(a) Before each
collective negotiation under this chapter, an authorized third party must
submit to the attorney general a written request containing the information
required by this section, along with the fee required by
9
AAC 23.030. The authorized third party must submit one
original and one copy of each request to the Anchorage office of the attorney
general.
(b) In a negotiation
request, the authorized third party must include the following information, and
must group and label the information by paragraph:
(1) information about the authorized third
party, including the name, title, business address, and telephone number of the
authorized third party and a description of
(A) the authorized third party's occupation,
professional training, credentials and licenses, and experience in the health
care field;
(B) the contracts for
services to be performed by the authorized third party in connection with AS
23.50 and this chapter, including any compensation arrangements;
(C) the legal and business relationships
between the authorized third party and the participating physicians, including
any other contracting services provided by the authorized third party for any
participating physician;
(D) the
authorized third party's pecuniary interest, if any, in the contracts to be
negotiated under AS 23.50 and this chapter; and
(E) any other physician groups the authorized
third party has represented, is representing, or currently plans to
represent;
(2)
information about the negotiation group as follows:
(A) a complete list of the physicians
represented, including the physical address of each physician's primary place
of business;
(B) a description of
each participating physician's specialties, primary practice areas, clinic
affiliations, and active hospital staff privileges;
(C) a description of each independent
practice association (IPA) to which each participating physician belongs,
including the group's name, business address, type of legal organization, and
approximate number of physician members;
(D) for each health benefit plan for which
collective negotiations are proposed, a statement about whether any
participating physician has contracted to be a provider for that health benefit
plan through any IPA, and, if so, a statement that indicates which IPA is a
party to that contract;
(E) a
description of the type of legal organization, if any, of the negotiation
group;
(F) for each health benefit
plan for which collective negotiations are proposed, a representative copy of
the most recent contract with the health benefit plan;
(G) a description of the geographic service
area in which the negotiation group provides services, including a percentage
estimate of the market share held by the negotiation group;
(H) a description of the different
specialties in the geographic service area identified in (G) of this paragraph,
and a listing of physicians who compete with the participating physicians in
the geographic service area; if the participating physicians have multiple
specialties, this information must be provided separately for each
specialty;
(3) the name
of each health benefit plan that the authorized third party will contact,
including the name and phone number of the contact person of the health benefit
plan;
(4) a plan of operation for
the authorized third party; the plan of operation must include a procedure to
manage communications between the authorized third party and the health benefit
plans, between the authorized third party and the participating physicians, and
among the participating physicians; the procedure must limit communications to
matters, terms, and conditions that are not fee-related;
(5) a procedure to ensure that the health
benefit plans remain free to contract with, or offer different contract terms
and conditions to, individual competing physicians;
(6) a summary of the procedures that the
authorized third party will use to ensure compliance with
AS
23.50.020;
(7) a brief report that identifies the
proposed subject matter of the collective negotiations with a health benefit
plan; the report must include
(A) the specific
contract terms and conditions to be negotiated;
(B) the proposed time line of the
negotiations;
(C) the expected
impact of the negotiations on the quality of patient care;
(D) the expected impact of the negotiations
on competition;
(E) the expected
impact of the negotiations on consumers;
(F) the benefits of a contract between the
identified health benefit plan and physicians; and
(G) an explanation of the efficiencies or
benefits expected to be achieved by the negotiations;
(8) a copy of each communication proposed to
be sent to the health benefit plan.
(c) The authorized third party must sign each
negotiation request submitted under this section. Copies of relevant supporting
documents must be included. If the request contains data from a source other
than the authorized third party or participating physicians, the source of the
data must be identified, if any of the information required by (b) of this
section is unavailable, the request must include an explanation of the efforts
made to obtain the information, and must identify the sources from which the
information was sought. If the participating physicians are contractually
prohibited from disclosing requested information, the request must identify the
information or documents subject to nondisclosure terms and the contract terms
that prohibit disclosure.
(d) The
attorney general will determine whether a negotiation request is complete. A
negotiation request will not be considered filed until the attorney general
receives a completed application and application fee in accordance with this
section and
9
AAC 23.030. The attorney general will return an
incomplete or unorganized application to the authorized third party and
identify any deficiencies.
(e) An
authorized third party may withdraw an application at any time by submitting a
written notice of withdrawal to the attorney general.
The address for submitting negotiation requests required by
9
AAC 23.020 is State of Alaska, Department of Law,
Office of to Attorney General, Attention: Physician Negotiation Request, 1031
W. 4th Avenue, Suite 200, Anchorage, Alaska
99501.