00 Enrolled HB 141 01 Setting the fee for medical treatment or services performed outside the state under the Alaska 02 Workers' Compensation Act, requiring a provider of medical treatment or services under the 03 Alaska Workers' Compensation Act to submit bills for treatment or services to employers 04 within 180 days after the date the treatment or services are rendered, and limiting the time for 05 appealing an employer's denial or reduction of a bill; and providing for an effective date. 06 _______________ 07 * Section 1. AS 23.30.097(a) is amended to read: 08 (a) All fees and other charges for medical treatment or service are subject to 09 regulation by the board consistent with this section. A fee or other charge for medical 10 treatment or service 11 (1) rendered in the state may not exceed the lowest of 12 (A) [(1)] the usual, customary, and reasonable fees for the 01 treatment or service in the community in which it is rendered, for treatment or 02 service provided on or after December 31, 2010, not to exceed the fees or other 03 charges as specified in a fee schedule established by the board and adopted by 04 reference in regulation; the fee schedule must be based on statistically credible 05 data, including charges for the most recent category I, II, and III medical 06 services maintained by the American Medical Association and the Health Care 07 Procedure Coding System for medical supplies, injections, emergency 08 transportation, and other medically related services, and must result in a 09 schedule that 10 (i) [(A)] reflects the cost in the geographical area where 11 services are provided; and 12 (ii) [(B)] is at the 90th percentile; 13 (B) [(2)] the fee or charge for the treatment or service when 14 provided to the general public; or 15 (C) [(3)] the fee or charge for the treatment or service 16 negotiated by the provider and the employer under (c) of this section; 17 (2) rendered in another state may not exceed the fee or charge for 18 a treatment or service set by the workers' compensation statutes of the state 19 where the services are rendered. 20 * Sec. 2. AS 23.30.097 is amended by adding new subsections to read: 21 (h) A provider of medical treatment or services may receive payment for 22 medical treatment and services under this chapter only if the bill for services is 23 received by the employer within 180 days after the later of 24 (1) the date of service; or 25 (2) the date that the provider knew of the claim and knew that the 26 claim related to employment. 27 (i) A provider whose bill has been denied or reduced by the employer may file 28 an appeal with the board within 60 days after receiving notice of the denial or 29 reduction. A provider who fails to file an appeal of a denial or reduction of a bill 30 within the 60-day period waives the right to contest the denial or reduction. 31 * Sec. 3. The uncodified law of the State of Alaska is amended by adding a new section to 01 read: 02 APPLICABILITY. AS 23.30.097(a), as amended by sec. 1 of this Act, and 03 AS 23.30.097(h) and (i), added by sec. 2 of this Act, apply to fees and charges for medical 04 treatment and services rendered before, on, or after the effective date of this Act. 05 * Sec. 4. The uncodified law of the State of Alaska is amended by adding a new section to 06 read: 07 TRANSITIONAL PROVISIONS. (a) Notwithstanding AS 23.30.097(h), added by 08 sec. 2 of this Act, a provider may submit bills for services rendered before the effective date 09 of this Act within 180 days after the effective date of the Act. 10 (b) Notwithstanding AS 23.30.097(i), added by sec. 2 of this Act, a provider may 11 appeal an employer's denial or reduction of a bill denied or reduced before the effective date 12 of this Act if the appeal is filed within 60 days after the effective date of this Act. 13 * Sec. 5. The uncodified law of the State of Alaska is amended by adding a new section to 14 read: 15 RETROACTIVITY. AS 23.30.097(a), as amended by sec. 1 of this Act, and 16 AS 23.30.097(h) and (i), added by sec. 2 of this Act, are retroactive. 17 * Sec. 6. This Act takes effect immediately under AS 01.10.070(c).