SB 197 - REGULATING HEALTH MAINTENANCE ORGS. CHAIRMAN KELLY brought SB 197 before the committee and noted there was a proposed Rules CS for the committee's consideration. SENATOR DAVE DONLEY, prime sponsor of SB 197, explained the committee substitute adds language on page 3, line 21, which provides that health maintenance organizations would have to provide an 'point of service' option that could require additional costs on the part of the people that choose option, but it would allow them to go to other types of health care. He said it is a way of making sure the consumers have an option to buy additional coverages of the types that they may feel is appropriate and not be limited by HMOs to not have that option available to them. Senator Donley voiced his support for an amendment that was being offered by Senator Leman. He said the amendment also increases consumer options within the HMO system. SENATOR TAYLOR moved the adoption of CSSB 197(RLS). Hearing no objection, the motion carried. SENATOR LEMAN moved adoption of the following amendment to CSSB 197(RLS). CHAIRMAN KELLY objected for the purpose of discussion on the amendment. Amendment No. 1 Page 1, following line 7, insert a new bill section to read: "*Section 1. AS 21.36.090(d) is amended to read: (d) Except to the extent necessary to comply with AS 21.42.365 and AS 21.56, a person may not practice or permit unfair discrimination against a person who provides a service covered under a group health insurance policy that extends coverage on an expense incurred basis, or under a group service or indemnity type contract issued by a health maintenance organization or a nonprofit corporation, if the service is within the scope of the provider's occupational license. In this subsection, "provider" means a state licensed physician, dentist, osteopath, optometrist, chiropractor, nurse midwife, advanced nurse practitioner, naturopath, physical therapist, occupational therapist, psychologist, psychological associate, or licensed clinical social worker, or certified direct- entry midwife." Page 1, line 8: Delete "Section 1." and insert "Sec. 2." Renumber the following bill sections accordingly. CHAIRMAN KELLY stated the committee would take testimony from Anchorage via the teleconference network. LYNN HARTZ, a family nurse practitioner and a legislative representative of the Alaska Nurse Practitioner Association, testified in support of CSSB 197(RLS). She said it contains some important consumer protection aspects relating to disclosure to the enrollee of what is covered and what will not be covered, as well as protecting the lines of communication between the clinician and patient. Ms. Hartz suggested that in addition to the changes in the committee substitute and the proposed amendment, there is additional language in the HMO statutes that would need to be changed to allow enrollees continued choice in their health care providers inside the HMO network. She said it is their view that the change will allow health care consumer choice in their preferred health care provider inside the HMO network as Senator Donley's amendment provides for choice in providers outside the HMO network. She said she would fax the suggested change to the Chairman. KATHY VOLZ, testifying from Anchorage on behalf of the Alaska Physical Therapy Association, voiced their support for the committee substitute and Senator Leman's amendment. CHAIRMAN KELLY removed his objection to the adoption of Amendment No. 1, and there being no further objection, he stated the amendment was adopted and it would be incorporated into a new Rules CS. SENATOR TAYLOR moved and asked unanimous consent CSSB 197(RLS), as amended, be approved for calendaring at the discretion of the Chair. Hearing no objection, it was so ordered.