Alaska 33rd Legislature (2023-2024) Status: In Committee 1 R cosponsors

SB 3 — An Act relating to a health care insurance policy incentive program; relating to health care services; and providing for an effective date.

Last action — (S) REFERRED TO LABOR & COMMERCE

  1. ✓
    Introduced
  2. 2
    In Committee
  3. 3
    Passed Senate
  4. 4
    Passed House
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 33rd Legislature (2023-2024). It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there are no live odds of enactment. It would have to be reintroduced in the current session to move again.

Bill Text

What changed in the latest version

317 added · 185 removed

Plain-language change summary

The updated version of SB 3 now includes provisions for "direct health care agreements," which allow patients and health care providers to establish a clear, written agreement for services in exchange for an annual fee. This change is significant because it aims to provide transparency and predictability for patients regarding their health care costs, allowing them to better manage their expenses. Additionally, the earlier version focused solely on health care insurance policies, whereas the current version broadens the scope to include direct agreements and potentially simplify access to health care services. This shift could help improve patient care and reduce unnecessary expenses.

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33-LS0072\S SPONSOR SUBSTITUTE FOR SENATE BILL NO.
33-LS0072\A SENATE BILL NO.
3/8/23 Referred:
1/18/23 Referred:
Labor and Commerce, Finance A BILL FOR AN ACT ENTITLED "An Act relating to a health care insurance policy incentive program;
Labor & Commerce, Judiciary A BILL FOR AN ACT ENTITLED "An Act relating to direct health care agreements;
relating to a health care insurance policy incentive program;
relating to unfair trade practices;
The uncodified law of the State of Alaska is amended by adding a new section to read:
AS 18.23 is amended by adding a new section to read:
SHORT TITLE.
Article 5.
This Act may be known as the Alaska Health Care Consumer's Right to Shop Act.
Direct Health Care Agreements.
Sec.
18.23.500.
Direct health care agreements.
(a) A direct health care agreement is a written health care agreement between a health care provider and a government entity, an individual patient, or the employer of a patient to provide health care services in exchange for payment of an annual fee.
The health care provider shall disclose the services to be provided under the agreement to the patient and to the person paying the fee.
The health care provider may not assess charges or receive compensation other than the annual fee for health care services and additional fees specified in the agreement.
However, a patient may submit a health care insurance SB0003A -1- SB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A claim and the health care provider may assess charges or receive compensation for health care services not included in the agreement.
A direct health care agreement must (1) describe the health care services to be provided by the health care provider;
(2) specify the annual fee for the health care services and additional fees that the health care provider may charge in addition to the annual fee;
(3) prominently state that the agreement is not health insurance and does not meet an individual or other health insurance mandate that may be required by federal law;
(4) prominently state that the patient is not entitled to the protections under AS 21.07 (Patient Protections Under Health Care Insurance Policies) or AS 21.36 (Trade Practices and Frauds);
(5) identify and include contact information for the person responsible for receiving and addressing a complaint made by a patient;
and (6) state that the annual fee under the agreement for services (A) must be comparable to the annual fee for comparable services provided by the health care provider to other patients under the provider's other direct health care agreements;
and (B) may not be based solely on the patient's health status or sex.
(b) A direct health care agreement between a health care provider and a patient must allow a patient to terminate the agreement in writing within 30 days after entering into the agreement.
If a patient terminates an agreement under this subsection, the provider shall, not later than 30 days after the patient terminates the agreement, refund to the patient payments made under the agreement, less payments made for services the provider has already performed.
The provider may charge a nominal termination fee for termination of an agreement under this subsection.
(c) A direct health care agreement between a health care provider and a patient must allow a party to terminate the agreement in writing after at least 30 days' notice and in accordance with the agreement.
The agreement may provide for a refund, a SB 3 -2- SB0003A New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A nominal termination penalty, or a nominal termination fee for termination of an agreement under this subsection.
(d) A direct health care agreement between a health care provider and a government entity or the employer of a patient may be terminated in accordance with the agreement.
An agreement may provide for a refund, a nominal termination penalty, or a nominal termination fee.
(e) The parties to a direct health care agreement may modify or renew the agreement by written agreement of the parties and in a manner consistent with this section.
A health care provider may not change the annual fee under the agreement more than once a year, and shall provide at least 45 days' written notice of a change in the annual fee.
(f) A direct health care agreement and health care services provided under a direct health care agreement are not subject to AS 21.07 (Patient Protections Under Health Care Insurance Policies) or AS 21.36 (Trade Practices and Frauds), but are subject to other consumer protection statutes and regulations, including AS 45.45.915.
(g) A person may not make, publish, or disseminate an assertion, representation, or statement with respect to the business of direct health care agreements, or with respect to a person in the conduct of the person's direct health care agreement business, that is untrue, deceptive, or misleading, and may not (1) misrepresent the benefits, advantages, conditions, sponsorship, source, or terms of a direct health care agreement;
(2) use a name or title of a direct health care agreement misrepresenting its true nature;
or (3) make a false or misleading statement as to a direct health care agreement.
(h) Offering or executing a direct health care agreement does not constitute engaging in the business of insurance or underwriting in this state, and a direct health care agreement and health care services provided under a direct health care agreement are exempt from regulation by the division of insurance, Department of Commerce, Community, and Economic Development.
A health care provider is not a health maintenance organization, insurer, or insurance producer by virtue of the offering or SB0003A -3- SB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A execution of a direct health care agreement or the provision of health care services under a direct health care agreement.
A certificate of authority or license to market, sell, or offer to sell a direct health care agreement or health care services under a direct health care agreement is not required to offer or execute a direct health care agreement or provide health care services under a direct health care agreement.
(i) In this section, (1) "health care provider" means a firm, corporation, association, institution, or other person licensed or otherwise authorized in this state to provide health care services;
(2) "health care service" means a health care service or procedure, other than a health care service or procedure that is immediately necessary to prevent the death or serious impairment of the health of the patient, that is provided in person or remotely by telemedicine or other means by a health care provider for the care, prevention, diagnosis, or treatment of a physical or mental illness, health condition, disease, or injury.
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SB0003B -1- SSSB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S (2) the name of each insurer whose certificate of authority was surrendered, suspended, or revoked during the year and the cause of surrender, suspension, or revocation;
(2) the name of each insurer whose certificate of authority was surrendered, suspended, or revoked during the year and the cause of surrender, suspension, or revocation;
(4) a statement in regard to examination of rating organizations, advisory organizations, joint underwriters, and joint reinsurers as required by AS 21.39.120;
(4) a statement in regard to examination of rating organizations, advisory organizations, joint underwriters, and joint reinsurers as required by SB 3 -4- SB0003A New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A AS 21.39.120;
Except as provided in AS 21.96.220 or otherwise expressly provided by law, a person may not knowingly permit or offer to make or SSSB 3 -2- SB0003B New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S make a contract of life insurance, life annuity or health insurance, or agreement under the contract other than as plainly expressed in the contract, or pay, allow, give or offer to pay, allow, or give, directly or indirectly, as inducement to the insurance, or annuity, a rebate of premiums payable on the contract, or a special favor or advantage in the dividends or other benefits, or paid employment or contract for services of any kind, or any valuable consideration or inducement whatever not specified in the contract;
Except as provided in AS 21.96.220 or otherwise expressly provided by law, a person may not knowingly permit or offer to make or make a contract of life insurance, life annuity or health insurance, or agreement under the contract other than as plainly expressed in the contract, or pay, allow, give or offer to pay, allow, or give, directly or indirectly, as inducement to the insurance, or annuity, a rebate of premiums payable on the contract, or a special favor or advantage in the dividends or other benefits, or paid employment or contract for services of any kind, or any valuable consideration or inducement whatever not specified in the contract;
or directly or indirectly give, sell, purchase or offer to agree to give, sell, purchase, or allow as inducement to the insurance or annuity or in connection therewith, whether or not to be specified in the policy or contract, an agreement of any form or nature promising returns, profits, stocks, bonds, or other securities, or interest present or contingent in the contract or as measured by the contract, of an insurance company or other corporation, association, or partnership, or dividends or profits accrued or to accrue under the contract;
or directly or indirectly give, sell, purchase or offer to agree to give, sell, purchase, or allow as inducement to the insurance or annuity or in connection therewith, whether or not to be specified in the policy or contract, an agreement of any SB0003A -5- SB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A form or nature promising returns, profits, stocks, bonds, or other securities, or interest present or contingent in the contract or as measured by the contract, of an insurance company or other corporation, association, or partnership, or dividends or profits accrued or to accrue under the contract;
(a) A health care insurer that offers a health care insurance policy in the group or individual market shall develop and implement a program that provides a monetary incentive for a covered person enrolled in a health care insurance policy to elect to receive a covered health care service under the health care insurance policy from a health care provider that charges less than the median contracted rate recognized by the health care insurer for that health care SB0003B -3- SSSB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S service.
(a) A health care insurer that offers a health care insurance policy in the group or individual market shall develop and implement a program that provides a monetary incentive for a covered person enrolled in a health care insurance policy to elect to receive a covered health care service under the health care insurance policy from a health care provider that charges less than the median contracted rate recognized by the health care insurer for that health care service.
A health care insurer is not required to provide an incentive payment to a covered person if the cost saved by the health care insurer is $200 or less.
Except as provided in (e) of this section, the total amount of incentive payments a health care insurer provides to a covered person in a calendar year under this subsection may not exceed the amount of the covered person's cost sharing in the calendar year by more than five percent.
(c) If a covered person receives coverage under a group health care insurance policy offered by an employer, a health care insurer shall provide the covered person with an incentive of at least 33.4 percent of the costs saved by the health care insurer resulting from the covered person's election to receive a health care service from a health care provider that charges less than the median of the contracted rates recognized by the health care insurer for that health care service.
A health care SB 3 -6- SB0003A New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A insurer is not required to provide an incentive payment to a covered person if the cost saved by the health care insurer is $200 or less.
(c) If a covered person receives coverage under a group health care insurance policy offered by an employer, a health care insurer shall provide the covered person with an incentive as provided in this subsection.
Except as provided in this subsection and (e) of this section, the incentive a health care insurer provides the covered person must be at least 33.4 percent of the costs saved by the health care insurer resulting from the covered person's election to receive a health care service from a health care provider that charges less than the median of the contracted rates recognized by the health care insurer for that health care service.
Except as provided in (e) of this section, the incentive a health care insurer provides to a covered person in a calendar year under this subsection may not exceed the amount of the covered person's cost sharing in the calendar year.
(e) An incentive payment to a covered person under this section is not (1) a violation of AS 21.36.100;
(e) For a dental insurance policy or a vision insurance policy, the incentives a health care insurer provides to a covered person in a calendar year may not exceed the amount of the dental benefits or vision benefits provided to the covered person under the dental insurance policy or the vision insurance policy.
(f) An incentive payment to a covered person under this section is not (1) a violation of AS 21.36.100;
Annually, at enrollment or renewal, a health care insurer shall provide notice about the availability of the program to a person covered under a health care insurance policy eligible for the program.
Annually, at enrollment or renewal, a health care SB0003A -7- SB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A insurer shall provide notice about the availability of the program to a person covered under a health care insurance policy eligible for the program.
Before offering an incentive program SSSB 3 -4- SB0003B New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S under AS 21.96.220, a health care insurer that offers a health care insurance policy in the group or individual market shall file a description of the program with the director in the manner determined by the director.
Before offering an incentive program under AS 21.96.220, a health care insurer that offers a health care insurance policy in the group or individual market shall file a description of the program with the director in the manner determined by the director.
(b) The director shall include the information provided under this section in the director's annual report under AS 21.06.110 and shall submit the annual report to the chairs of the committee in each house of the legislature with jurisdiction over labor and commerce.
(b) The director shall include the information provided under this section in the director's annual report under AS 21.06.110 and shall submit the annual report to the chairs of the committee in each house of the legislature with jurisdiction over labor SB 3 -8- SB0003A New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A and commerce.
(a) Except as provided in (b) of this section, AS 21.96.210 - 21.96.300 apply to a health care insurance policy or contract but do SB0003B -5- SSSB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S not apply to excepted benefits.
(a) Except as provided in (b) of this section, AS 21.96.210 - 21.96.300 apply to a health care insurance policy or contract but do not apply to excepted benefits.
In AS 21.96.210 - 21.96.300, (1) "health care insurance" has the meaning given in AS 21.12.050;
In AS 21.96.210 - 21.96.300, (1) "cost sharing" means a deductible, coinsurance, copayment, or similar expense owed by a covered person under the terms of the covered person's health care insurance policy;
(2) "health care insurer" has the meaning given in AS 21.54.500;
(2) "health care insurance" has the meaning given in AS 21.12.050;
(3) "health care provider" has the meaning given in AS 18.23.400(n);
(3) "health care insurer" has the meaning given in AS 21.54.500;
(4) "health care service" has the meaning given in AS 18.23.400(n);
(4) "health care provider" has the meaning given in AS 18.23.400(n);
(5) "policy" has the meaning given in AS 21.97.900.
(5) "health care service" has the meaning given in AS 18.23.400(n);
(6) "policy" has the meaning given in AS 21.97.900.
(3) "health care provider" has the meaning given in AS 18.23.400(n);
SB0003A -9- SB 3 New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A (3) "health care provider" has the meaning given in AS 18.23.400(n);
AS 45.45 is amended by adding a new section to read:
Sec.
45.45.915.
Direct health care agreements.
(a) A health care provider may not decline to enter into a direct health care agreement with a new patient or terminate a direct health care agreement with an existing patient solely because of the patient's race, religion, color, national origin, age, sex, physical or mental disability, marital status, change in marital status, pregnancy, parenthood, or any other characteristic of a class of persons protected by federal or state laws that prohibit discrimination.
(b) A health care provider may decline to enter into a direct health care agreement with a new patient or terminate a direct health care agreement with an existing patient based on the patient's health status only if the health care provider is unable to provide to the patient the level or type of care the patient requires for a medical condition.
Before terminating a direct health care agreement with an existing patient, a health care provider shall ensure that the patient is transferred to a health care provider who (1) is able to provide the level or type of care the patient requires;
and (2) agrees to provide to the patient the level or type of care the patient requires.
(c) In this section, (1) "direct health care agreement" means an agreement described in AS 18.23.500;
(2) "health care provider" has the meaning given in AS 18.23.500.
* Sec.
8.
AS 45.50.471(b) is amended by adding new paragraphs to read:
(59) violating AS 18.23.500 (direct health care agreements);
(60) violating AS 45.45.915 (direct health care agreements).
* Sec.
9.
The Department of Administration shall analyze whether the state or SSSB 3 -6- SB0003B New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\S employees covered by a group health care insurance policy for a participating governmental unit would benefit if a group health care insurance policy obtained or provided under AS 39.30.090 or 39.30.091 were required to comply with the provisions of AS 21.96.210 - 21.96.300, added by sec.
The Department of Administration shall analyze whether the state or SB 3 -10- SB0003A New Text Underlined [DELETED TEXT BRACKETED] 33-LS0072\A employees covered by a group health care insurance policy for a participating governmental unit would benefit if a group health care insurance policy obtained or provided under AS 39.30.090 or 39.30.091 were required to comply with the provisions of AS 21.96.210 - 21.96.300, added by sec.
8.
10.
9.
11.
Sections 7 and 8 of this Act take effect immediately under AS 01.10.070(c).
Sections 9 and 10 of this Act take effect immediately under AS 01.10.070(c).
10.
12.
9 of this Act, this Act takes effect January 1, 2024.
11 of this Act, this Act takes effect January 1, 2024.
SB0003B -7- SSSB 3 New Text Underlined [DELETED TEXT BRACKETED]
SB0003A -11- SB 3 New Text Underlined [DELETED TEXT BRACKETED]
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Action History

  1. (S) REFERRED TO LABOR & COMMERCE

  2. (S) L&C, FIN

  3. (S) SPONSOR SUBSTITUTE INTRODUCED-REFERRALS

  4. (S) L&C, JUD

  5. (S) READ THE FIRST TIME - REFERRALS

  6. (S) Prefile released 1/9/23

Sponsors

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 64 not signed on

Sponsors (1)

Co-sponsors (0)

None.

Not signed on (64)

64 members have not signed on to this bill.

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"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Subjects

healthcare health-insurance
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Frequently asked questions

Who sponsors SB 3?
SB 3 is sponsored by Shelley Hughes (R).
What is the current status of SB 3?
This bill died with 33rd Legislature (2023-2024). It reached “In Committee” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track SB 3?
Track SB 3 free on One Click Politics — get push/email alerts when it moves.

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