HOUSE HEALTH, EDUCATION AND SOCIAL SERVICES STANDING COMMITTEE March 23, 1994 3:00 p.m. MEMBERS PRESENT Rep. Cynthia Toohey, Co-Chair Rep. Con Bunde, Co-Chair Rep. Gary Davis, Vice Chair Rep. Al Vezey Rep. Harley Olberg Rep. Bettye Davis Rep. Tom Brice MEMBERS ABSENT Rep. Kott Rep. Nicholia COMMITTEE CALENDAR HB 414: "An Act creating the Alaska Health Commission; relating to the delivery, quality, access, and financing of health care; relating to health insurers, health maintenance organizations, and medical service corporations; relating to certain civil actions against health care providers and health insurers; amending Alaska Rules of Civil Procedure 26 and 27 and Alaska Rules of Evidence 802, 803, and 804; repealing Alaska Rule of Civil Procedure 82.1; and providing for an effective date" PASSED OUT OF COMMITTEE WITNESS REGISTER DON KOCH Marketing Surveillance Division of Insurance Department of Commerce and Economic Development P.O. Box 110805 Juneau, Alaska 99811-0805 Phone: (907) 465-3422 Position Statement: Testified on HB 414 NANCY USERA Commissioner Department of Administration P.O. Box 110200 Juneau, Alaska 99811-0200 Phone: (907) 465-2200 Position Statement: Opposed Amendment 25 to HB 414 THELMA SNOW WALKER Deputy Director Division of Insurance Department of Commerce and Economic Development 800 E. Dimond Blvd., Ste. 3-560 Anchorage, Alaska 99515-2045 Phone: (907) 349-1230 Position Statement: Addressed Amendment 27 to HB 414 PREVIOUS ACTION BILL: HB 414 SHORT TITLE: COMPREHENSIVE HEALTH CARE SPONSOR(S): RULES BY REQUEST OF THE GOVERNOR JRN-DATE JRN-PG ACTION 01/28/94 2182 (H) READ THE FIRST TIME/REFERRAL(S) 01/28/94 2182 (H) HES, JUDICIARY, FINANCE 01/28/94 2182 (H) -2 FISCAL NOTES (GOV, DCED) 1/28/94 01/28/94 2183 (H) GOVERNOR'S TRANSMITTAL LETTER 02/15/94 (H) HES AT 03:00 PM CAPITOL 106 02/15/94 (H) MINUTE(HES) 03/04/94 (H) HES AT 03:00 PM CAPITOL 106 03/04/94 (H) MINUTE(HES) 03/09/94 (H) HES AT 03:00 PM CAPITOL 106 03/09/94 (H) MINUTE(HES) 03/12/94 (H) HES AT 01:00 PM CAPITOL 106 03/12/94 (H) MINUTE(HES) 03/16/94 (H) HES AT 03:00 PM CAPITOL 106 03/21/94 (H) HES AT 03:00 PM CAPITOL 106 03/23/94 (H) HES AT 03:00 PM CAPITOL 106 ACTION NARRATIVE TAPE 94-60, SIDE A Number 000 CHAIR BUNDE called the meeting to order at 3:10 p.m., noted members present and announced the calendar. He brought HB 414 to the table. HB 414 - COMPREHENSIVE HEALTH CARE CHAIR BUNDE indicated that the committee substitute (CS) was dated 3/22/94 version J (8-GH2024\J). He said the committee would continue addressing amendments and taking public testimony. He noted that COMMISSION USERA, COMMISSIONER LOWE, and COMMISSIONER WALSH were present. REP. B. DAVIS said she could not find the amendments that she submitted. Number 087 CHAIR BUNDE directed the committee's attention to Amendment 16 that was tabled from the last meeting. He brought Amendment 16 to the table for discussion. REP. TOOHEY made a motion to adopt Amendment 16. CHAIR BUNDE objected for discussion purposes. He then asked DON KOCH to address Amendment 16. REP. B. DAVIS said she did not have Amendment 16. She then located the amendment. Number 162 DON KOCH, Marketing Surveillance, Division of Insurance, Department of Commerce and Economic Development, testified on HB 414. He stated that in current statute there is a fairly well structured set of requirements that address the payment of all insurance claims. He said a number of statutes apply directly to the type of insurance being addressed in HB 414. He explained that there are requirements within the regulation that certain responses occur within certain time frames and penalties are also outlined in the statutes. He further indicated that there are time frames for acknowledgement of correspondence. He said, "You have 15 days on any piece of correspondence that appears to be structured in a way that requires response to get a response." There is a 30 day period in which an insurer must pay the claim or have an explanation available to the insured person as to why the extra time is warranted. He expressed that the department felt the statutes are working. Although, he said, he felt the 15 days provided for in HB 414 may not be able to meet all situations. He felt the time period was too short. Number 262 REP. TOOHEY asked if there is a 10.5% charge for unpaid claims. MR. KOCH said he was unaware of any state that has that type of requirement on disability insurance. He stated that the charge would be an added cost feature included by the drafters. He guessed that a penalty would come through the unfair claims practice regulations. Number 290 REP. TOOHEY asked Mr. Koch if there would be any benefits to the fiscal note if any of the changes in Amendment 16 were adopted. MR. KOCH said no. He explained that the interest provision is not in the fiscal note. He said, "I think as far as the consumer protection angle goes, we cover this as well as the amendment." CHAIR BUNDE observed that whatever is accomplished, health care should be user friendly. He asked for further testimony. Hearing none, Chair Bunde called for the vote. Reps. Toohey, Bunde, G. Davis, Vezey, Olberg, B. Davis, and Brice voted Nay. There were no Yea votes. Amendment 16 failed to be adopted. CHAIR BUNDE then asked Rep. Brice to move his Amendment 24. Number 352 REP. BRICE made a motion to adopt Amendment 24. REP. TOOHEY objected. CHAIR BUNDE asked Rep. Brice to speak to the amendment. REP. BRICE explained that the bill has no teeth. He felt the amendment expressed his feeling that the legislation does not provide for decisive measures. He then withdrew his amendment. Number 397 CHAIR BUNDE brought Amendment 25 to the table for discussion. REP. B. DAVIS made a motion to adopt Amendment 25. CHAIR BUNDE objected for discussion purposes. REP. B. DAVIS stated that in order to give more credence to the bill she felt Amendment 25 would be appropriate to ensure the availability of universal health care for all residents of Alaska. CHAIR BUNDE asked Rep. B. Davis to expound on her amendment. REP. B. DAVIS asserted that the amendment would allow for a process that would provide health care. She said she knows that the committee has seen the proposal before and is almost positive it will not pass. She said she did not want to go through a line by line analysis. She offered to answer any specific questions a committee member might have. She explained that the proposal addresses statewide health care, targets, and data systems, all of which she believes will help the state come on-line with universal health care for Alaskans before the national health care plan is passed. Number 466 CHAIR BUNDE referred to Rep. B. Davis' request for specific questions and said it was a point well taken. REP. TOOHEY referred to page 2, line 5, and asserted that the intent of the legislation addresses Rep. B. Davis' concerns. REP. B. DAVIS said, "It says findings, but there is nothing in statute that could make it happen. So therefore, I maintain my amendment." She reiterated her previous motion. REP. TOOHEY objected. CHAIR BUNDE asked for further discussion. REP. BRICE commented that if the administration and the legislature was concerned about addressing the health care issue, they should support the amendment. He maintained that HB 414 does nothing more than establish three job positions of a commission and asks that "they might" look into certain areas. He felt the amendment would provide the teeth that HB 414 needs to be effective. Number 530 NANCY USERA, Commissioner, Department of Administration, testified on HB 414. She stated that the administration opposes Amendment 25. CHAIR BUNDE said, "I would say that if we wanted to pass the Senate bill, I guess we would have passed that Senate bill." He asked for further discussion. Hearing none, Chair Bunde called for the vote. Reps. B. Davis and Brice voted Yea and Reps. Toohey, Bunde, G. Davis, Vezey, and Olberg voted Nay. Chair Bunde declared that Amendment 25 failed to be adopted. CHAIR BUNDE brought Amendment 26 to the table. Number 556 REP. BRICE made a motion to adopt Amendment 26. REP. TOOHEY objected. CHAIR BUNDE asked Rep. B. Davis or Rep. Brice to address the amendment. REP. B. DAVIS explained that it was a proposal that had been given prior consideration. She said if there were members who felt that there were valuable points, she would be happy to discuss it. REP. BRICE reiterated that he felt it was important that the legislature take proactive measures this year regarding the health care issue and Amendment 26 fulfills that obligation to the state. CHAIR BUNDE asked for further discussion. Hearing none, he called for the vote. Reps. B. Davis and Brice voted Yea and Reps. Toohey, Bunde, G. Davis, Vezey and Olberg voted Nay. Chair Bunde announced that Amendment 26 failed. He brought HB 27 to the table. Chair Bunde indicated that the amendment was submitted by the Division of Insurance. Number 623 REP. TOOHEY made a motion to adopt Amendment 27. CHAIR BUNDE objected. Number 624 THELMA SNOW WALKER, Deputy Director, Division of Insurance, Department of Commerce and Economic Development, testified on HB 414. She referred to page 20, line 21, and indicated that the Division of Insurance would have to implement a uniform claim form by 7/1/95. She then referred to page 16, Section 44.19.628 and said the provision indicates that the division shall adopt by regulation uniform claim forms, uniform standards, and uniform procedures for the processing of data relating to billing for payment of health care services provided to state residents. MS. WALKER said the division does not know what is meant by uniform standards and uniform procedures. She said the division has no basis upon which to build those definitions. She said the amendment proposes to insert the phrase "the uniform claim form described by" on page 20, line 21, after the word "implement." She said the division anticipates that they will adopt regulations to formulate the uniform claim form, but not uniform standards or procedures for the collection of the billing data. Number 697 REP. TOOHEY assumed that the amendment would not change the fiscal note. MS. WALKER said it would not. CHAIR BUNDE asked for other questions. He reminded the committee that the amendment had been moved and objected to. He then called for the vote. Reps. Toohey, Bunde, G. Davis, Vezey, Olberg, B. Davis, and Brice voted Yea. No one voted Nay. Chair Bunde stated that Amendment 27 was so moved. CHAIR BUNDE asked if there was further testimony on HB 414. He asked the pleasure of the committee. REP. TOOHEY made a motion to pass the CS for HB 414 out of committee with individual recommendations and attached fiscal note. REP. BRICE objected. CHAIR BUNDE asked for further discussion. Hearing none, he called for the vote. Reps. Toohey, Bunde, G. Davis, Vezey, and Olberg voted Yea and Reps. B. Davis and Brice voted Nay. Chair Bunde declared that HB 414 was so moved. CHAIR BUNDE then noted the committee's calendar for the remainder of the week. Seeing no further business before the committee, CHAIR BUNDE adjourned the meeting at 3:32 p.m.