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A
I
get
started
here,
he's
I
treat
him
like
my
dad
of
course
he's
a
lot
older
than
me
and
I
have
to
like
to
call
the
meeting
order
and
Madam
Secretary.
Will
you
please
call
the.
A
Any
members
that
gun
in
Communications
are
announcements
for
guests
or
anything
like
that.
All
right.
First
on
the
agenda,
there's
representative,
Weber
and
I
think
he's
bringing
his
priest
with
him.
Well,
y'all
yeah.
C
Mr
chairman
members
of
the
committee
House
Bill
148,
is
is
an
assignment
of
benefits
for
substance,
use
disorder
and
mental
health
treatment
centers
currently
for
out
of
network
providers.
Many
health
insurance
companies
will
not
send
payments
for
the
services
rendered
to
the
patient
insured
directly
to
the
provider,
but
instead
funds
are
paid
directly
to
the
patient
patients
and
the
insured.
The
expectation
is
that
they
will
in
turn,
pay
their
bills.
This
is
because
many
of
these
insurers
have
anti-assignment
Clauses
as
part
of
their
contract.
C
So
even
if
the
patient
or
the
insured
instructs
the
insurance
company
to
pay
the
provider
directly,
it
won't
be
honored.
This
pay-to-pay
patient
model
for
out-of-network
models
has
been
outlawed
in
17
States
for
health
care
in
another
seven
states
of
specified
provider.
Carve-Outs
that
bans
this
practice.
So
what
does
House
Bill
148?
Do?
It
requires
health
insurance
companies
to
recognize
the
patient's
assignment
of
benefits
for
substance,
Substance,
Abuse
and
Mental
Health
Facilities.
C
Only
under
this
proposed
Bill
patience
of
a
substance,
abuse
or
mental
health
facility
will
be
allowed
to
instruct
their
insurance
to
assign
and
pay
benefits
directly
to
their
treatment
provider
of
choice.
Due
to
the
nature
of
Substance
Abuse
and
Mental
Health
disorders
and
the
severity
of
the
drug
epidemic,
our
state
encounters
continues
to
face
daily.
We
believe
the
carve
out
of
these
providers
and
health
House
Bill
148
is
necessary.
Providing
access
to
such
funds
to
the
vulner
to
these
vulnerable
individuals
has
and
will
continue
to
lead
to
a
relapse,
overdose
or
even
death.
C
C
There
was
a
committee
sub
that
passed
in
was
attached
in
the
house
and
I'll
outline.
What
some
of
that
does
here?
The
committee
substitute
to
House
Bill
148
is
the
work
product
of
discussions
and
negotiations
between
Anthem
and
the
substance,
use
disorder,
treatment,
provider
Community.
The
parties
have
agreed
to
the
language
in
house
bill
148..
C
It
does
not
make
any
substantive
changes
to
the
underlying
bill.
It
simply
provides
some
additional
safeguards
in
the
assignment
of
benefit
process
between
the
provider.
The
insured
and
the
insurance
company,
some
of
these
requirements
include
submission
of
a
more
detailed
statement
of
the
sud
or
mental
health
provider
to
the
insured
about
the
charges
and
aob
process.
They
will
face
a
time
frame
when
the
aob
claims
can
be
submitted
to
the
insurance
company.
C
E
C
The
the
structure
is-
and
this
was
brought
to
me
by
a
recovery
facility
in
Bullitt
County-
that
Senator
Nevis
and
I
represent,
and
what
happened
is
those
individuals
are
going
through
a
about
a
30-day
treatment
program
and
they
are
receiving
the
checks
payment
that
should
go
to
the
facility
for
the
service
and
what's
happening?
Is
that
check
is
going
directly
to
that
individual
in
recovery?
Well,.
D
Let
me
say,
representative
Weber
went
in
detail,
pretty
good
I
know.
He
said
it
was
a
summary
of
what
the
bill
does,
but
let
me
bring
it
succinctly
down
to
a
layperson's
understanding.
There
were
people
getting
checks
that
need
services
and
need
and
they're
walking
away
with
the
checks
without
getting
the
help
they
need.
E
F
Help
me
out
with
this
in
this
particular
Bill.
What
we're
saying
is
is
is
that
when
that
patient
receives
a
service,
the
facility
must
the
insurance
company
must
directly
pay
the
facility
and
and
not
to
the
patient,
because
traditionally
there
are
patients
who
were
walking
away
with
the
money.
So,
first
and
foremost,
this
is
kind
of
a
a
collection
shifting
piece
of
legislation.
F
The
other
question
I
had
was
with
the
out
of
network
charges,
are
the
are
the
facilities
that
are
out
of
network
going
to
charge
the
same
as
those
facilities
that
are
in
network?
Is
there
I
I
didn't
see?
That
in
here?
Is
that
part
of
the
agreement.
G
F
H
I
introduced
myself
to
the
record
Jeff
Busick
partner
at
MacArthur,
strategic
Solutions
contract
lobbyists
and
work
for
the
center
that
they're
talking
about
Robert
Alexander
Center
there
in
Boulder,
County.
You
and
I
had
a
conversation
earlier
today
about
this
topic
and
I.
You
know
talked
to
my
client
and
he
informed
me
that,
at
least
in
the
substance
use
disorder,
Arena
right
that
the
at
a
network
rate
for
fully
insured
plans
is
only
about
one,
maybe
two
percent
higher
than
the
in-network
rate.
That
might
be
different.
H
You
know
for
different
providers,
like
you
know,
I'm,
not
privy
to
different
rates
of
in-network
and
out
Network
for
all
different
type
of
Provider
groups,
but
they
don't
see
that
there
will
be
this
sort
of
incentive
for
providers
to
if
they
are
already
in
network
with
an
insurance
company
to
go
out
of
network,
because
the
financial
incentive
isn't
that
big
and
there's
also
additional
reasons
for
providers
to
be
in
network
with
an
insurance
company
such
as
you
know
that
they
want
those,
the
you
know,
the
insurer
or
the
patients.
H
The
client
tell
right
they
want
that
wider
range
of
patients
and
that's
why
they're?
In
network,
it's
not
just
about
rates
necessarily
in
network,
so
we
don't.
We
don't
think
that
the
that
you're
going
to
see
Mass
exits
of
people
leaving
right
at
least
have
how
we
nearly
tearled
this,
but
you
know
that
the
rate
may
be
a
little
higher
right
and
I
think
it
depends
on
what
the
insurance
company
is.
But
so
the
rate
will
be
whatever
the
added
Network
rate
is
that
the
insurance
company
has
agreed
to
with
their
insured.
F
Matt
ask
one
more
question:
Mr
chair,
thank
you
as
a
provider
for
longer
than
I
care
to
say
here.
I
have
concerns
and
I
shared
those
with
you
this
morning,
and
my
concerns
are
that
there
is
no
reason
to
be
an
in-net
work
provider.
F
H
Sorry
and
like
we
talked
about
I,
understand
your
concerns
right
I.
Do
we
think
that,
like
as
I
just
mentioned
before
I,
we
think
that
there
are
other
reasons
to
be
in
network?
A
provider
goes
in
network
for
for
other
reasons,
than
just
the
rate.
Now
the
rate
probably
is
obviously
a
big
reason.
I
don't
disagree
with
you
there,
but
I
think
there
are
other
reasons
to
be
in
network.
Besides
just
the
race.
H
A
You,
let
me
ask
you
this
John:
if
it's,
if
it's
in
network
they
pay
in
network
price,
all
right,
that's.
H
A
H
Twenty
percent,
so
they'll
continue
to
pay.
What
the
at
a
network
rate
is
right.
All
this
bill
does
is
it
requires
the
insurance
company
to
recognize
an
assignment
of
benefit
from
the
patient,
because
most
insurance
contracts,
if
you're
at
a
network
for
the
insured
side,
has
anti-assignment
causes,
and
so
all
this
bill
will
do
is
requires
them
to
recognize
that
assignment
of
benefit.
So.
A
H
A
Right,
you're
only
assigning
what
that
insurer
pays.
That's
right
if
that
insurer
pays,
if
the
bill
is
twelve
thousand,
but
they
only
pay
8
000
they're
going
to
assign
the
eight
thousand.
This
don't
raise
the
price
of
in
or
out
of
network
they're
going
to
pay
what
they
normally
pay.
That's
correct.
So
in
his
situation
and
I
know
his
concerns
and
I
and
I
would
be
concerned
too.
A
There
would
be
no
reason
to
be
in
network
or
out
of
network,
but
they're
only
going
to
pay
what
they
pay
for
in
network
and
then
the
the
the
patient
is
going
to
pay
a
surprise
billing.
It's
going
to
have
that
difference
of
billing,
because
it's
out
of
network
compared
to
end
network
is
is
but
the
bill
only
just
says
that
you
can
do
an
assignment
right.
That's.
D
Correct
and
and
that
that's
the
same
as
if
a
patient
goes
to
out
of
network
place,
they
get
the
money
and
if
they
don't
run
off
with
the
money
and
pay
they
still
owe
more
than
they
were
paid
from
it.
So
it
doesn't
change
the
amounts
paid.
They
can
still
decide
to
go
to
an
in-network
facility,
whether
they
get
paid
directly
or
the
facility
gets.
A
Paid
well
I
think
if,
if
I
understand
what
he
was
asking
we're
not
going,
the
insurance
company
is
not
going
to
pay
an
out
out
of
network
price
higher
because
they're
out
of
network
they're
going
to
pay
an
in-network
price
and
then,
if
it's
40
higher
than
that,
insurance
company
is
going
to
pay
that
less
the
40
percent.
Yes.
So
so
it's
going
to
be
a
what
we
call
a
surprise
billing,
because
it's
going
to
be
out
of
the
network
and.
A
So
that
is
it,
we
have
a
most
are
getting
more
questions
all
right.
We
have
a
motion
first
and
second,
do
I
yeah,
yeah,
Madam
Secretary.
Please
call
the
roll.
F
I
vote
I,
but
I'd
like
to
explain
my
vote.
Mr
chair
go
ahead,
I
vote
I
because,
because
I
think
patients
already
have
the
access,
but
I
will
be
keeping
an
eye
on
this
to
ensure
that
the
carriers
are
not
getting
a
raw
deal
by
being
assigned
and
having
to
pay
a
lot
more
simply
because
the
patient
decides
to
go
to
some
place,
that's
out
of
network.
That's
that's
important
to
me.
I
want
to
be
fair
across
the
board
and
make
sure
that
what
we're
talking
about
today
is
exactly
what's
occurring.
Thank
you.
A
A
I
It
primarily
deals
with
cancer
fertility
preservation,
as
many
of
you
all
may
know,
chemotherapy
and
radiation
can
have
a
negative
impact
on
one's
fertility.
What
you
may
not
know
is
that
currently
Health
Plans
health
coverage
does
not
cover
fertility
preservation
services
for
those
patients.
This
bill
aims
to
remedy
that
situation.
Motion.
A
Promotion
she's
got
a
second
Center
's
buddy
storm.
A
C
C
A
I've
got
to
be
real
nice
to
this
next
guy
he's
a
house
Banking
and
insurance
brother
Meredith.
Would
you
come
forward
with
your
guest,
House
Bill
429.
J
J
So
the
bill
that
you
have
before
you
right
now
is
a
bill
that
deals
with
bank
legal
lending
limits
and
I.
Don't
know
how
familiar
you
all
are
with
that
issue,
but
there
are
multiple
ways
to
calculate
that
legal
lending
limit.
There
is
a
federal
standard
in
federal
statute.
There
is
a
state
standard
and
our
statutes.
J
The
state
standard
is
for
any
state
Chartered
Bank.
The
federal
standard
is
for
National
Banks.
J
So
you
have
an
unsecured
and
a
secured
limit
under
the
state
legal
lending
limit
statute,
the
unsecured
limit.
You
could
technically
lend
completely
unsecured
all
the
way
up
to
that
limit.
But
then,
after
you
go
over
that
you
have
to
secure
in
practicality,
no
bank
is
doing
that
in
Kentucky,
that
I
know
of
and
I
don't
think
it
would
be
prudent
for
any
bank
to
do
that.
They're
securing
the
bulk
of
the
debt
that
they
have
even
at
the
unsecured
limit.
J
What
this
does
is
it
provides
the
flexibility
for
banks
that,
if
they
are
secured
on
that,
and
they
go
over
with
some
small
amount
of
unsecured
debt
relative
to
the
total
legal
legal
ending
limits,
you
have
to
secure
everything
over
the
the
current
unsecured
limit,
and
so
what
happens
in
practicality?
Again,
you
have
a
20
million
dollar
secured
limit.
You
have
a
16
million
or
14
million
dollar
unsecured
limit.
J
If
that
person,
that
was
over
the
14
million
dollar
amount,
who
are
right
at
the
14
million
dollar
amount,
is
fine,
completely
unsecured.
But
then
there's
this
donut
hole
that
kind
of
exists
between
the
two
limits,
and
you
can't
even
offer
to
pay
an
overdraft
to
give
a
small,
unsecured
revolving
line
of
credit,
to
give
a
credit
card
to
somebody
who's,
one
of
your
best
customers.
If
they
get
above
that
unsecured
limit,
because
they
can't
have
anything
unsecured
once
they
go
over
that
limit
nothing,
nothing
whatsoever,
and
this
fixes
that
issue.
A
A
G
A
This
faster's
favorite
passes
favorably
and
with
Dean
bad
luck
didn't
motion
from
John
chicken.
Second
from
Rocky
Adams,
all
in
favor,
say
aye
any
opposed.
You
know
my
hero
is
John
sickle.
You
all
know
that
right
and
the
reason
he's
my
hero.
He
knows
how
to
play
this
game
with
people
like
you.
So
that's
the
reason
he's
my
hero.
A
K
But
thank
you
Mr
chair
and
thank
you.
Members,
House
Bill
433
establishes
dates
for
Renewal
and
reinstatement
of
deferred
deposit
businesses
and
check
cashing
licenses.
The
department
of
financial
institutions
under
the
public
protection
cabinet
supports
this
bill,
as
it
makes
the
needed
changes
to
get
Kentucky
law
in
line
with
the
national.
The
Nationwide
multi-state
licensing
system,
which
is
the
system
of
record
for
non-depository
Financial,
Services
licensing
or
registration
in
participating,
States
making.
A
All
right
make
a
motion
to
consent.
All
right
got
a
motion.
78
consent
got
a
second
by
Senator
storm,
I'll
ever
say.