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28th Legislature(2013-2014)

Bill Text 28th Legislature


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).                                                 
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