Legislature(2015 - 2016)BARNES 124

04/15/2015 03:15 PM LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
-- Delayed to 4:45 p.m. Today --
+= HB 12 MORTGAGE LENDING AND LOAN ORIGINATORS TELECONFERENCED
Moved CSHB 12(L&C) Out of Committee
+= SB 47 LIFE INSURANCE/ANNUITY EXEMPTIONS TELECONFERENCED
Heard & Held
+= SB 71 VACCINE CERTIFICATION FOR PHARMACISTS TELECONFERENCED
Moved SB 71 Out of Committee
*+ HB 159 HEALTH CARE RETAINER; INSURANCE EXEMPT TELECONFERENCED
Heard & Held
*+ HB 185 ALCOHOLIC BEVERAGE CONTROL TELECONFERENCED
Heard & Held
          HB 159-HEALTH CARE RETAINER; INSURANCE EXEMPT                                                                     
                                                                                                                                
4:52:28 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON  announced that  the next order  of business  would be                                                              
HOUSE  BILL  NO.  159,  "An  Act  exempting  certain  health  care                                                              
agreements from regulation as insurance."                                                                                       
                                                                                                                                
4:53:38 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  WES KELLER,  Alaska State  Legislature, stated  he                                                              
served on  the Alaska Health  Commission in  2007.  He  has become                                                              
convinced that  health care reform  means that the market  must be                                                              
working.     This   bill   would   exempt  direct   primary   care                                                              
associations  from  the  Alaska   insurance  code  definitions  of                                                              
insurance.   The bill  would not  propose any  new regulations  or                                                              
incur  additional  expenses.    This   would  allow  primary  care                                                              
physicians  to  have  contractual   agreement  with  patients  for                                                              
primary  care services.   It would  remove the  third party  payer                                                              
since patients  would subscribe to  the primary care service.   He                                                              
characterized  it  as  the  doctor  being  one  call  away.    The                                                              
contracts would be  handled by existing law.  He  offered that the                                                              
positive  effects  of  this  bill  include  improved  quality  and                                                              
access  of care  that  patients would  have  with their  provider,                                                              
which could reduce  overall health care cost  since administrative                                                              
costs are  drastically reduced.   Further, the number  of patients                                                              
per  doctor  is   also  higher  than  the  current   system.    He                                                              
highlighted  that doctors often  have 15  minutes per patient  and                                                              
if one takes longer it can create stress for everyone.                                                                          
                                                                                                                                
4:57:04 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HUGHES  thanked for bringing this  concept forward.                                                              
She asked  how reimbursement would  work for the patient  since it                                                              
will prohibit the provider from billing insurance.                                                                              
                                                                                                                                
KEN  TRUITT,  Staff,  Representative   Wes  Keller,  Alaska  State                                                              
Legislature, on  behalf of the  prime sponsor, Representative  Wes                                                              
Keller,  said the  concept behind  the  bill is  that it  wouldn't                                                              
change  any  existing  relationship.    Patients  can  still  seek                                                              
reimbursement for  their primary care costs,  including membership                                                              
into the primary care network.                                                                                                  
                                                                                                                                
4:58:03 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE HUGHES  asked whether  insurers will pay  a monthly                                                              
service fee  and if patient and  doctor contracts happen  in other                                                              
states.                                                                                                                         
                                                                                                                                
MR. TRUITT said he  was not certain.  The language  for HB 159 was                                                              
modeled  on legislation  that passed  in  Michigan.   He has  also                                                              
reviewed  other   states  that  have  primary   care  legislation,                                                              
including Utah.                                                                                                                 
                                                                                                                                
CHAIR OLSON  answered that  several bills  before the  legislature                                                              
this session are related to medical costs.                                                                                      
                                                                                                                                
4:58:51 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LEDOUX  asked for further clarification  on whether                                                              
this  bill  would  prohibit the  doctors  from  billing  insurance                                                              
companies.                                                                                                                      
                                                                                                                                
MR.  TRUITT  answered  yes;  that   the  concept  was  to  relieve                                                              
physicians  from dealing  with third-party  payers.  For  example,                                                              
he said  that billing manuals  for Blue  Cross was over  200 pages                                                              
and  showed several.    The benefit  from  the  provider would  be                                                              
payment via contract  with the patient and no longer  need to deal                                                              
with the third party payers.                                                                                                    
                                                                                                                                
5:00:00 PM                                                                                                                    
                                                                                                                                
CHAIR OLSON asked for a copy of the manuals.                                                                                    
                                                                                                                                
REPRESENTATIVE KELLER offered to provide it.                                                                                    
                                                                                                                                
5:00:09 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE LEDOUX  said that currently some doctors  hold down                                                              
fees  by not  billing insurance.   She  asked the  reason to  have                                                              
statutory  provisions  that  prohibit   doctors  from  billing  an                                                              
insurance  company since  doctors can  currently opt  not to  bill                                                              
insurance.   She said  it seemed to  interfere, which  didn't seem                                                              
like limited government to her.                                                                                                 
                                                                                                                                
REPRESENTATIVE  KELLER offered  to  provide the  logic from  other                                                              
states.                                                                                                                         
                                                                                                                                
5:01:06 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE KITO  asked which provider networks  would use this                                                              
program.   He asked  whether any  doctor's office  or company  was                                                              
seeking  an alternate  option  or if  it was  a  concept that  the                                                              
sponsor wanted to make available.                                                                                               
                                                                                                                                
REPRESENTATIVE  KELLER replied  he  did not  specifically know  of                                                              
anyone  although   he  has  doctor  friends  who   have  expressed                                                              
interest or  positively inclined.   He  said he became  acquainted                                                              
with  health care  agreements via  the  Alaska Health  Commission,                                                              
however, this type of contract is not currently available.                                                                      
                                                                                                                                
5:02:08 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KITO asked  whether  these  health care  agreement                                                              
contracts will  result in monthly fees  for patients or  a fee for                                                              
services.   He was unsure how  the patient would find  the billing                                                              
code and the amount of the procedure.                                                                                           
                                                                                                                                
REPRESENTATIVE KELLER  answered that this  bill does not  speak to                                                              
fees, but he  noted it would need  to be addressed.   He said this                                                              
bill  allows contracts  between  doctor and  their  patients.   He                                                              
surmised  that some  of  these  contracts or  subscriptions  might                                                              
even include  clauses for  visitor care.   For example,  a patient                                                              
might pay  a certain amount for  a subscription for  primary care,                                                              
which allows  visiting family or  friends to use the  service when                                                              
in town.   He  said that  in other  states the  rates have  ranged                                                              
from $80-$200 per month for these subscriptions.                                                                                
                                                                                                                                
5:04:07 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  JOSEPHSON asked  for the client  and patient  care                                                              
protections  that  might  be  given  up  in  terms  of  regulatory                                                              
protections in order to accrue the benefits.                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER  answered  that  he  wasn't  aware  of  any                                                              
increased risk to patients.                                                                                                     
                                                                                                                                
5:04:55 PM                                                                                                                    
                                                                                                                                
CHAIR  OLSON offered  that the  sponsor may  continue work  during                                                              
the legislative interim.                                                                                                        
                                                                                                                                
REPRESENTATIVE  KELLER said  that  the Division  of Insurance  has                                                              
indicated a willingness to work on this bill during the interim.                                                                
                                                                                                                                
5:05:33 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  LEDOUX  noted  that  this  bill  doesn't  prohibit                                                              
doctors  from  billing   insurance,  but  the  process   would  be                                                              
addressed as  part of  the contract.   She recalled reading  about                                                              
these  services,  also  known  as  concierge  services,  in  which                                                              
people  pay $200-300  per month  to  have the  benefit of  private                                                              
physicians.    She  recalled  that  concierge  plans  have  become                                                              
popular in  California in order for  people to avoid  dealing with                                                              
Medicaid,  Medicare, and  the various  private  insurers.   Again,                                                              
she said,  it might  be difficult  if the  doctor doesn't  provide                                                              
billing information,  but some people might be  interested in this                                                              
to get a doctor's appointment.                                                                                                  
                                                                                                                                
5:06:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  KELLER  said  many stories  are  available  online                                                              
that illustrate the benefits of this type of health care.                                                                       
                                                                                                                                
[HB 159 was held over.]                                                                                                         

Document Name Date/Time Subjects
HB159 Ver W.pdf HL&C 4/15/2015 3:15:00 PM
HB 159
HB159 Sponsor Statement.pdf HL&C 4/15/2015 3:15:00 PM
HB 159
HB159 Supporting Documents-Powerpoint Am Academy Family Physicians DPC Leg - Reg update.pdf HL&C 4/15/2015 3:15:00 PM
HB 159
SB47 ver A.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Sponsor Statement.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Sectional Analysis.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Fiscal Note-SB47-DCCED-DOI-02-20-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-AS09.38.010-.030 Alaska Exemptions Act.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-AS09.38.065 Claims Enforceable Against Exempt Property.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-AS34.40.010 Invalidity Generally..pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-Legal Opinion on Retirement Benefits 3-20-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-Letter-Cook Schuhmann & Groseclose Inc-3-26-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB47 Supporting Documents-Letter-Hompesch & Evans Attorneys at Law 3-26-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 47
SB71 ver W.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Sponsor Statement.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Sectional Analysis.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Fiscal Note DCCED-CBPL 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Fiscal Note DHSS-MAA 3-14-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Fiscal Note DHSS-MAA 4-7-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Emails-3-19-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Document-Collaborative Agreement costs.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Document-Pharmacist Collaborative Prctc Detail.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Adele Garrison.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-AK Pharmacists Assn 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Bd of Pharmacy 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Brown 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Island Pharmacy 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-NACDS 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Ron's Apothecary 3-13-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Safeway 3-16-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Letter-Soden 3-23-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
SB71 Supporting Documents-Physician Collaborative Prctce detail.pdf HL&C 4/15/2015 3:15:00 PM
SB 71
HB185 ver A.PDF HL&C 4/15/2015 3:15:00 PM
HB 185
HB185 Sponsor Statement.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
HB185 Sectional Analysis of SB 99- Updated 04-10-15.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
SB 99
HB185 Supporting Documents-Executive Summary.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
HB185 Supporting Documents-Powerpoint - Title 4 Review.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
HB185 Supporting Documents-Title 4 Recommendations.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
HB185 Supporting Documents-Title 4 Review Process.pdf HL&C 4/15/2015 3:15:00 PM
HB 185
SB47 Opposing Documents-Letter AK Bankers Assoc 4-10-15.pdf HL&C 4/15/2015 3:15:00 PM
SB 47