Legislature(2017 - 2018)BELTZ 105 (TSBldg)

03/28/2017 01:30 PM LABOR & COMMERCE

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Audio Topic
01:29:47 PM Start
01:30:23 PM Confirmation Hearings
02:06:24 PM HB48
02:11:30 PM SB93
02:36:36 PM SB38
03:29:49 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Governor's Appointees to State Boards & TELECONFERENCED
Commissions
Board of Professional Counselors
Board of Certified Direct-Entry Midwives
Real Estate Commission
-- Public Testimony on Appointees --
+= HB 48 ARCHITECTS,ENGINEERS,SURVEYORS: EXTEND BD TELECONFERENCED
Moved HB 48 Out of Committee
-- Public Testimony --
*+ SB 38 PHARMACY BENEFITS MANAGERS TELECONFERENCED
Heard & Held
-- Public Testimony --
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= SB 93 CREDIT REPORT SECURITY FREEZE TELECONFERENCED
Heard & Held
Bill Postponed from 9:00 a.m. 3/28/17
-- Public Testimony --
+= SB 51 EXTEND BOARD OF VETERINARY EXAMINERS TELECONFERENCED
Scheduled but Not Heard
Bill Postponed from 9:00 a.m. 3/28/17
-- Public Testimony --
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                         March 28, 2017                                                                                         
                           1:29 p.m.                                                                                            
                                                                                                                                
                                                                                                                              
                                                                                                                                
MEMBERS PRESENT                                                                                                               
                                                                                                                                
Senator Mia Costello, Chair                                                                                                     
Senator Shelley Hughes, Vice Chair                                                                                              
Senator Kevin Meyer                                                                                                             
Senator Gary Stevens                                                                                                            
Senator Berta Gardner                                                                                                           
                                                                                                                                
MEMBERS ABSENT                                                                                                                
                                                                                                                                
All members present                                                                                                             
                                                                                                                                
COMMITTEE CALENDAR                                                                                                            
                                                                                                                                
CONFIRMATION HEARINGS                                                                                                           
                                                                                                                                
Real Estate Commission                                                                                                        
     David Pruhs - Fairbanks                                                                                                    
     Guy Mickel - Ketchikan                                                                                                     
                                                                                                                                
          CONFIRMATIONS HELD                                                                                                    
                                                                                                                                
Board of Certified Direct-Entry Midwives                                                                                      
     Dr. Kathryn Ostrom - Homer                                                                                                 
     Dana Brown - Fairbanks                                                                                                     
     Kathryn Roberts - Anchorage                                                                                                
                                                                                                                                
          CONFIRMATIONS HELD                                                                                                    
                                                                                                                                
Board of Professional Counselors                                                                                              
     Anne Brainerd-Marko - Fairbanks                                                                                            
                                                                                                                                
          CONFIRMATIONS HELD                                                                                                    
                                                                                                                                
HOUSE BILL NO. 48                                                                                                               
"An  Act  relating to  the  composition  of  the State  Board  of                                                               
Registration  for  Architects,  Engineers,  and  Land  Surveyors;                                                               
extending   the  termination   date   of  the   State  Board   of                                                               
Registration for  Architects, Engineers, and Land  Surveyors; and                                                               
providing for an effective date."                                                                                               
                                                                                                                                
     - MOVED  HB 48 OUT OF COMMITTEE                                                                                            
                                                                                                                                
SENATE BILL NO. 93                                                                                                              
"An Act  relating to  security freezes on  the credit  reports or                                                               
records of incapacitated persons and certain minors."                                                                           
                                                                                                                                
     - HEARD AND HELD                                                                                                           
                                                                                                                                
SENATE BILL NO. 38                                                                                                              
"An  Act relating  to  the registration  and  duties of  pharmacy                                                               
benefits  managers;  relating   to  procedures,  guidelines,  and                                                               
enforcement mechanisms for pharmacy  audits; relating to the cost                                                               
of  multi-source   generic  drugs  and   insurance  reimbursement                                                               
procedures;  relating  to  the  duties of  the  director  of  the                                                               
division of insurance; and providing for an effective date."                                                                    
                                                                                                                                
     - HEARD & HELD                                                                                                             
                                                                                                                                
SENATE BILL NO. 51                                                                                                              
"An  Act  extending   the  termination  date  of   the  Board  of                                                               
Veterinary Examiners; and providing for an effective date."                                                                     
                                                                                                                                
     - SCHEDULED BUT NOT HEARD                                                                                                  
                                                                                                                                
PREVIOUS COMMITTEE ACTION                                                                                                     
                                                                                                                                
BILL: HB  48                                                                                                                  
SHORT TITLE: ARCHITECTS, ENGINEERS, SURVEYORS: EXTEND BD                                                                        
SPONSOR(s): REPRESENTATIVE(s) KITO                                                                                              
                                                                                                                                
01/18/17       (H)       READ THE FIRST TIME - REFERRALS                                                                        
01/18/17       (H)       L&C, FIN                                                                                               
02/08/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/08/17       (H)       Heard & Held                                                                                           
02/08/17       (H)       MINUTE(L&C)                                                                                            
02/10/17       (H)       L&C AT 3:15 PM BARNES 124                                                                              
02/10/17       (H)       Moved  HB 48 Out of Committee                                                                          
02/10/17       (H)       MINUTE(L&C)                                                                                            
02/13/17       (H)       L&C RPT 6DP                                                                                            
02/13/17       (H)       DP: SULLIVAN-LEONARD, JOSEPHSON, BIRCH,                                                                
                         KNOPP, STUTES, KITO                                                                                    
02/22/17       (H)       FIN AT 1:30 PM HOUSE FINANCE 519                                                                       
02/22/17       (H)       Moved  HB 48 Out of Committee                                                                          
02/22/17       (H)       MINUTE(FIN)                                                                                            
02/24/17       (H)       FIN RPT 9DP                                                                                            
02/24/17       (H)       DP: GARA, WILSON, KAWASAKI, PRUITT,                                                                    
                         ORTIZ, THOMPSON, GUTTENBERG, TILTON,                                                                   
02/24/17       (H)       SEATON                                                                                                 
03/06/17       (H)       TRANSMITTED TO (S)                                                                                     
03/06/17       (H)       VERSION: HB 48                                                                                         
03/08/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/08/17       (S)       L&C, FIN                                                                                               
03/21/17       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
03/21/17       (S)       Heard & Held                                                                                           
03/21/17       (S)       MINUTE(L&C)                                                                                            
03/28/17       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
BILL: SB  93                                                                                                                  
SHORT TITLE: CREDIT REPORT SECURITY FREEZE                                                                                      
SPONSOR(s): SENATOR(s) COGHILL                                                                                                  
                                                                                                                                
03/13/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
03/13/17       (S)       L&C                                                                                                    
03/28/17       (S)       L&C AT 9:00 AM BELTZ 105 (TSBldg)                                                                      
03/28/17       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
BILL: SB  38                                                                                                                  
SHORT TITLE: PHARMACY BENEFITS MANAGERS                                                                                         
SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST                                                                                       
                                                                                                                                
01/25/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
01/25/17       (S)       L&C, FIN                                                                                               
03/28/17       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
                                                                                                                                
                                                                                                                                
WITNESS REGISTER                                                                                                              
                                                                                                                                
DAVID PRUHS, Appointee                                                                                                          
Real Estate Commission                                                                                                          
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT: Testified as nominee to the Real Estate                                                                   
Commission.                                                                                                                     
                                                                                                                                
GUY MICKEL, Appointee                                                                                                           
Real Estate Commission                                                                                                          
Ketchikan, Alaska                                                                                                               
POSITION STATEMENT: Testified as nominee to the Real Estate                                                                   
Commission.                                                                                                                     
                                                                                                                                
DR. KATHRYN OSTROM, Appointee                                                                                                   
Board of Certified Direct-Entry Midwives                                                                                        
Homer, Alaska                                                                                                                   
POSITION STATEMENT: Testified as nominee to the Board of                                                                      
Certified Direct-Entry Midwives.                                                                                                
                                                                                                                                
DANA BROWN, Appointee                                                                                                           
Board of Certified Direct-Entry Midwives                                                                                        
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT: Testified as nominee to the Board of                                                                      
Certified Direct-Entry Midwives.                                                                                                
                                                                                                                                
KATHRYN ROBERTS, Appointee                                                                                                      
Board of Certified Direct-Entry Midwives                                                                                        
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified as nominee to the Board of                                                                      
Certified Direct-Entry Midwives.                                                                                                
                                                                                                                                
ANNE BRAINERD-MARKO, Appointee                                                                                                  
Board of Professional Counselors                                                                                                
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT: Testified as nominee to the Board of                                                                      
Professional Counselors.                                                                                                        
                                                                                                                                
REPRESENTATIVE SAM KITO                                                                                                         
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of HB 48.                                                                                         
                                                                                                                                
SENATOR CATHY GIESSEL                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 38.                                                                                         
                                                                                                                                
RYNNIEVA MOSS, Staff                                                                                                            
Senator John Coghill                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Introduced SB 93 on behalf of the sponsor.                                                                
                                                                                                                                
ERIC ELLMAN                                                                                                                     
Consumer Data Industry Association (CDIA)                                                                                       
Washington, D.C.                                                                                                                
POSITION STATEMENT: Offered supporting testimony for SB 93.                                                                   
                                                                                                                                
CARLIE CHRISTENSEN, Director of Government Relations                                                                            
Equifax                                                                                                                         
Atlanta, Georgia                                                                                                                
POSITION STATEMENT: Testified in support of SB 93.                                                                            
                                                                                                                                
JANE CONWAY, Staff                                                                                                              
Senator Cathy Giessel                                                                                                           
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions and provided information                                                               
related to SB 38.                                                                                                               
                                                                                                                                
LORI WING-HEIER, Director                                                                                                       
Division of Insurance                                                                                                           
Department of Commerce, Community and Economic Development                                                                      
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified that she does not expect passage                                                                
of SB 38 to be a burden on the Division of Insurance.                                                                           
                                                                                                                                
EMILY RICCI, Chief Health Policy Administrator                                                                                  
Division of Retirement and Benefits                                                                                             
Department of Administration (DOA)                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions related to SB 38.                                                                      
                                                                                                                                
MICHELE MICHAUD, Chief Health Official                                                                                          
Division of Retirement and Benefits                                                                                             
Department of Administration (DOA)                                                                                              
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Answered questions related to SB 38.                                                                      
                                                                                                                                
LEIF HOLM, Pharmacy Owner                                                                                                       
North Pole, Alaska                                                                                                              
POSITION STATEMENT: Testified in support of SB 38.                                                                            
                                                                                                                                
MATTHEW KEITH, Vice President of Pharmacy Services                                                                              
Geneva Woods Pharmacy, Inc.                                                                                                     
Anchorage, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 38.                                                                            
                                                                                                                                
SCOTT WATTS, Pharmacist and Independent Pharmacy Owner                                                                          
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified in support of                                                                                   
SB 38.                                                                                                                          
                                                                                                                                
GERALD BROWN, Pharmacist and Independent Pharmacy Owner                                                                         
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 38.                                                                            
                                                                                                                                
ERIC DOUGLAS, CVS Health                                                                                                        
Illinois                                                                                                                        
POSITION STATEMENT: Expressed concern with SB 38.                                                                             
                                                                                                                                
TOM WADSWORTH, Associate Clinical Professor                                                                                     
Anchorage, Alaska                                                                                                             
POSITION STATEMENT: Testified in support of SB 38.                                                                            
                                                                                                                                
BARRY CHRISTENSEN, RPh                                                                                                          
Co-Chair Legislative Committee                                                                                                  
Alaska Pharmacists Association                                                                                                  
Ketchikan, Alaska                                                                                                               
POSITION  STATEMENT:  Stated  that  the   passage  of  SB  38  is                                                             
important for Alaska pharmacies to remain viable.                                                                               
                                                                                                                                
FRED BROWN                                                                                                                      
Health Care Cost Management Corporation of Alaska                                                                               
Fairbanks, Alaska                                                                                                               
POSITION STATEMENT: Testified in support of SB 38.                                                                            
                                                                                                                                
                                                                                                                                
ACTION NARRATIVE                                                                                                              
                                                                                                                                
1:29:47 PM                                                                                                                    
CHAIR MIA COSTELLO called the  Senate Labor and Commerce Standing                                                             
Committee meeting to  order at 1:29 p.m.  Present  at the call to                                                               
order  were Senator  Gardner and  Chair Costello.  Senator Hughes                                                               
arrived soon  thereafter, and Senators  Stevens and  Meyer joined                                                               
the committee during the course of the meeting.                                                                                 
                                                                                                                                
^Confirmation Hearings                                                                                                          
                     CONFIRMATION HEARINGS                                                                                  
                                                                                                                                
                     Real Estate Commission                                                                                 
            Board of Certified Direct-Entry Midwives                                                                        
                Board of Professional Counselors                                                                            
                                                                                                                                
                                                                                                                                
1:30:23 PM                                                                                                                    
CHAIR COSTELLO  announced the  first order  of business  would be                                                               
confirmation  hearings  of  governor  appointees  to  boards  and                                                               
commissions. She thanked the nominees for their service.                                                                        
                                                                                                                                
She asked  David Pruhs  of Fairbanks to  express his  interest in                                                               
serving on the Real Estate Commission in a broker seat.                                                                         
                                                                                                                                
1:32:09 PM                                                                                                                    
DAVID  PRUHS,  Appointee,   Real  Estate  Commission,  Fairbanks,                                                               
Alaska, said  he was born and  raised in Fairbanks and  has had a                                                               
career in real estate since 1982.  He started as a commercial and                                                               
residential  real  estate  appraiser   and  received  his  broker                                                               
license  in  2001.   He  also  has  a  license   in  real  estate                                                               
instruction. He  advised that  he served  on the  Fairbanks North                                                               
Star  Borough Planning  Commission from  2007-2014, the  Board of                                                               
Equalization  for  the Fairbanks  North  Star  Borough for  seven                                                               
years, and is a current member of the Fairbanks City Council.                                                                   
                                                                                                                                
1:32:50 PM                                                                                                                    
SENATOR MEYER and SENATOR STEVENS joined the committee.                                                                         
                                                                                                                                
CHAIR COSTELLO  asked him to  comment on  the fact that  the Real                                                               
Estate Commission has failed to  meet its statutory obligation to                                                               
adopt  an  errors  and  omissions   (E&O)  insurance  policy  for                                                               
licensees. She noted that this  requirement was placed in statute                                                               
about 10 years ago when the  legislature did away with the surety                                                               
fund.                                                                                                                           
                                                                                                                                
MR. PRUHS said he has had an  E&O policy since he started in real                                                               
estate. He  maintained that  brokers should  be required  to list                                                               
their E&O policy  on their license renewals and  then Real Estate                                                               
Commission staff can use that  information to do spot audits just                                                               
as they do now to spot  check that a licensee has fulfilled their                                                               
educational requirements.                                                                                                       
                                                                                                                                
SENATOR  GARDNER  asked  what  can  be done  to  help  part  time                                                               
licensees who can't afford the cost  of the E&O policies that are                                                               
required.                                                                                                                       
                                                                                                                                
MR. PRUHS clarified that it is  the broker who must carry the E&O                                                               
policy. The  licensees working under  that broker are  covered by                                                               
that policy.                                                                                                                    
                                                                                                                                
SENATOR GARDNER asked if every licensee works under a broker.                                                                   
                                                                                                                                
MR. PRUHS said yes.                                                                                                             
                                                                                                                                
1:36:54 PM                                                                                                                    
SENATOR HUGHES joined the committee.                                                                                            
                                                                                                                                
CHAIR  COSTELLO found  no further  questions or  public testimony                                                               
and thanked Mr. Pruhs for being willing to serve.                                                                               
                                                                                                                                
CHAIR  COSTELLO asked  Guy  Mickel of  Ketchikan  to express  his                                                               
interest in  serving on  the Real Estate  Commission in  a broker                                                               
seat.                                                                                                                           
                                                                                                                                
1:37:57 PM                                                                                                                    
GUY  MICKEL, Appointee,  Real  Estate Commission,  said  he is  a                                                               
lifetime Ketchikan  resident and  has had  a real  estate license                                                               
since 1987. He  noted that a current commission  member asked him                                                               
to put  his name  forward and  he did  so in  the belief  that he                                                               
could be of service to the state.                                                                                               
                                                                                                                                
CHAIR  COSTELLO  found  no  questions  or  public  testimony  and                                                               
thanked Mr. Mickel for being willing to serve.                                                                                  
                                                                                                                                
1:38:48 PM                                                                                                                    
CHAIR  COSTELLO asked  Kathryn  Ostrom of  Homer  to express  her                                                               
interest  in  serving  on the  Board  of  Certified  Direct-Entry                                                               
Midwives in  the physician/OB practice  seat. She also  asked her                                                               
to address any challenges the board will be addressing.                                                                         
                                                                                                                                
1:39:39 PM                                                                                                                    
DR. KATHRYN  OSTROM, Appointee,  Board of  Certified Direct-Entry                                                               
Midwives, Homer,  Alaska, said she  has been an OB/GYN  in Alaska                                                               
since 2006.  Initially she worked  for the Alaska  Native Medical                                                               
Center  for three  years followed  by  seven years  in a  private                                                               
practice. For  the last year  she has  been the OB/GYN  in Homer.                                                               
Some  of  the  current  issues include  building  the  number  of                                                               
direct-entry midwives  in the state.  While she was  in Anchorage                                                               
she helped  start a  program to  have an OB/GYN  on staff  at all                                                               
times. That provided a good way  to work with the lay midwives in                                                               
the community. When  she moved to Homer, she knew  she would work                                                               
with certified nurse  midwives in her fulltime job,  but she also                                                               
knew that  she could be  a direct referral source  and consultant                                                               
for the community of direct-entry  midwives. That was the impetus                                                               
to apply to serve on this board, she said.                                                                                      
                                                                                                                                
She advised that one of the  issues the board will address is the                                                               
very  high  professional license  fees.  She  explained that  one                                                               
reason  the  licensing  fees  went   up  is  that  the  board  is                                                               
responsible for  investigating the cases where  somebody comes to                                                               
the  state and  is  not  licensed but  nevertheless  does a  home                                                               
delivery. Last  year 13 people  did not renew their  licenses and                                                               
she  predicted  that the  repercussions  of  high licensing  fees                                                               
would be more dramatic in the coming year.                                                                                      
                                                                                                                                
CHAIR  COSTELLO asked  the size  of the  deficit and  the current                                                               
cost of a license.                                                                                                              
                                                                                                                                
DR. OSTROM  replied the licensing  fee is about $3,800  every two                                                               
years and the deficit is about $60,000.                                                                                         
                                                                                                                                
SENATOR HUGHES asked what the board  plans to do to eliminate the                                                               
deficit.                                                                                                                        
                                                                                                                                
DR.  OSTROM  said the  board  hopes  to  increase the  number  of                                                               
licensees  by keeping  the apprentices  currently working  in the                                                               
state after  they graduate their  program. They are  also working                                                               
to  cut the  cost  of meeting  by  using teleconferencing,  which                                                               
should save about $5,000 a year.                                                                                                
                                                                                                                                
SENATOR  HUGHES  asked  if  the   board  is  having  to  pay  for                                                               
investigations related to individuals  who are practicing but are                                                               
not licensed in the state.                                                                                                      
                                                                                                                                
DR. OSTROM  said that is  correct; the cost to  investigate cases                                                               
of a provider who practices without  a license falls to the Board                                                               
of Direct-Entry Midwives.                                                                                                       
                                                                                                                                
SENATOR  GARDNER   noted  that   Dr.  Ostrom  indicated   on  her                                                               
application  that  she was  not  willing  to disclosure  personal                                                               
financial data. She asked if this board requires that.                                                                          
                                                                                                                                
DR. OSTROM said she didn't  know and didn't recall answering "no"                                                               
to that question.                                                                                                               
                                                                                                                                
SENATOR  GARDNER   noted  that   Dr.  Ostrom  indicated   on  her                                                               
application  that  she  or  her  family  could  potentially  gain                                                               
financially by serving  on the board but declined  to explain the                                                               
potential financial  benefit. She asked  if this was a  matter of                                                               
mixed signals.                                                                                                                  
                                                                                                                                
DR. OSTROM answered yes and added  that she did have trouble with                                                               
the online  application and is  surprised at the  answers because                                                               
neither  she  nor  her  family  would  have  a  direct  financial                                                               
benefit.                                                                                                                        
                                                                                                                                
CHAIR   COSTELLO  suggested   Dr.  Ostrom   submit  a   corrected                                                               
application. Finding  no further  questions or  public testimony,                                                               
she thanked Dr. Ostrom for being willing to serve.                                                                              
                                                                                                                                
1:47:31 PM                                                                                                                    
CHAIR  COSTELLO asked  Dana  Brown of  Fairbanks  to express  her                                                               
interest  in  serving  on the  Board  of  Certified  Direct-Entry                                                               
Midwives  in the  certified direct-entry  midwife seat.  She also                                                               
asked  her  to comment  on  the  licensing  fees and  efforts  to                                                               
address the deficit.                                                                                                            
                                                                                                                                
DANA BROWN, Appointee, Board  of Certified Direct-Entry Midwives,                                                               
Fairbanks, Alaska, said  she was licensed in 1993 as  part of the                                                               
first group  of midwives to be  licensed in Alaska. She  said she                                                               
helped  Alaska develop  its licensing  program  for midwives  and                                                               
served on the  board from 2000 to  2009. Unlicensed practitioners                                                               
were an  issue at  that time,  so the board  has been  paying for                                                               
investigations since  its inception.  She opined that  a previous                                                               
licensing  examiner  contributed to  the  size  of the  debt  and                                                               
stated support  for the  current one.  She described  the current                                                               
board as strong and said it  is looking at ways to streamline the                                                               
application process and conducting meetings via teleconference.                                                                 
                                                                                                                                
CHAIR  COSTELLO  commented  on the  importance  of  institutional                                                               
memory on boards and commissions.                                                                                               
                                                                                                                                
SENATOR HUGHES  asked if she had  any ideas about how  to get the                                                               
people  who   are  investigated   to  pay   the  cost   of  their                                                               
investigation.                                                                                                                  
                                                                                                                                
MS. BROWN  said she  believes that HB  90 will  help direct-entry                                                               
midwives if it passes. She  highlighted that midwives are willing                                                               
to pay  the high fees  in the interest  of paying down  the debt.                                                               
She also commented  on fluctuating licensing fees  and past legal                                                               
advice that  licensing fees could  not be held  high artificially                                                               
because that would amount to "paying ahead."                                                                                    
                                                                                                                                
CHAIR COSTELLO said  the legislature is aware  of fluctuations in                                                               
licensing   fees.  Finding   no  further   questions  or   public                                                               
testimony, she thanked Ms. Brown for being willing to serve.                                                                    
                                                                                                                                
1:58:53 PM                                                                                                                    
CHAIR COSTELLO asked Kathryn Roberts  of Anchorage to express her                                                               
interest  in  serving  on the  Board  of  Certified  Direct-Entry                                                               
Midwives in the certified nurse midwife seat.                                                                                   
                                                                                                                                
KATHRYN  ROBERTS,  Appointee,  Board  of  Certified  Direct-Entry                                                               
Midwives,  Anchorage, Alaska,  said she  has been  practicing for                                                               
about  three years  and  started  working alongside  direct-entry                                                               
midwives on  out-of-hospital births.  She said  she now  works at                                                               
the Alaska  Native Medical  Center. She has  served on  the board                                                               
for a  little over a  year and  is interested in  continuing this                                                               
important and interesting work helping  the women and families in                                                               
this state.                                                                                                                     
                                                                                                                                
CHAIR  COSTELLO  commented  on  Ms.  Roberts  qualifications  and                                                               
tremendous  experience. Finding  no further  questions or  public                                                               
testimony, she thanked Ms. Roberts  for being willing to continue                                                               
to serve.                                                                                                                       
                                                                                                                                
CHAIR COSTELLO asked Anne Brainerd-Marko  of Fairbanks to express                                                               
her interest in  serving on the Board  of Professional Counselors                                                               
and to comment on any challenges the board faces going forward.                                                                 
                                                                                                                                
2:02:15 PM                                                                                                                    
ANNE   BRAINERD-MARKO,    Appointee,   Board    of   Professional                                                               
Counselors,  Fairbanks,  Alaska, said  she  has  been a  licensed                                                               
professional  counselor in  Alaska for  14 years  and is  also an                                                               
approved counselor supervisor. She related  that this will be her                                                               
second term and  she was compelled to apply  initially because of                                                               
her broad  experience and  interest in  mental health  in Alaska.                                                               
She  worked in  the village  of Galena  for five  years and  then                                                               
moved to  Fairbanks and  ran a  residential treatment  center for                                                               
women  with  addictions  for  a  year. She  now  works  for  Hope                                                               
Community Resources. She opined that  her experience has been and                                                               
will continue to be helpful to the board.                                                                                       
                                                                                                                                
SENATOR  GARDNER commented  that Ms.  Brainerd-Marko's resume  is                                                               
exhaustively long and has widely varied.                                                                                        
                                                                                                                                
CHAIR  COSTELLO  asked  Ms.  Brainerd-Marko  to  comment  on  the                                                               
board's $264,000  surplus and if  licensing fees will  be reduced                                                               
in the future.                                                                                                                  
                                                                                                                                
MS. BRAINERD-MARKO  explained that  the board increased  the fees                                                               
significantly  when an  earlier audit  found a  $125,000 deficit.                                                               
She estimated that the board would  be at or a bit over breakeven                                                               
by the end of FY17.                                                                                                             
                                                                                                                                
CHAIR  COSTELLO found  no further  questions or  public testimony                                                               
and thanked Ms.  Brainerd-Marko for being willing  to continue to                                                               
serve.                                                                                                                          
                                                                                                                                
2:06:12 PM                                                                                                                    
CHAIR COSTELLO stated that the  committee's review of nominations                                                               
for boards and commissions is complete for today.                                                                               
                                                                                                                                
        HB  48-ARCHITECTS,ENGINEERS,SURVEYORS: EXTEND BD                                                                    
                                                                                                                                
2:06:24 PM                                                                                                                    
CHAIR COSTELLO  announced the consideration  of HB 48.  She noted                                                               
that this is the second hearing and public testimony is closed.                                                                 
                                                                                                                                
REPRESENTATIVE SAM KITO, Alaska  State Legislature, sponsor of HB                                                               
48 summarized the bill extends  the termination date of the State                                                               
Board  of  Registration  for   Architects,  Engineers,  and  Land                                                               
Surveyors the  full eight  years to 2025.  The bill  also changes                                                               
the status of  the current landscape architect  board member from                                                               
nonvoting  to  voting. There  is  no  cost associated  with  this                                                               
change because the board is  self-sustaining with all costs borne                                                               
by  the  licensees.  There  are   currently  about  50  landscape                                                               
architects  who  are  licensed  and the  same  number  of  mining                                                               
engineers. He  noted that the  size of  the board will  change in                                                               
statute from 10 to 11 in recognition of the new voting member.                                                                  
                                                                                                                                
CHAIR COSTELLO found no questions and solicited a motion.                                                                       
                                                                                                                                
2:08:21 PM                                                                                                                    
SENATOR  HUGHES  moved  to  report  HB  48  from  committee  with                                                               
individual recommendations and attached fiscal note(s).                                                                         
                                                                                                                                
CHAIR  COSTELLO  announced  that  without  objection,  HB  48  is                                                               
reported from the Senate Labor and Commerce Standing Committee.                                                                 
                                                                                                                                
2:08:37 PM                                                                                                                    
At ease                                                                                                                         
                                                                                                                                
              SB  93-CREDIT REPORT SECURITY FREEZE                                                                          
                                                                                                                                
2:11:30 PM                                                                                                                    
CHAIR  COSTELLO   reconvened  the   meeting  and   announced  the                                                               
consideration of  SB 93. She  stated that  intent is to  hear the                                                               
introduction, take  questions and public testimony,  and hold the                                                               
bill for further consideration.                                                                                                 
                                                                                                                                
2:11:48 PM                                                                                                                    
RYNNIEVA  MOSS,   Staff,  Senator  John  Coghill,   Alaska  State                                                               
Legislature,  explained that  SB 93  supplements Senate  Bill 121                                                               
that passed  last year. It  establishes a process for  setting up                                                               
security  freezes  for minors  who  are  [16]  years of  age  and                                                               
younger  that  mirrors the  process  that  26 other  states  have                                                               
adopted.                                                                                                                        
                                                                                                                                
She presented SB 93 speaking to the following PowerPoint:                                                                       
                                                                                                                                
     Sec. 1                                                                                                                   
     Who is a protected consumer?                                                                                               
                                                                                                                                
     A person  who is  an incapacitated  person or  under 16                                                                    
     years of age.                                                                                                              
                                                                                                                                
     Definition of incapacitated person                                                                                         
                                                                                                                                
          An incapacitated person is  a person whose ability                                                                    
          to   receive  and   evaluate  information   or  to                                                                    
          communicate  decisions is  impaired to  the extent                                                                    
          that the  person lacks the  ability to  provide or                                                                    
          arrange  for the  essential  requirements for  the                                                                    
          person's physical health or safety without court-                                                                     
          ordered assistance.                                                                                                   
                                                                                                                                
     Why Sixteen?                                                                                                             
                                                                                                                                
     Consumers at  16 years of age  typically begin working,                                                                    
     own  a  cell  phone,  have a  bank  account,  and  have                                                                    
     established  active   credit.  26  other   states  have                                                                    
     reduced the age from 18 to 16.                                                                                             
                                                                                                                                
     A credit freeze for a minor  and a credit freeze for an                                                                  
     adult, while similar in name,  in practice they operate                                                                  
     in very different ways.                                                                                                  
                                                                                                                                
        A  credit  freeze   for  an   adult  is   placed  to                                                                    
        temporarily turn  off  the  availability of  already                                                                    
        established credit for that  individual. The request                                                                    
        for a freeze could be due to a recent identity theft                                                                    
        or for other purposes.  Because a credit  report was                                                                    
        previously created by a lending agency and therefore                                                                    
        currently exists for an  adult, one can turn  on and                                                                    
        off their credit by placing a freeze.                                                                                   
                                                                                                                                
        In the case of  a minor, a credit  report should not                                                                    
        exist for a person  under the age of  16. Therefore,                                                                    
        in order  to  place  a  freeze, a  credit  reporting                                                                    
        agency  must   (1)  verify   and  authenticate   the                                                                    
        identities of both the minor and  the requester, (2)                                                                    
        verify the relationship of the person requesting the                                                                    
        freeze for the  minor, and (3)  create a  new record                                                                    
        (prohibiting a credit  report from being  created in                                                                    
        the future for the minor)                                                                                               
                                                                                                                                
     Sec. 2                                                                                                                   
     Creates  Article  2A.  Security  Freeze  for  Protected                                                                  
     Consumers                                                                                                                
                                                                                                                              
        Article 2A  sets up  a system  in state  statute for                                                                    
        placement of and  removal of  a security  freeze for                                                                    
        minors and incapacitated consumers. The bill puts in                                                                    
        place requirements  for  identification  of  parties                                                                    
        involved,  verification  of  authority  of  personal                                                                    
        representatives,  accessing   the   record  by   the                                                                    
        representative or other entities with legal purpose,                                                                    
        and the lifting of a security freeze.                                                                                   
                                                                                                                                
2:16:28 PM                                                                                                                    
     Placement of a Security Freeze                                                                                           
                                                                                                                              
      AS 45.48.300 - A consumer credit reporting agency is                                                                    
      mandated to place a freeze on a protected consumer's                                                                    
     report if:                                                                                                               
                                                                                                                                
      A protected consumer's representative requests one.                                                                       
                                                                                                                                
        The protected consumer's representative                                                                                 
          Submits the request in a manner specified by the                                                                      
          agency                                                                                                                
          Submits proof of identification of the protected                                                                      
          consumer                                                                                                              
          Submits   proof    of   identification    of   the                                                                    
          representative and proof of authority                                                                                 
          Pays the fee of not more than $5.00                                                                                   
                                                                                                                                
     Creation of a Record for a Protected Consumer                                                                            
                                                                                                                              
     AS 45.48.310   Record                                                                                                    
                                                                                                                              
     If a protected consumer does not have a credit report                                                                      
      with the agency, the agency will create a record for                                                                      
     the protected consumer and place a freeze on it.                                                                           
                                                                                                                                
     Proof of Identification and Authority                                                                                    
                                                                                                                              
     AS 45.48.320 - Proof of Identification                                                                                   
                                                                                                                                
     Proof of identification includes:                                                                                          
        Social Security number or copy of SS Card                                                                               
        Certified or official birth certificate                                                                                 
        A driver's license or identification  card issued by                                                                    
        the Division of Motor Vehicles                                                                                          
       Other identification issued by a government agency                                                                       
                                                                                                                                
     Proof of Authority Includes:                                                                                               
        A court order                                                                                                           
        A written, notarized statement  expressly describing                                                                    
        the authority that the representative has signed                                                                        
                                                                                                                                
     Time of Placement of Security Freeze                                                                                     
                                                                                                                              
     AS 45.48.330 - Placement of Freeze                                                                                       
                                                                                                                                
        The agency must place a freeze  on the credit report                                                                    
        of record no later than 30  days after receiving the                                                                    
        request.                                                                                                                
                                                                                                                                
     Operation of Security Freeze                                                                                             
                                                                                                                              
     AS 45.48.340 - Operation of Freeze                                                                                       
                                                                                                                                
        Once a freeze is placed on the report or record, the                                                                    
        agency cannot release  information about  the record                                                                    
        without  permission   from  the   representative  or                                                                    
        consumer unless  the  freeze  was  placed  based  on                                                                    
        misrepresentation of fact or the agency has received                                                                    
        a request for  removal of  the security  freeze from                                                                    
        the representative.                                                                                                     
                                                                                                                                
     Duration of Security Freeze                                                                                              
                                                                                                                              
     AS 45.48.350 - Duration of Freeze                                                                                        
                                                                                                                              
        A  security  freeze  remains  in  effect  until  the                                                                    
        representative requests the freeze be  removed or if                                                                    
        the agency determines the freeze occurred because of                                                                    
        a misrepresentation of facts.                                                                                           
                                                                                                                                
     Effect of Material Misrepresentation of Fact                                                                             
                                                                                                                              
     AS 45.48.370 - Material Misrepresentation of Fact                                                                        
                                                                                                                              
        The agency may  remove a  security freeze  or delete                                                                    
        the record if the security freeze was obtained using                                                                    
        a material misrepresentation of fact.                                                                                   
                                                                                                                                
     Removal of Security Freeze                                                                                               
                                                                                                                              
     AS 45.48.360 - Removal of Security Freeze.                                                                               
     (a) The protected consumer or his representative can have a                                                                
     freeze removed by:                                                                                                         
                                                                                                                              
        Submitting a request in the manner prescribed by the                                                                    
        agency                                                                                                                  
        Providing sufficient proof of:                                                                                          
          Identification of protected consumer                                                                                  
          Identification of representative                                                                                      
          Authority for the representative                                                                                      
                                                                                                                                
        Paying the agency a fee of not more than $5.00                                                                          
                                                                                                                                
     (b) The agency has not more than 30 days to remove the                                                                     
     freeze.                                                                                                                    
                                                                                                                                
     Charges                                                                                                                  
                                                                                                                              
     AS 45.48.380 - Charges.                                                                                                  
                                                                                                                                
        A consumer credit reporting agency may not charge                                                                       
        more than $5.00                                                                                                         
                                                                                                                                
        The agency may not charge a fee when:                                                                                   
          The protected consumer's  representative submits a                                                                    
          police report,  investigative report  of complaint                                                                    
          involving  criminal   impersonation  in   the  1st                                                                    
          degree                                                                                                                
          The protected consumer is under the age of 16 and                                                                     
          the agency has created a credit record for that                                                                       
          consumer                                                                                                              
                                                                                                                                
2:18:36 PM                                                                                                                    
     Exemptions                                                                                                               
                                                                                                                              
     AS   45.48.390  -   Exemptions.  Under   the  following                                                                  
     conditions  a frozen  report  of  a protected  consumer                                                                    
     will be made available to the requestor:                                                                                   
                                                                                                                                
     A person with a court order                                                                                                
     A  government agency  establishing and  enforcing child                                                                    
     support orders                                                                                                             
     Dept. of  Health &  Social Services  and its  agents in                                                                    
     investigating fraud                                                                                                        
     Dept. of  Revenue and its agents  when investigating or                                                                    
     collecting  delinquent taxes,  unpaid court  orders, or                                                                    
     other statutory responsibilities                                                                                           
     A   credit  file   monitoring  service   the  protected                                                                    
     consumer is a subscriber to                                                                                                
     A  person preparing  a credit  report for  an inquiring                                                                    
     bank   or  financial   institution  regarding   account                                                                    
     closures  because  of  fraud,  substantial  overdrafts,                                                                    
     automated teller machine  abuse, or similar information                                                                    
     regarding a protected consumer                                                                                             
                                                                                                                                
     Exemptions (continued)                                                                                                     
                                                                                                                                
     AS   45.48.390  -   Exemptions.  Under   the  following                                                                  
     conditions  a frozen  report  of  a protected  consumer                                                                    
     will be made available to the requestor:                                                                                   
                                                                                                                                
     If  the  report  of  the agency  consists  entirely  of                                                                    
     information  used  solely  for   one  or  more  of  the                                                                    
     following:                                                                                                                 
                                                                                                                                
        Criminal   records   information                                                                                        
        information                                                                                                             
        Fraud prevention or detection                                                                                           
        Tenant screening                                                                                                        
        Employment screening                                                                                                    
                                                                                                                                
     Definitions                                                                                                                
                                                                                                                                
     AS 45.48.395 - Definitions                                                                                               
                                                                                                                                
     "consumer credit reporting agency"  - a person who, for                                                                    
     monetary  fees, dues,  or  on  a cooperative  nonprofit                                                                    
     basis,  regularly engages,  in  whole or  part, in  the                                                                    
     practice  of assembling  or evaluating  consumer credit                                                                    
     information  or  other   information  on  consumers  to                                                                    
     furnishing credit  reports to  third parties,  but does                                                                    
     not include a person who issues the report.                                                                                
                                                                                                                                
2:19:19 PM                                                                                                                    
     Sec. 3 - Transition                                                                                                      
                                                                                                                                
     This transition language provides  that security freezes put                                                               
     in  place prior  to the  effective  date of  this Act,  will                                                               
     remain enforced  under the  same statutes  as they  did when                                                               
     the freeze was placed on the record.                                                                                       
                                                                                                                                
SENATOR MEYER commented  that age 16 as opposed to  age 18 can be                                                               
discussed as a  policy call. He asked if all  the provisions that                                                               
passed last year remain the same,  but that this bill is directed                                                               
at minors and incapacitated people.                                                                                             
                                                                                                                                
MS. MOSS said that's correct.                                                                                                   
                                                                                                                                
SENATOR GARDNER  asked if  adolescents would  need to  go through                                                               
the process  of removing  a freeze placed  by their  parents once                                                               
they reach age 16.                                                                                                              
                                                                                                                                
MS. MOSS  said she believes they  would be allowed to  remove the                                                               
freeze  once  they  turn  16. She  deferred  further  comment  to                                                               
invited expert testimony.                                                                                                       
                                                                                                                                
2:21:47 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on SB 93.                                                                                
                                                                                                                                
2:21:59 PM                                                                                                                    
ERIC   ELLMAN,  Consumer   Data   Industry  Association   (CDIA),                                                               
Washington, D.C.,  stated that CDIA represents  over 100 consumer                                                               
reporting  agencies including  the  three  major credit  bureaus.                                                               
They  have  worked  with  legislators   in  26  other  states  to                                                               
establish minor  credit freezes  and SB 93  will make  Alaska law                                                               
consistent with those states.                                                                                                   
                                                                                                                                
Addressing  the  question regarding  age  16  versus age  18,  he                                                               
explained that  all the  minor credit  freeze statutes  that have                                                               
passed apply to individuals below  16 years-of-age. The reasoning                                                               
is that 16-year-olds  get jobs and are  essentially credit active                                                               
consumers. That  is why  CDIA is  asking that  SB 93  follow what                                                               
other states  have done and  adopt age 16. Responding  to Senator                                                               
Gardner's question,  he explained  that once  the minor  turns 16                                                               
he/she  can affirmatively  request the  credit bureau  remove the                                                               
freeze.                                                                                                                         
                                                                                                                                
2:25:10 PM                                                                                                                    
SENATOR  MEYER continued  to question  the age  16 provision  and                                                               
pointed out that a parent  or guardian is legally responsible for                                                               
their child or ward.                                                                                                            
                                                                                                                                
MR. ELLMAN argued  that those in the  credit reporting community,                                                               
the  banking  and  financial   services  community,  and  schools                                                               
encourage  the pursuit  of credit  education  for youngsters.  He                                                               
agreed  that a  parent or  guardian might  need to  step in  if a                                                               
minor fails financially, but maintained  it is not appropriate to                                                               
address that  through a  minor freeze.  The goal  in establishing                                                               
age 16 as the threshold is  to protect individuals who should not                                                               
be credit  active. Once they reach  the age of 16  many consumers                                                               
will become  credit active and  we want  to meet their  needs and                                                               
their parents' needs, he said.                                                                                                  
                                                                                                                                
SENATOR MEYER  questioned the notion of  encouraging his 17-year-                                                               
old to  be credit active. He  observed that she could  get a job,                                                               
but she could not get a credit card or a bank loan on her own.                                                                  
                                                                                                                                
MR. ELLMAN reminded members that the  goal of the minor freeze is                                                               
to  prevent commerce  from  occurring, whereas  the  goal of  the                                                               
adult freeze is to allow adult  consumers to turn their credit on                                                               
and off as needed.                                                                                                              
                                                                                                                                
CHAIR COSTELLO  asked if  there is  a way  to communicate  with a                                                               
minor's parent if someone steals  a minor's identity and there is                                                               
a freeze on their credit.                                                                                                       
                                                                                                                                
MR. ELLMAN  said yes.  He explained  that 99  percent or  more of                                                               
minors under age  16 do not and should not  have a credit report.                                                               
If they do, it  is most certainly due to fraud  and the bill will                                                               
allow  a parent  or  guardian  to lock  down  the minor's  credit                                                               
history.  Procedures are  also in  place to  allow the  parent or                                                               
guardian to monitor activity on the credit report.                                                                              
                                                                                                                                
2:31:41 PM                                                                                                                    
CARLIE  CHRISTENSEN, Director  of Government  Relations, Equifax,                                                               
Atlanta, Georgia, testified in support  of SB 93. She agreed with                                                               
previous testimony that SB 93 would  amend Alaska law to bring it                                                               
in line with minor freeze laws  in other states. It specifies the                                                               
way a  protected consumer's representative  must place  a request                                                               
to  place or  remove a  security freeze.  It also  clarifies what                                                               
constitutes   sufficient   proof   of  identification   for   the                                                               
representative to  act on behalf  of the protected  consumer. She                                                               
also stated support for the bill  covering minors 16 years of age                                                               
and younger.                                                                                                                    
                                                                                                                                
SENATOR GARDNER asked  if she's aware of any  dueling parents who                                                               
have placed a credit freeze on a minor's record.                                                                                
                                                                                                                                
MS. CHRISTENSEN  said she isn't  aware of any  specific instance,                                                               
but the company likely has  an established procedure to deal with                                                               
that circumstance.                                                                                                              
                                                                                                                                
CHAIR COSTELLO asked Mr. Ellman to respond to the question.                                                                     
                                                                                                                                
MR. ELLMAN  said he suspects  that there  would be times  when it                                                               
might  be  necessary to  arbitrate  between  dueling parents.  He                                                               
offered  to  do  some  research and  provide  a  more  definitive                                                               
answer.                                                                                                                         
                                                                                                                                
SENATOR GARDNER  commented that this  could be  both a bug  and a                                                               
feature.                                                                                                                        
                                                                                                                                
2:36:20 PM                                                                                                                    
CHAIR  COSTELLO closed  public testimony  on SB  93 and  held the                                                               
bill in committee.                                                                                                              
                                                                                                                                
               SB  38-PHARMACY BENEFITS MANAGERS                                                                            
                                                                                                                                
2:36:36 PM                                                                                                                    
CHAIR COSTELLO announced  the consideration of SB  38. She stated                                                               
that the intent  is to hear the introduction,  take questions and                                                               
public testimony, and hold the bill for further consideration.                                                                  
                                                                                                                                
2:37:21 PM                                                                                                                    
SENATOR CATHY  GIESSEL, Alaska State  Legislature, sponsor  of SB                                                               
38, stated that  SB 38, which is about  pharmacy benefit managers                                                               
(PBMs), covers: 1)  the cost of health care in  Alaska, 2) Alaska                                                               
hire, and 3) Alaska's small businesses.                                                                                         
                                                                                                                                
She  recognized  that  a  group of  pharmacy  students  from  the                                                               
University of Alaska, Anchorage were in the audience.                                                                           
                                                                                                                                
CHAIR COSTELLO welcomed the students.                                                                                           
                                                                                                                                
SENATOR  GIESSEL  displayed  a  graphic  to  show  that  pharmacy                                                               
benefit managers are the middlemen  between the insurance company                                                               
and  the pharmacy  and leave  the pharmacy  in a  position to  be                                                               
reimbursed less  than it  pays for a  prescription. She  cited an                                                               
example  of  an  insurance  company  that pays  out  $100  for  a                                                               
prescription for which a pharmacy  pays $60. The PBM captures $50                                                               
off the  top and pays  the pharmacy $50, essentially  telling the                                                               
pharmacy to "eat" the $10 difference.                                                                                           
                                                                                                                                
She stated  that PBMs  also audit  pharmacies and  sometimes make                                                               
egregious  finds  that  can  result  in  significant  fines.  She                                                               
highlighted  that  she  is  offering   the  bill  by  request  of                                                               
pharmacists. She  directed attention  to articles in  the packets                                                               
from Newsweek and  Bloomberg. She concluded saying  the bill will                                                               
allow the  state to  license PBMs and  constrain action  on minor                                                               
technical errors found during audits.                                                                                           
                                                                                                                                
2:42:39 PM                                                                                                                    
SENATOR STEVENS  asked if some  agencies can  avoid the use  of a                                                               
PBM.                                                                                                                            
                                                                                                                                
SENATOR   GIESSEL  responded   that  PBMs   work  for   insurance                                                               
companies. She noted that the PBM  that Aetna uses will not allow                                                               
covered consumers  to order  prescriptions by  mail order  from a                                                               
local Alaska  pharmacy. It  requires the  use of  pharmacies from                                                               
out-of-state.                                                                                                                   
                                                                                                                                
SENATOR  MEYER asked  if  similar legislation  is  used in  other                                                               
states.                                                                                                                         
                                                                                                                                
SENATOR  GIESSEL said  she believes  that 37  states have  passed                                                               
similar legislation.  She directed  attention to  the map  in the                                                               
packet.                                                                                                                         
                                                                                                                                
SENATOR MEYER asked if this has saved money for consumers.                                                                      
                                                                                                                                
SENATOR GIESSEL deferred the question to her aide, Jane Conway.                                                                 
                                                                                                                                
JANE  CONWAY,   Staff,  Senator   Cathy  Giessel,   Alaska  State                                                               
Legislature,  said there  are claims  that  the legislation  will                                                               
increase health  care costs, but  the sponsor has been  unable to                                                               
find   data  to   substantiate  that   claim.  However,   similar                                                               
legislation may have helped local pharmacies stay afloat.                                                                       
                                                                                                                                
SENATOR  GARDNER observed  that a  variation of  this legislation                                                               
has been offered before.                                                                                                        
                                                                                                                                
SENATOR GIESSEL agreed.                                                                                                         
                                                                                                                                
CHAIR COSTELLO asked if the  auditing practices that PBMs use are                                                               
based on some guidelines.                                                                                                       
                                                                                                                                
MS. CONWAY  replied that  PBMs are  largely unregulated  and have                                                               
few sidebars on their procedures.                                                                                               
                                                                                                                                
CHAIR  COSTELLO  asked for  an  explanation  of how  PBMs  manage                                                               
prescriptions.                                                                                                                  
                                                                                                                                
SENATOR GIESSEL  said they  essentially ensure  the person  is an                                                               
insured, that  the quantity of  the prescription  is appropriate,                                                               
and when they  do the audits they check to  see that the pharmacy                                                               
has  charged   the  appropriate   amount.  She   highlighted  the                                                               
complaint  with  the  audits that  small  clerical  errors  often                                                               
result  in   a  fine.  She   suggested  the  committee   ask  the                                                               
pharmacists about their experience with these audits.                                                                           
                                                                                                                                
CHAIR  COSTELLO asked  if PBMs  have access  to the  prescription                                                               
database.                                                                                                                       
                                                                                                                                
SENATOR GIESSEL said she didn't know.                                                                                           
                                                                                                                                
2:48:36 PM                                                                                                                    
SENATOR  HUGHES said  she was  surprised  to see  that the  State                                                               
Chamber of Commerce has reservations  with the bill. She asked if                                                               
the pharmacists have attempted to  work directly with the PBMs to                                                               
resolve the audit problems and payment arrangements.                                                                            
                                                                                                                                
SENATOR  GIESSEL said  pharmacists have  tried but  the contracts                                                               
are offered as take it or  leave it. The pharmacies have no power                                                               
to negotiate.                                                                                                                   
                                                                                                                                
SENATOR HUGHES  asked if she has  asked the state chamber  why it                                                               
is taking the position it has.                                                                                                  
                                                                                                                                
SENATOR  GIESSEL  said her  understanding  is  the state  chamber                                                               
wanted to  see what  Congress would do  with the  Affordable Care                                                               
Act. She  noted that Congress  did not act  on the AFC  last week                                                               
and she  was unaware  of whether the  state chamber  continues to                                                               
have reservations.                                                                                                              
                                                                                                                                
SENATOR HUGHES asked  if the bills Congress  is currently working                                                               
on related to changing the  Affordable Care Act include the issue                                                               
of PBMs.                                                                                                                        
                                                                                                                                
MS.  CONWAY said  she didn't  know if  they were  related to  the                                                               
Affordable Care Act,  but Congress is considering  four pieces of                                                               
legislation  that try  to  shine  a light  on  the activities  of                                                               
pharmacy benefit managers.                                                                                                      
                                                                                                                                
SENATOR  STEVENS asked  if the  bill would  change the  way Aetna                                                               
works with its PBM.                                                                                                             
                                                                                                                                
MS.  CONWAY   said  the  indeterminate   fiscal  note   from  the                                                               
Department  of  Administration  (DOA)  posits that  SB  38  might                                                               
increase  costs.  However, a  letter  in  the packet  from  Barry                                                               
Christensen,  a pharmacist  from Ketchikan,  refutes many  of the                                                               
points in the  letter from the state chamber. "I  don't think the                                                               
pharmacists agree  that this would  actually be  increasing costs                                                               
or changing  anything that Aetna  is doing. However,  there could                                                               
be some good  suggestions to our health plan that  could help our                                                               
local  pharmacies rather  than be  to  the detriment  of them  in                                                               
terms of the mail order component," she said.                                                                                   
                                                                                                                                
2:52:47 PM                                                                                                                    
SENATOR  STEVENS  asked  how  this   would  cause  Aetna  to  act                                                               
differently than it does now.                                                                                                   
                                                                                                                                
SENATOR GIESSEL said Aetna will  likely continue to have the PBM.                                                               
SB  38 does  not address  their  existence; it  seeks to  address                                                               
their conduct.                                                                                                                  
                                                                                                                                
SENATOR GARDNER  expressed surprise that  PBMs could get  half of                                                               
the retail  cost of  a prescription. "No  wonder the  consumer is                                                               
paying  so much,"  she  said.  She wondered  if  anyone would  be                                                               
testifying about why PBMs, that  are essentially auditors, should                                                               
get so much.                                                                                                                    
                                                                                                                                
SENATOR GIESSEL replied, "That's the point of the bill."                                                                        
                                                                                                                                
2:54:33 PM                                                                                                                    
CHAIR COSTELLO invited Lori Wing-Heier  to testify and noted that                                                               
one of the two fiscal notes  mentions the role of the director of                                                               
the Division of Insurance.                                                                                                      
                                                                                                                                
2:55:24 PM                                                                                                                    
LORI WING-HEIER,  Director, Division of Insurance,  Department of                                                               
Commerce,  Community  and  Economic Development  (DCCED),  stated                                                               
that if  SB 38 were to  pass, pharmacy benefit managers  would be                                                               
required  under  Alaska  statute  to register  as  a  third-party                                                               
administrator  (TPA)  and  pay  a  biannual  licensing  fee.  The                                                               
division tracks  TPA activity and would  be able to follow  up if                                                               
there were consumer complaints.                                                                                                 
                                                                                                                                
She advised that  SB 38 is not  expected to be a  great burden on                                                               
the state  because not many TPAs  are operating in the  state and                                                               
the first  part of the bill  is just a licensing  or registration                                                               
matter for  the division.  While the division  does not  know how                                                               
many audit appeals  there will be, they would  be handled through                                                               
the established procedures for appeals within the division.                                                                     
                                                                                                                                
CHAIR COSTELLO asked if the  administration has a position on the                                                               
bill.                                                                                                                           
                                                                                                                                
MS.  WING-HEIER replied  the division  looks on  it as  a process                                                               
that can be  handled internally and within  existing statute. She                                                               
added that  the position  of the  administration is  reflected in                                                               
the   indeterminate   fiscal   note  from   the   Department   of                                                               
Administration.                                                                                                                 
                                                                                                                                
CHAIR  COSTELLO,  noting that  a  fiscal  note doesn't  generally                                                               
reflect a  philosophical position,  asked if  she was  aware that                                                               
the administration supports or does not support the bill.                                                                       
                                                                                                                                
MS. WING-HEIER  said she  was not  aware of  the administration's                                                               
position.                                                                                                                       
                                                                                                                                
SENATOR MEYER  asked if  the legislature  could require  Aetna to                                                               
stop using PBMs.                                                                                                                
                                                                                                                                
MS.  WING-HEIER suggested  that  the Division  of Retirement  and                                                               
Benefits could  best answer that  question then pointed  out that                                                               
every  insurance company  uses  a pharmacy  benefit manager.  She                                                               
described the  bill as a  consumer protection which  is something                                                               
the administration  supports. The  bill has  two parts;  first is                                                               
the audit piece for the PBMs,  which resembles the Fair Audit Act                                                               
and the  second part is  about pricing  of generic drugs  and the                                                               
impact  that would  have  on any  employer plan  as  well as  the                                                               
individual market.                                                                                                              
                                                                                                                                
SENATOR  MEYER  asked  how many  insurance  companies  in  Alaska                                                               
provide health insurance.                                                                                                       
                                                                                                                                
MS. WING-HEIER  said less than six  insurance companies currently                                                               
are writing for the public. This  does not include those that are                                                               
writing for one or two  accounts or ConocoPhillips or Fred Meyer,                                                               
for example.                                                                                                                    
                                                                                                                                
SENATOR STEVENS asked what the PBMs do.                                                                                         
                                                                                                                                
MS. WING-HEIER  explained that  a PBM  negotiates the  price from                                                               
the wholesaler  or drug  manufacturer to  the pharmacist  and the                                                               
insurance company  is somewhere  in the middle.  She acknowledged                                                               
that the  methodology of the  charge is a little  fuzzy regarding                                                               
what  the PBM  pays the  pharmacist,  what it  receives from  the                                                               
insurance  company,  and what  it  pays  the wholesaler  or  drug                                                               
company.                                                                                                                        
                                                                                                                                
SENATOR  STEVENS said  it's a  shocking situation,  but he  would                                                               
hope that negotiating  with the drug companies for  a lower price                                                               
would ultimately benefit the consumer.                                                                                          
                                                                                                                                
MS.  WING-HEIER confirmed  that their  purpose is  to obtain  the                                                               
best  possible  cost  so  the  consumer or  the  employer  in  an                                                               
employer-sponsored plan receives the benefit of the lowest cost.                                                                
                                                                                                                                
SENATOR GARDNER asked if PBMs  don't have an adverse incentive to                                                               
negotiate  the lowest  cost if  they  receive 50  percent of  the                                                               
cost.                                                                                                                           
                                                                                                                                
MS.   WING-HEIER    advised   that   rebates   are    common   in                                                               
pharmaceuticals  from   providers  to   PBMs  to   the  insurance                                                               
companies.                                                                                                                      
                                                                                                                                
CHAIR COSTELLO  asked if other  states have  similar legislation,                                                               
specifically regarding  the role  that the Division  of Insurance                                                               
has in the bill.                                                                                                                
                                                                                                                                
MS. WING-HEIER said  quite a few states have Fair  Audit Acts and                                                               
most reside with insurance of licensing.                                                                                        
                                                                                                                                
CHAIR COSTELLO  invited Michele Michaud  and Emily  Ricci forward                                                               
to  respond  to   the  question  relating  to   the  Division  of                                                               
Retirement and Benefits.                                                                                                        
                                                                                                                                
3:02:57 PM                                                                                                                    
EMILY  RICCI,  Chief  Health Policy  Administrator,  Division  of                                                               
Retirement  and  Benefits,  Department of  Administration  (DOA),                                                               
introduced herself.                                                                                                             
                                                                                                                                
MICHELE MICHAUD,  Chief Health  Official, Division  of Retirement                                                               
and  Benefits,  Department  of Administration  (DOA),  introduced                                                               
herself.                                                                                                                        
                                                                                                                                
CHAIR COSTELLO  asked if they  wanted to  comment on the  bill or                                                               
any questions or testimony they heard.                                                                                          
                                                                                                                                
MS. MICHAUD answered no.                                                                                                        
                                                                                                                                
SENATOR MEYER  asked if the  state could ask  Aetna not to  use a                                                               
PBM.                                                                                                                            
                                                                                                                                
MS. MICHAUD said  if the Department of Law advised  that would be                                                               
possible under the existing agreement  with Aetna, it would still                                                               
take  significant analysis  to see  if it  would be  in the  best                                                               
interest of the plan.                                                                                                           
                                                                                                                                
SENATOR STEVENS  asked how much  the state's  retirement programs                                                               
pay in pharmacy benefits each year.                                                                                             
                                                                                                                                
MS. MICHAUD reported that the  state spent $55 million on generic                                                               
medication last year and the  overall pharmacy spend was close to                                                               
$300 million.                                                                                                                   
                                                                                                                                
SENATOR STEVENS  commented, "That would balance  our budget right                                                               
there."                                                                                                                         
                                                                                                                                
MS. RICCI added that she didn't  know when the state health plans                                                               
first  adopted PBMs  to manage  pharmacy  benefits, but  it is  a                                                               
common practice among  large employers. When she  looked at other                                                               
options several  years ago,  she found that  there isn't  an easy                                                               
alternative to using a PBM to manage the pharmacy spend.                                                                        
                                                                                                                                
SENATOR  GARDNER asked  if a  50  percent cut  is standard  among                                                               
pharmacy benefit plans.                                                                                                         
                                                                                                                                
MS. RICCI deferred the question  to Aetna or other pharmaceutical                                                               
experts in the room.                                                                                                            
                                                                                                                                
3:07:41 PM                                                                                                                    
CHAIR COSTELLO opened public testimony on SB 38.                                                                                
                                                                                                                                
3:08:03 PM                                                                                                                    
LEIF  HOLM,  Pharmacy Owner,  North  Pole,  Alaska, testified  in                                                               
support of SB  38. He reported that the three  pharmacies he owns                                                               
in Interior Alaska are most affected  by the MAC pricing that the                                                               
bill  seeks to  correct. He  stated that  passage of  SB 38  will                                                               
regulate  audit   practices  and  correct   questionable  pricing                                                               
strategies  which will  be a  step toward  achieving transparency                                                               
with PBMs. It's the  right thing to do to rein  in PBMs and begin                                                               
to  eliminate their  abusive tactics  that are  ultimately costly                                                               
for health plan sponsors and patients, he said.                                                                                 
                                                                                                                                
CHAIR COSTELLO  advised that the  committee would  eagerly accept                                                               
any  written  testimony or  response  to  questions that  members                                                               
posed.                                                                                                                          
                                                                                                                                
SENATOR  STEVENS  asked Mr.  Holm  to  contact the  committee  to                                                               
describe abusive audit practices.                                                                                               
                                                                                                                                
MR. HOLM agreed.                                                                                                                
                                                                                                                                
3:10:19 PM                                                                                                                    
MATTHEW KEITH, Vice President of  Pharmacy Services, Geneva Woods                                                               
Pharmacy,  Inc., Anchorage,  Alaska, testified  in support  of SB                                                               
38. He  said that  Geneva Woods is  a small  independent pharmacy                                                               
that constantly  struggles with the practices  and abusive audits                                                               
that have been  described. He questioned why  the state shouldn't                                                               
regulate   PBMs  just   as  it   regulates  pharmacies,   medical                                                               
practices, wholesalers, and insurance  providers in the state. He                                                               
said  SB   38  isn't  about   eliminating  PBMs  but   rather  it                                                               
establishes guardrails,  so the negotiations are  more reasonable                                                               
and fair. He  noted that many PBMs own mail  order pharmacies and                                                               
questioned  whether  the intent  is  to  steer business  in  that                                                               
direction.                                                                                                                      
                                                                                                                                
3:12:10 PM                                                                                                                    
SCOTT WATTS,  Pharmacist and independent pharmacy  owner, Juneau,                                                               
Alaska,  said he  has practiced  pharmacy  for 27  years and  his                                                               
pharmacy  daily dispenses  medication below  his cost  because of                                                               
MAC price  listing. He said that  talking with the PBMs  would be                                                               
the best  way to resolve  the issue, but  most of the  time these                                                               
departments do  not have a phone  number. He said that  MAC price                                                               
listing is a way to keep costs  down, but they need to be updated                                                               
more frequently  to reflect the cost.  It should not be  borne on                                                               
the  backs of  the pharmacists  to  keep those  prices down."  He                                                               
explained that  his out-of-town customers  come in to  have their                                                               
prescriptions  filled when  they are  in town  and would  like to                                                               
have  them   refilled  when  they  return   home.  However,  some                                                               
contracts  don't  allow that,  and  the  people must  have  their                                                               
prescriptions refilled from an  out-of-state mail order pharmacy.                                                               
He  cited  an example  of  the  pricing  issue. When  a  customer                                                               
questioned their  co-pay, he directed  them to their  health care                                                               
plan  because   the  pricing  is   set  by  the  PBMs   when  the                                                               
prescription  is transmitted.  The PBM  responded that  afternoon                                                               
telling the  pharmacist he was  in breach of contract  by telling                                                               
the customer what the plan  was paying for their prescription. He                                                               
said the PBMs  have their reasons to not want  the customer to be                                                               
aware of  the price of  their medication, but he  feels customers                                                               
should have that information.                                                                                                   
                                                                                                                                
                                                                                                                                
CHAIR  COSTELLO  said  the committee  would  accept  his  written                                                               
testimony if he chose to submit it.                                                                                             
                                                                                                                                
3:14:40 PM                                                                                                                    
GERALD  BROWN, Pharmacist,  Fairbanks,  Alaska, said  he owns  an                                                               
independent pharmacy with his wife  and they too are experiencing                                                               
the problems  that have been  discussed earlier. The  MAC pricing                                                               
list does not  reflect price increases for six months  to a year,                                                               
so  they are  constantly  under-reimbursed. It  amounts to  about                                                               
$1,000 per  month for  their small pharmacy.  He reported  that a                                                               
large  chain  pharmacy  in  town  has  been  under-reimbursed  by                                                               
$30,000  a month.  "This is  a prevalent  problem with  PBMs." He                                                               
explained  that PBMs  are  like a  credit  card; Alaska  Airlines                                                               
sponsors  the card  and VISA  administers the  benefit. The  VISA                                                               
card,  for example,  is setting  the co-pay  amount. He  said the                                                               
problem  is  that  the  pharmacies are  getting  about  $0.45  to                                                               
dispense the prescription plus 21  percent less than cost. A bank                                                               
would  not  lend  on  that business  model.  Referencing  the  50                                                               
percent  that the  PBMs capture,  he clarified  that the  rebates                                                               
from  the  pharmaceutical  company  to  the  PBMs  are  generally                                                               
between 30 percent  and 60 percent. "So now  your formulators are                                                               
based not on therapeutics, but they're  based on who gives us the                                                               
bigger rebates."  The pharmacies  don't generally see  that; they                                                               
are  just told  how much  they will  be reimbursed.  Further, the                                                               
amount  the  pharmacy  receives  may not  reflect  the  cost  the                                                               
pharmacy paid. He highlighted that  the PBMs are certainly making                                                               
money and  their executives are as  well. Last year the  CEOs for                                                               
these  PBMs  received bonuses  ranging  from  $9 million  to  $49                                                               
million. He summarized  that SB 38 simply seeks to  give the PBMs                                                               
structure, so they  can't squash the small  businesses. "We don't                                                               
have a problem  with the audits; we have a  problem with the take                                                               
it or leave  it attitude." These large organizations  at the very                                                               
least should be required to register with the state.                                                                            
                                                                                                                                
SENATOR  GARDNER asked  if the  bill addresses  either the  issue                                                               
that the  back prices are met  but the increases to  the pharmacy                                                               
don't follow  timely or the issue  that formulas can be  based on                                                               
who gives the largest rebate.                                                                                                   
                                                                                                                                
MR. BROWN said no.                                                                                                              
                                                                                                                                
3:19:44 PM                                                                                                                    
ERIC  DOUGLAS,  CVS  Health,  Illinois, said  he  is  calling  to                                                               
express concern  with SB 38. He  said many of the  comments today                                                               
have been  off the topic  that the  bill addresses and  PBMs have                                                               
been portrayed  inaccurately. He  said PBMs  save money  and they                                                               
wouldn't  be utilized  if  they  didn't. He  said  CVS Health  is                                                               
concerned that SB 38 would  unintentionally promote fraud, waste,                                                               
and abuse  because it  inserts the state  in private  audit terms                                                               
that  are  well  addressed  in  current  contracts.  It  is  also                                                               
inappropriate that the bill charges  the director of the Division                                                               
of Insurance to be the  arbiter of private contract disputes when                                                               
that  division   does  not   have  expertise   regarding  generic                                                               
pharmaceutical   reimbursement.   The   bill   also   establishes                                                               
requirements  that  would be  impossible  to  meet. For  example,                                                               
insuring  that a  specific pharmacy  can buy  a specific  product                                                               
from  a  specific wholesaler  at  a  specific price.  This  would                                                               
increase costs  just as setting  up a  no loss guarantee  on MACS                                                               
would.  Noting that  the  Board  of Pharmacy  is  defined in  the                                                               
definitions  but  isn't used  in  the  legislation, he  said  CVS                                                               
Health would  not support the  Board of Pharmacy  having anything                                                               
to  do with  PBMs if  there is  a financial  relationship between                                                               
pharmacy benefit managers and pharmacies.                                                                                       
                                                                                                                                
3:22:35 PM                                                                                                                    
TOM  WADSWORTH,  Associate   Clinical  Professor,  University  of                                                               
Alaska Anchorage  (UAA), said UAA  has a pharmacy program  and he                                                               
is the assistant dean of  the program. He introduced the pharmacy                                                               
students in  the audience  as Alaskans  and highlighted  that the                                                               
founding  principles  of the  program  is  to train  Alaskans  in                                                               
Alaska,  so they  serve Alaskans  living  in the  rural areas  of                                                               
Alaska. He said he supports SB  38 because the largest issue with                                                               
sending these  students into rural  areas is that there  won't be                                                               
any  pharmacies to  go to.  Brick  and mortar  pharmacies are  in                                                               
jeopardy  and pharmacists  see patients  seven  times more  often                                                               
than a  doctor. He  highlighted that  pharmacists in  these rural                                                               
communities only  make their money  be selling  prescriptions and                                                               
as the  profit margins have  shrunk, the sustainability  of these                                                               
businesses is in question. He  offered his belief that PBMs serve                                                               
a good  role in controlling  formularies but the money  they save                                                               
goes into a pot also controlled by the PBMs.                                                                                    
                                                                                                                                
He concluded,  "We need  to see  that pharmacists  are reimbursed                                                               
for what they  do for these communities, so they  can be there to                                                               
serve  the  patients  of these  communities,  particularly  rural                                                               
Alaska."                                                                                                                        
                                                                                                                                
CHAIR COSTELLO  invited the  pharmacy students  to talk  with her                                                               
after the meeting  for the committee's Facebook  page. "That's an                                                               
important message to  get out. That we need more  Alaska born and                                                               
raised pharmacists here in our state."                                                                                          
                                                                                                                                
3:24:42 PM                                                                                                                    
BARRY  CHRISTENSEN, RPh,  Co-Chair Legislative  Committee, Alaska                                                               
Pharmacists  Association,  Ketchikan,  Alaska,  stated  that  the                                                               
passage of  SB 38  is important for  Alaska pharmacies  to remain                                                               
viable. Responding to Senator Stevens'  request for an example of                                                               
an audit abuse practice, he  explained that his pharmacy received                                                               
a large desk  audit from a PBM that required  submitting over 100                                                               
pages of  documentation. The only secure  option for transmitting                                                               
the material was through FAX  and their machine could only handle                                                               
50  pages  at  a  time.   They  informed  the  auditor  that  the                                                               
transmission  was in  two parts,  yet  the results  of the  audit                                                               
showed that  only half of  the documentation was  considered. The                                                               
pharmacy  received permission  to  resend the  material, but  the                                                               
auditor allowed  just five days  on the final audit  findings for                                                               
appeal.  The  final   findings  included  a  $400   claim  for  a                                                               
prescription that  was not  part of the  original audit.  The PBM                                                               
gave the pharmacy  less than 24 hours to get  their documents and                                                               
a letter  from that  prescriber in the  mail. He  maintained that                                                               
this was not a fair turnaround time.                                                                                            
                                                                                                                                
MR.  CHRISTENSEN summarized  that SB  38 will  set standards  for                                                               
PBMs and that is all the bill asks for.                                                                                         
                                                                                                                                
3:27:34 PM                                                                                                                    
FRED BROWN,  Health Care Cost  Management Corporation  of Alaska,                                                               
Fairbanks,  Alaska,  advised  that  he would  not  reiterate  the                                                               
written testimony he  submitted but would respond to  some of the                                                               
comments  made  earlier in  the  hearing.  He reported  that  his                                                               
organization  has over  100,000 covered  lives in  Alaska and  is                                                               
comprised of more than 25  self-funded plans. They offer a myriad                                                               
of options for  member plans to select, among which  is access to                                                               
prescription  benefit  management  (PBM) plan.  Thirteen  of  the                                                               
plans in Alaska use the  PBM program his organization offers. The                                                               
total gross drug  valuation for those 13 plans in  2016 was $74.1                                                               
million. Noting that earlier testimony  stated that 50 percent of                                                               
that goes to the PBM, he  reported that in 2016 their plans saved                                                               
49 percent  of that total or  about $37.8 million. He  added, "If                                                               
the earlier  descriptions are correct,  then the PBM only  made 1                                                               
percent." The point, he said, is  that there is more to the story                                                               
than has been told.                                                                                                             
                                                                                                                                
CHAIR  COSTELLO held  SB 38  in committee  with public  testimony                                                               
open.                                                                                                                           
                                                                                                                                
3:29:49 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Costello  adjourned the Senate Labor  and Commerce Standing                                                               
Committee meeting at 3:39 p.m.                                                                                                  
                                                                                                                                

Document Name Date/Time Subjects
SB 38.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Sponsor Statement.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Sectional Analysis.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Fiscal Note DCCED.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - NACDS.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - NASPA Map PBM Legislation.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Fiscal Note DOA.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Article - Bloomberg.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Article - Caterpillar Reduces Costs.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Board of Pharmacy.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - AKPhA.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Island Pharmacy.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Niebert Hewitts Drug.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Whale Tail.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - White's Race Pharmacy.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Soden.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Opposition Letter - PCMA.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Opposition Letter - CVS Health.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Opposition Letter - AK Chamber.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
Midwives - Roster.pdf SL&C 3/28/2017 1:30:00 PM
Midwives - Fact Sheet.pdf SL&C 3/28/2017 1:30:00 PM
Midwives Resume - Ostrom.pdf SL&C 3/28/2017 1:30:00 PM
Midwives Resume - Roberts.pdf SL&C 3/28/2017 1:30:00 PM
Midwives Resume - Brown.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors - Fact Sheet.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors - Roster.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors Resume - Brainerd.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors Resume - Hamilton.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors Resume - Henderson.pdf SL&C 3/28/2017 1:30:00 PM
Professional Counselors Resume - Vinson.pdf SL&C 3/28/2017 1:30:00 PM
Real Estate Commission - Fact Sheet.pdf SL&C 3/28/2017 1:30:00 PM
Real Estate Commission - Roster.pdf SL&C 3/28/2017 1:30:00 PM
Real Estate Commission Resume - Bushnell.pdf SL&C 3/28/2017 1:30:00 PM
Real Estate Commission Resume - Mickel.pdf SL&C 3/28/2017 1:30:00 PM
Real Estate Commission Resume - Pruhs.pdf SL&C 3/28/2017 1:30:00 PM
SB 38 - AkPhA Response Letter to ADMIN Fiscal Note.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - Newsweek Article.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - Chain Store Pharmacies AK.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - PBM Business Model.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - PBM How it Works.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Background Document - PBM Profits Graph.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Opposition Letter - HCCMA.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Sponsor Presentation - PBM Slides.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Board of Pharmacy.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 38 - Support Letter - Ron's Apothecary.pdf SL&C 3/28/2017 1:30:00 PM
SB 38
SB 93 – Sponsor Sectional Presentation.pdf SL&C 3/28/2017 1:30:00 PM
SB 93
CS SB 51 - Ver. J.pdf SL&C 3/28/2017 1:30:00 PM
SB 51