and methodology.". On page 3, line 3, Sec. 21.07.020(2), emergency room provisions had been changed to read, "(2) emergency room services shall be covered if authorized by the attending physician;". Chairman Rokeberg indicated the language which had been subsection (3) in Version J, "copayment requirements shall be uniform between health care providers", had been deleted from Version M. He commented, "Subsection 3, the word 'provided' was put in there in Amendment 1. We're still on page 3." On page 3, line 13, in Sec. 21.07.030(a), after "insurer" the words "or managed care contractor" had been inserted to "pick up the definition." Number 0266 CHAIRMAN ROKEBERG noted in Sec. 21.07.250(1) "health insurance" had been changed to "health care insurance", indicating this subsection had formerly been had been subsection (3) and was now (1). He indicated Sec. 21.07.250(3), on page 4, the health care services, had been redefined to mean "services for diagnosis, prevention, treatment, or cure or relief of a health condition, illness, injury, or disease" ["subsection 2" stated on tape]. Managed care plan was redefined in Sec. 21.07.250(6). In Sec.07.250(9) the utilization review definition had been changed to read, "(9) "utilization review" means a system of reviewing the medical necessity, appropriateness, efficacy, or efficiency of health care services, procedures, settings, and supplies provided under a managed care plan using specified guidelines, including preadmission certification, case management, second opinion, the application of practice guidelines, concurrent review, discharge planning, ambulatory review, and retrospective review.". Chairman Rokeberg explained the change in Section 4, which would amend AS 21.42 by adding new section, "Sec. 21.42.390. Required health care insurance coverage provisions.". He indicated the language, "this paragraph does not apply to a health care insurance plan or contract if the covered person signs a written waiver of the provisions of this paragraph" had been added to Sec. 21.42.390(a)(1) after "prohibits a covered person from obtaining health care service from a health care provider of the person's choice, including a specialist". He continued, "And it goes on to ... and the old 'c' sub '1' was deleted." He noted those were the changes in Version M. Number 0449 CHAIRMAN ROKEBERG asked if he heard a motion to adopt the proposed committee substitute, Version M. There being no motion to adopt Version M, Chairman Rokeberg stated HB 300 had been tabled.