Alaska 2023-2024 Regular Session

Alaska House Bill HB47 Compare Versions

Only one version of the bill is available at this time.

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2	2	HB0047a -1- HB 47
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5	5	33-LS0324\A
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11	11	HOUSE BILL NO. 47
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13	13	IN THE LEGISLATURE OF THE STATE OF ALASKA
14	14
15	15	THIRTY-THIRD LEGISLATURE - FIRST SESSION
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17	17	BY REPRESENTATIVE MCCABE
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19	19	Introduced: 1/25/23
20	20	Referred: Health and Social Services, Labor and Commerce
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22	22
23	23	A BILL
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25	25	FOR AN ACT ENTITLED
26	26
27	27	"An Act relating to insurance; relating to direct health care agreements; and relating to 1
28	28	unfair trade practices." 2
29	29	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
30	30	* Section 1. AS 21.03 is amended by adding a new section to read: 4
31	31	Sec. 21.03.025. Direct health care agreements. (a) A direct health care 5
32	32	agreement is a written agreement between a health care provider or health care 6
33	33	business and a patient or the representative of a patient to provide health care services 7
34	34	in exchange for payment of a periodic fee. A patient is not eligible to enter into a 8
35	35	direct health care agreement under this section if the patient is eligible to receive 9
36	36	assistance under AS 47.07 (Medical Assistance for Needy Persons) or AS 47.08 10
37	37	(Assistance for Catastrophic Illness and Chronic or Acute Medical Conditions). 11
38	38	(b) A direct health care agreement must 12
39	39	(1) describe the health care services that the health care provider or 13
40	40	health care business makes available to the patient in exchange for payment of a 14 33-LS0324\A
41	41	HB 47 -2- HB0047a
42	42	New Text Underlined [DELETED TEXT BRACKETED]
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44	44	periodic fee and each location at which the health care services are available; 1
45	45	(2) specify 2
46	46	(A) the amount of the periodic fee a patient or the 3
47	47	representative of a patient pays in exchange for the health care services that the 4
48	48	health care provider or health care business makes available to the patient; 5
49	49	(B) the period covered by the periodic fee under (A) of this 6
50	50	paragraph; and 7
51	51	(C) additional fees that the health care provider or health care 8
52	52	business may charge in addition to the periodic fee, including cancellation 9
53	53	fees; 10
54	54	(3) identify and include contact information for a representative of the 11
55	55	health care provider or health care business that is responsible for receiving and 12
56	56	addressing a complaint made by a patient relating to the agreement; 13
57	57	(4) prominently state that the agreement is not health insurance and 14
58	58	does not meet an individual or other health insurance mandate that may be required by 15
59	59	federal law; and 16
60	60	(5) prominently state that the patient is not entitled to the protections 17
61	61	under AS 21.07 (Patient Protections Under Health Care Insurance Policies) or 18
62	62	AS 21.36 (Trade Practices and Frauds). 19
63	63	(c) A direct health care agreement must allow a patient or the representative of 20
64	64	a patient to terminate the agreement in writing within 30 days after entering into the 21
65	65	agreement. If a patient or representative terminates an agreement under this 22
66	66	subsection, the health care provider or health care business shall, not later than 30 days 23
67	67	after the patient or representative terminates the agreement, refund to the patient or 24
68	68	representative payments made under the agreement, less payments made for services 25
69	69	the health care provider or health care business has already performed that are not 26
70	70	included in the periodic fee. The health care provider or health care business may 27
71	71	charge a termination fee for termination of an agreement under this subsection, not to 28
72	72	exceed an amount equal to one month's cost of the periodic fee. 29
73	73	(d) A direct health care agreement must allow a health care provider, a health 30
74	74	care business, a patient, or the representative of a patient to terminate the agreement in 31 33-LS0324\A
75	75	HB0047a -3- HB 47
76	76	New Text Underlined [DELETED TEXT BRACKETED]
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78	78	writing after at least 30 days' notice. The agreement must require that the patient pay 1
79	79	the health care provider or health care business the periodic fee, prorated through the 2
80	80	date of termination of the agreement, and that the patient pay any additional fees for 3
81	81	services the health care provider or health care business has already performed that are 4
82	82	not included in the periodic fee. The health care provider or health care business may 5
83	83	charge a termination fee for termination of an agreement under this subsection by a 6
84	84	patient or representative, not to exceed an amount equal to one month's cost of the 7
85	85	periodic fee. 8
86	86	(e) A health care provider or health care business may not change the periodic 9
87	87	fee under the agreement more than once a year and shall provide at least 45 days' 10
88	88	written notice of a change in the periodic fee. 11
89	89	(f) A health care provider or health care business may bill a patient or the 12
90	90	representative of a patient for the periodic fee only after the end of the period to which 13
91	91	the periodic fee applies. 14
92	92	(g) A patient's employer may pay the periodic fee and additional fees the 15
93	93	patient owes a health care provider or health care business under a direct health care 16
94	94	agreement. A payment by the employer under this subsection does not constitute 17
95	95	engaging in the business of insurance or underwriting in this state, and the employer is 18
96	96	not an insurer, a health maintenance organization, a health care insurer, or a medical 19
97	97	service corporation by virtue of the payment. 20
98	98	(h) A health care provider or health care business may immediately terminate 21
99	99	a direct health care agreement if 22
100	100	(1) a patient repeatedly fails to comply with the treatment plan for the 23
101	101	patient recommended by the health care provider or health care business; 24
102	102	(2) a patient's behavior threatens the safety of the health care provider, 25
103	103	the staff of the health care provider or health care business, or other patients of the 26
104	104	health care provider or health care business; or 27
105	105	(3) a patient engages in disrespectful, derogatory, or prejudiced 28
106	106	behavior that is within the patient's control and the patient does not stop the behavior 29
107	107	even after the health care provider or the staff of the health care provider or health care 30
108	108	business requests the patient to stop the behavior. 31 33-LS0324\A
109	109	HB 47 -4- HB0047a
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112	112	(i) A health care provider or a health care business may immediately terminate 1
113	113	a direct health care agreement if a patient or the representative of a patient breaches 2
114	114	the terms of the agreement. A patient or representative may immediately terminate a 3
115	115	direct health care agreement if a health care provider or a health care business 4
116	116	breaches the terms of the agreement. 5
117	117	(j) A direct health care agreement and health care services provided under a 6
118	118	direct health care agreement are not subject to AS 21.07 (Patient Protections Under 7
119	119	Health Care Insurance Policies) or AS 21.36 (Trade Practices and Frauds), but are 8
120	120	subject to other consumer protection statutes and regulations, including AS 45.45.915. 9
121	121	(k) Offering or executing a direct health care agreement does not constitute 10
122	122	engaging in the business of insurance or underwriting in this state, and, except as 11
123	123	provided in this section, a direct health care agreement and health care services 12
124	124	provided under a direct health care agreement are exempt from regulation by the 13
125	125	division under this title. A direct health care agreement is not insurance, health 14
126	126	insurance, health care insurance, or a health care insurance policy. A health care 15
127	127	provider or health care business is not an insurer, a health maintenance organization, a 16
128	128	health care insurer, or a medical service corporation by virtue of the offering or 17
129	129	execution of a direct health care agreement or the provision of health care services 18
130	130	under a direct health care agreement. A certificate of authority or license to market, 19
131	131	sell, or offer to sell a direct health care agreement or health care services under a direct 20
132	132	health care agreement is not required to offer or execute a direct health care agreement 21
133	133	or provide health care services under a direct health care agreement. 22
134	134	(l) In this section, 23
135	135	(1) "health care business" means a business licensed by the state that is 24
136	136	entirely owned by health care providers; 25
137	137	(2) "health care insurance" has the meaning given in AS 21.12.050(b); 26
138	138	(3) "health care insurer" has the meaning given in AS 21.54.500; 27
139	139	(4) "health care provider" has the meaning given in AS 21.07.250; 28
140	140	(5) "health care service" 29
141	141	(A) means a health care service or procedure that is provided in 30
142	142	person or remotely by telemedicine or other means by a health care provider 31 33-LS0324\A
143	143	HB0047a -5- HB 47
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146	146	for the care, prevention, diagnosis, or treatment of a physical or mental illness, 1
147	147	health condition, disease, or injury; 2
148	148	(B) does not include "emergency services" as defined in 3
149	149	AS 21.07.250; 4
150	150	(6) "health insurance" has the meaning given in AS 21.12.050; 5
151	151	(7) "health maintenance organization" has the meaning given in 6
152	152	AS 21.86.900; 7
153	153	(8) "medical service corporation" has the meaning given in 8
154	154	AS 21.87.330. 9
155	155	* Sec. 2. AS 45.45 is amended by adding a new section to read: 10
156	156	Sec. 45.45.915. Direct health care agreements. (a) A health care provider or 11
157	157	health care business may not decline to enter into a direct health care agreement with a 12
158	158	new patient or terminate a direct health care agreement with an existing patient solely 13
159	159	because of the patient's race, religion, color, national origin, age, sex, physical or 14
160	160	mental disability, marital status, change in marital status, pregnancy, parenthood, or 15
161	161	any other characteristic of a class of persons protected by a state law that prohibits 16
162	162	discrimination. 17
163	163	(b) A health care provider or health care business may decline to enter into a 18
164	164	direct health care agreement with a new patient if the health care provider or health 19
165	165	care business 20
166	166	(1) is unable to provide to the patient the health care services the 21
167	167	patient requires; or 22
168	168	(2) does not have the capacity to accept new patients. 23
169	169	(c) A health care provider or health care business may terminate a direct 24
170	170	health care agreement with an existing patient based on the patient's health status only 25
171	171	if the health care provider is unable to provide to the patient the health care services 26
172	172	the patient requires or in accordance with AS 21.03.025. 27
173	173	(d) In this section, 28
174	174	(1) "direct health care agreement" means an agreement described in 29
175	175	AS 21.03.025; 30
176	176	(2) "health care business" has the meaning given in AS 21.03.025(l); 31 33-LS0324\A
177	177	HB 47 -6- HB0047a
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180	180	(3) "health care provider" has the meaning given in AS 21.07.250; 1
181	181	(4) "health care service" has the meaning given in AS 21.03.025(l). 2
182	182	* Sec. 3. AS 45.50.471(b) is amended by adding a new paragraph to read: 3
183	183	(58) violating AS 45.45.915 (direct health care agreements). 4