Coming to Alaska in January 2019:
Health Care Cost Disclosure
In 2017, after hearing about the way that health care costs were bankrupting families, crowding out profits and wage growth in the private sector, and forcing state budgets upward, I introduced legislation to make the price of the most commonly provided health care services available to the public.

It seems straightforward enough; consumers would be able to see the prices for health care services displayed on a list in their doctor's office and website. Consumers and small businesses loved the idea. HB123 , health care price transparency, earned the support of the Anchorage, Fairbanks and Ketchikan Chambers of Commerce along with Alaskans for Sustainable Health Care Costs and many others.

Health care is one of the only industries where consumers have almost no idea how much it will cost before committing to payment. In Alaska, we have some of the highest health care costs in the nation--and it's just getting worse. You can see how Alaska's health care costs compare to the rest of the nation at the Kaiser Family Foundation website.

The Nuts and Bolts of Health Care Price Transparency

We worked on this bill for two years which made the final version stronger than the original bill. It requires the following:
  • All health care providers, hospitals, and insurers must provide a good faith estimate (GFE) for medical services upon request.
  • The GFE must say if the provider is "in" or "out-of-network" with your insurer.
  • Health care providers, clinics and hospitals will post their top ten health care services in each of six categories of Current Procedure Terminology (CPT) codes: surgery, anesthesiology, pathology and labs, medicine, radiology, and evaluation and management. Sole practitioners will list their 25 most frequently provided services.
  • The price list must include the CPT codes (so you can compare between providers) and list the undiscounted price. (If you have insurance, you may pay less than this price so talk to the billing office about what your actual costs may be,)
  • Providers, clinics and hospitals will send these price lists to the Department of Health and Social Services (DHSS) once a year where it will be published on a public website.

In effect, you would be able to see a price menu for 60 health care services with the undiscounted price, and the cost of facility fees associated with the service at any clinic or hospital in the state of Alaska.

There was an effort to keep this bill from becoming law in the last weeks of the legislature. However, we refused to give up and in the last hours on the final day of Session, we amended HB 123 into into Senator David Wilson's (R) Senate Bill 105 and it passed both the House and the Senate!

You are invited: Bill Signing on August 6th!
SB 105 will be signed into law by Governor Bill Walker on Monday, August 6th at the Anchorage Chamber of Commerce's "Make it Monday" luncheon .

If you would like to attend this bill signing, you can register for the luncheon here. The more the merrier!
Thank You to the following organizations and businesses!
We could not have gotten health care price transparency passed without the help of those listed below. Thank you for:
  • contacting your Senators and Representatives,
  • calling in to testify in to every committee,
  • writing letters and emails of support, and
  • meeting with me to help make this bill better!

We could not have done this without all of the following organizations and businesses:
  • Aetna
  • Alaska Association of Health Underwriters
  • Alaska Association of School Board Administrators
  • Alaska Commission on Aging
  • Alaska Employee Benefits
  • Alaska Nurses Association
  • Alaska Permanent Capital Management
  • Alaska Professional Fire Fighters Association
  • Alaska State Hospitals and Nursing Home Association (ASHNHA)
  • Alaskans for Sustainable Health Care Costs
  • Allen & Petersen: Cooking & Appliance Center
  • Anchorage Chamber of Commerce
  • Anchorage Heart Institute
  • Bean's Cafe
  • Continental Motors
  • Denali Federal Credit Union
  • Denali Flying Services
  • Fairbanks Chamber of Commerce
  • Greater Ketchikan Chamber of Commerce
  • Marsh & McClennan Agency
  • Municipality of Anchorage
  • Northrim Benefits Group, LLC
  • Peak Neurology
  • Premera Blue Cross
  • Public Education Health Trust
  • Solsten XP
  • Taku Engineering, LLC
  • The Wilson Agency, LLC
  • Valley Block and Concrete
  • Wilson Agency
Commonly Asked Questions
What is the undiscounted price?
The undiscounted price is the amount billed for a service rendered without complications or exceptional circumstances; it does not include the negotiated discount for an in-network or out-of-network service or the cost paid by a third party.

What is a CPT code?
CPT stands for current procedural terminology. The code is a five digit number that corresponds to a procedure or service used for billing purposes ( AAPC, 2018).

What are facility fees?
A facility fee is a charge billed by a health care facility or provider that is in addition to fees billed for a health care provider's professional services. The facility fee is intended to cover building, electronic medical records systems, billing, and other administrative and operational expenses.

What are the 6 sections of Category I, CPT codes?
The 6 sections are surgery, anesthesiology, medicine, radiology, pathology and labs, and evaluation and management. The categories are determined by the American Medical Association.

How will this bill help me figure out the exact cost of what I will pay out-of-pocket? Providers, hospitals, and insurers are now required to provide you with a personalized good faith estimate (GFE). If you speak directly with your insurer for a GFE, they can tell you what your co-pay and deductible will be for a specific health care service or procedure.

What if I'm at a hospital that is in-network?
If you receive your health care services at your local, in-network clinic, you can still see what they charge for certain services or procedures. You can also ask for a GFE to estimate what your out-of-pocket or co-pay will be.

What if I don't have insurance?
If you don't have insurance, you can use the price list to shop around for your health care service. To get an accurate estimate of what you might pay for a procedure, providers and hospitals are now required to give you a personalized GFE if you ask for one.

When should I expect to see a price list at my local clinic?
The implementation process for disclosing health care costs will begin January 1, 2019. Health care providers and hospitals should have their price information posted in their reception area or website (if they have one) no later than March 31st.
Saturdays, 9am to 2pm
1301 Muldoon Road

Summer's abundance is at its peak with beautiful blossoms from Mountain Bloom Peonies and delicious smoothies from Sweet Berry Yogurt and Drinks.Valley strawberries, tomatoes, new potatoes, onions, beets, radishes, kohlrabi and cabbages from our farm and garden vendors.
Eggs, honey, jams, salsa, pickles and gorgeous greens plus Alaska seafood. Locally cooked foods & baked goods, vegan treats! Alaska crafts & live music.

Kid friendly with a great playground. Parking at Muldoon Mall (DeBarr & Muldoon); follow the short, paved walkway right to the heart of the market in Chanshtnu Muldoon Park.

For more info visit the Muldoon Farmer's Market Facebook page.
If you have every any questions about any legislation passed this year, please let me know!

I can be reached at rep.ivy.spohnholz@akleg.gov or 907-269-0123.
PS - To learn about other upcoming events and meetings, follow me on Facebook and Twitter . You can also check my website for past newsletters and updates on legislation.