Juneau -- The Alaska Senate Tuesday passed House Bill 211, the Alaska Patients Bill of Rights, sponsored by Representative Norman Rokeberg (R-Anchorage). This bill is similar to a federal bill that would affect self-insured groups in Alaska.

This landmark health care reform legislation provides Alaskans with:

• choice of physician;
• use of a "prudent person" standard concerning emergency room services, if a policy covers such services;
• right to appeal any "utilization review" decision made by a managed care entity's licensed health care provider to: (1) an internal appeal process, at which time a professional health care provider holding the same professional license as the patient's health care provider would review the decision; and (2) an external review organization which is not connected with the managed care entity.
• use of clinical peer review at the external review process (for example, specialist-to-specialist review);
• prohibition of "gag clauses" so that a health care provider may fully inform a patient of all treatment options available;
• prohibition of financial incentives clauses in contracts with health care providers which reward the providers for not recommending expensive procedures or for not going over a "budgeted" amount;
• ability to go to a provider not in a patient's community;
• description of which prescription medications are covered and which are excluded;
• description of availability of translation or interpreter services, if needed; and
• consideration of community standards of care in external review process.

"HB 211 will help overcome the frustration most Alaskans have experienced when dealing with pre-approval of health insurance benefits," Rokeberg said. "The two-step internal review mechanism and the third-party external review appeal procedure gives the average person an opportunity to have a fair and impartial hearing of whether or not any disputed benefits should be paid.

"This legislation has been developed with input from Alaskan health care providers, insurance companies, unions, and other interested parties," said Rokeberg. "It address issues similar to those being discussed on the national level with the Federal Patients Bill of Rights."

HB 211 passed the Senate unanimously. Notice of reconsideration was filed.

Sponsor Statement for HB 211