Legislature(2025 - 2026)DAVIS 106
04/08/2025 03:15 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB96 | |
| HB144 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| += | HB 96 | TELECONFERENCED | |
| += | HB 144 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 8, 2025
4:07 p.m.
DRAFT
MEMBERS PRESENT
Representative Genevieve Mina, Chair
Representative Andrew Gray
Representative Zack Fields
Representative Donna Mears
Representative Mike Prax
Representative Justin Ruffridge
Representative Rebecca Schwanke
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
HOUSE BILL NO. 96
"An Act establishing the Home Care Employment Standards Advisory
Board; relating to payment for personal care services; and
providing for an effective date."
- MOVED CSHB 96(HSS) OUT OF COMMITTEE
HOUSE BILL NO. 144
"An Act relating to prior authorization requests for medical
care covered by a health care insurer; relating to a prior
authorization application programming interface; relating to
step therapy; and providing for an effective date."
- MOVED CSHB 144(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: HB 96
SHORT TITLE: HOME CARE EMPLOYMENT STANDARDS ADV BOARD
SPONSOR(s): REPRESENTATIVE(s) PRAX
02/12/25 (H) READ THE FIRST TIME - REFERRALS
02/12/25 (H) HSS, L&C
03/25/25 (H) HSS AT 3:15 PM DAVIS 106
03/25/25 (H) Heard & Held
03/25/25 (H) MINUTE(HSS)
04/08/25 (H) HSS AT 3:15 PM DAVIS 106
BILL: HB 144
SHORT TITLE: INSURANCE; PRIOR AUTHORIZATIONS
SPONSOR(s): REPRESENTATIVE(s) RUFFRIDGE
03/21/25 (H) READ THE FIRST TIME - REFERRALS
03/21/25 (H) HSS, L&C
04/03/25 (H) HSS AT 3:15 PM DAVIS 106
04/03/25 (H) Heard & Held
04/03/25 (H) MINUTE(HSS)
04/08/25 (H) HSS AT 3:15 PM DAVIS 106
WITNESS REGISTER
JARED KOSIN, President and CEO
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
144.
ACTION NARRATIVE
4:07:47 PM
CHAIR GENEVIEVE MINA called the House Health and Social Services
Standing Committee meeting to order at 4:07 p.m.
Representatives Prax, Fields, Mears, Ruffridge, Schwanke, and
Mina were present at the call to order. Representative Gray
arrived as the meeting was in progress.
HB 96-HOME CARE EMPLOYMENT STANDARDS ADV BOARD
4:08:25 PM
CHAIR MINA announced that the first order of business would be
HOUSE BILL NO. 96, "An Act establishing the Home Care Employment
Standards Advisory Board; relating to payment for personal care
services; and providing for an effective date."
4:09:06 PM
REPRESENTATIVE PRAX, as prime sponsor, provided a brief recap of
the history of HB 96. He said that HB 96 would establish an
advisory board to address challenges with home care in Alaska.
4:10:16 PM
REPRESENTATIVE PRAX moved to adopt Amendment 1 to HB 96, labeled
34-LS0297\I.1, Radford, 4/2/25, which read as follows:
Page 6, lines 2 - 3:
Delete "enrolled with"
Insert "certified by"
CHAIR MINA objected for the purpose of discussion.
REPRESENTATIVE PRAX explained that Amendment 1 would clarify
previous concerns regarding HB 96.
CHAIR MINA removed her objection to the motion to adopt
Amendment 1. There being no further objection, Amendment 1 was
adopted.
4:11:13 PM
REPRESENTATIVE PRAX moved to adopt Amendment 2 to HB 96, labeled
34-LS0297\I.2, Radford, 4/5/25, which read as follows:
Page 5, lines 11 - 23:
Delete all material and insert:
"(c) The department shall take the
recommendations of the board into consideration
when setting rates for covered services. If the
rate set by the department for a covered service
differs significantly from the rate recommended by
the board, the commissioner shall notify the board
and the chair of each legislative committee having
jurisdiction of health and social services in
writing."
CHAIR MINA objected for the purpose of discussion.
REPRESENTATIVE PRAX explained that Amendment 2 would simplify
the process of producing the annual report by the advisory
board.
CHAIR MINA removed her objection to the motion to adopt
Amendment 2. There being no further objection, Amendment 2 was
adopted.
4:12:59 PM
REPRESENTATIVE MEARS moved to report HB 96, as amended, out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSHB 96(HSS) was
reported out of the House Health and Social Services Standing
Committee.
4:13:19 PM
The committee took an at-ease from 4:13 p.m. to 4:15 p.m.
HB 144-INSURANCE; PRIOR AUTHORIZATIONS
4:15:49 PM
CHAIR MINA announced that the final order of business would be
HOUSE BILL NO. 144, "An Act relating to prior authorization
requests for medical care covered by a health care insurer;
relating to a prior authorization application programming
interface; relating to step therapy; and providing for an
effective date." [Before the committee, adopted as a working
document on 4/3/25, was the proposed committee substitute (CS)
for HB 144, Version 34-LS0780\N, Wallace, 4/1/25.]
4:16:16 PM
REPRESENTATIVE RUFFRIDGE, as prime sponsor, provided a brief
recap of the history of HB 144. He said that the proposed
legislation would improve prior authorization by reducing wait
times and increasing access for patients.
4:17:23 PM
CHAIR MINA opened public testimony HB 144, Version N. After
ascertaining that no one wished to testify, she closed public
testimony.
4:17:49 PM
The committee took an at-ease from 4:17 p.m. to 4:22 p.m.
4:22:23 PM
CHAIR MINA ascertained that Amendment 1 would not be offered.
REPRESENTATIVE GRAY moved to adopt Amendment 2 to HB 144,
Version N, labeled 34-LS0780\N.2, Wallace, 4/7/25, which read as
follows:
Page 2, line 19:
Delete "If"
Insert "Except as provided in (g) of this
section, if"
Page 2, line 27, following "request":
Insert "under (b) of this section,"
Page 3, line 13, following "under":
Insert "(b) of"
Page 3, following line 15:
Insert new subsections to read:
"(g) The times specified in (b) of this
section for notifying a health care provider of a
decision do not apply to a health care provider
that submits a prior authorization request for
medical care to be provided on equipment owned by the
health care provider, the facility where the health
care provider is employed, or an entity affiliated
with the facility where the health care provider is
employed.
(h) The provisions of (g) of this section
do not apply to a prior authorization request
submitted by a health care provider employed by a
hospital licensed in this state."
REPRESENTATIVE RUFFRIDGE objected.
REPRESENTATIVE PRAX objected.
REPRESENTATIVE RUFFRIDGE stated that HB 144 has been carefully
crafted with compromises, and he does not believe Amendment 2
would help the bill move forward.
4:23:33 PM
REPRESENTATIVE GRAY explained that Amendment 2 would
disincentivize the practice of self-dealing, during which
physicians prescribe imaging on equipment they already own. He
said that this practice is already outlawed in other states and
contributes to the increasing cost of healthcare.
4:26:54 PM
CHAIR MINA asked how Amendment 2 would help lower healthcare
costs.
REPRESENTATIVE GRAY responded that Amendment 2 would
disincentivize ordering tests that are unnecessary. He said
that HB 144 would provide an expedited pathway for physicians to
have prior authorizations approved quickly for tests performed
on their own equipment. This may cause physicians to prescribe
testing that is more expensive to the patient, yet more
profitable for the physician.
CHAIR MINA asked about the situation in rural Alaska, where a
patient might have access only to one federally qualified health
center (FQHC), which owns its own equipment.
REPRESENTATIVE GRAY responded that equipment at an FQHC is not
owned by the providers ordering tests, so Amendment 2 would not
apply to them.
CHAIR MINA asked about the situation in rural Alaska where there
is only one provider who owns their own equipment.
REPRESENTATIVE GRAY responded that he believes that situation is
extremely unlikely and emphasized that imaging for emergency
care does not require prior authorization, so Amendment 2 would
still not apply.
4:30:31 PM
REPRESENTATIVE RUFFRIDGE said that there is a diverse range of
FQHCs in Alaska. He described one FQHC in Skagway and the
limited access that Skagway residents have to healthcare other
than that FQHC. Therefore, patients do not always have multiple
options for care that will be approved with a prior
authorization.
4:32:12 PM
REPRESENTATIVE GRAY moved Conceptual Amendment 1 to Amendment 2,
as follows:
Page 1, line 19
Insert "or FQHC" after "hospital"
REPRESENTATIVE RUFFRIDGE objected.
REPRESENTATIVE PRAX objected.
REPRESENTATIVE RUFFRIDGE said that he appreciated the
opportunity to exempt FQHCs from the provisions of Amendment 2,
but he believes that exemptions highlight the difficulty of
Amendment 2 itself.
4:34:17 PM
REPRESENTATIVE PRAX emphasized that the goal of HB 144 would be
to compromise the interests of all the parties it involves, and
Amendment 2 with its conceptual amendment, would disrupt that
process.
4:35:45 PM
REPRESENTATIVE GRAY [moved to withdraw] Conceptual Amendment 1
to Amendment 2. [There being no objection, Conceptual Amendment
1 was withdrawn.]
4:36:05 PM
REPRESENTATIVE PRAX said that his objection to Amendment 2 is
the same as his objection to its conceptual amendment. He
explained that Amendment 2 would complicate HB 144 in a way that
would make it difficult for the bill to move forward.
4:36:55 PM
REPRESENTATIVE GRAY said that there is nothing in HB 144 that
would reduce healthcare costs. He said that expediting the
timeline of prior authorizations might actually increase costs.
He emphasized that self-dealing is extraordinarily problematic.
He said that removing the barriers that prior authorization
creates to prescribe expensive testing may increase the practice
of self-dealing.
4:40:05 PM
CHAIR MINA asked what types of equipment other than magnetic
resonance imaging (MRI) machines Amendment 2 would apply to.
4:40:32 PM
JARED KOSIN, President and CEO, Alaska Hospital and Healthcare
Association, responded that he does not entirely understand the
intention behind Amendment 2. He said that the equipment
typically owned by physicians is imaging equipment. He said
that this amendment, by focusing on providers rather than
patients, would undermine patients' ability to quickly receive
care.
REPRESENTATIVE GRAY responded that he has never done a prior
authorization for an x-ray and that Amendment 2 would not
prevent a patient from receiving any kind of procedure. He
emphasized that the intention of Amendment 2 is to stop self-
dealing.
4:43:04 PM
REPRESENTATIVE SCHWANKE said she appreciates the thought behind
Amendment 2. She expressed concern about restricting private
businesses who made business decisions, like buying their own
equipment, under laws that allowed them to do so for their own
profit.
4:44:45 PM
REPRESENTATIVE RUFFRIDGE asked if healthcare providers, or their
employers, would be on a list of entities that own their own
equipment. He also asked who would police insurance companies
from approving prior authorizations from those entities on their
own equipment.
REPRESENTATIVE GRAY responded to Representative Schwanke's
concerns, stating that the owners of imaging equipment are
making millions of dollars at the expense of Alaska. He
emphasized that it is unfair to self-deal. He responded to
Representative Ruffridge, stating that Amendment 2 would not
place a burden on the state, but insurance companies should know
who orders a test and on what equipment.
4:48:53 PM
REPRESENTATIVE RUFFRIDGE said that Amendment 2 would add a
burden to the state because the responsibility would not fall
solely on the insurance company. He emphasized that Amendment 2
would delay care and hurt patients.
4:50:34 PM
REPRESENTATIVE GRAY said that current law in Alaska requires
that doctors being paid by Medicare or Medicaid, who own their
equipment, must disclose that information to their patients. He
disagreed that Amendment 2 would delay care.
4:51:42 PM
REPRESENTATIVE MEARS asked if Amendment 2 would address an
existing issue or would close a loophole that HB 144 would
create.
REPRESENTATIVE GRAY responded that there is an existing problem
in Alaska. He said that Amendment 2 would not fix this problem
but would prevent the problem from becoming easier to occur.
REPRESENTATIVE MEARS asked about practices of self-dealing that
could be addressed outside of Amendment 2.
REPRESENTATIVE GRAY responded that a bill stopping self-dealing
practices would not be widely supported.
4:54:35 PM
CHAIR MINA said she would not support Amendment 2.
4:55:29 PM
A roll call vote was taken. Representative Gray voted in favor
of Amendment 2 to HB 144, Version N. Representatives Prax,
Ruffridge, Schwanke, Mears, Fields, and Mina voted against it.
Therefore, Amendment 2 failed to be adopted by a vote of 1-6.
4:56:36 PM
REPRESENTATIVE GRAY asked the sponsor of the bill to address how
all entities would save money under HB 144, Version N.
REPRESENTATIVE RUFFRIDGE responded that the prior authorization
process requires a large workload, which increases their cost.
He said HB 144, Version N, would increase efficiency and
decrease the employees needed to complete the prior
authorization process, thus decreasing the cost to treat
patients.
5:00:41 PM
REPRESENTATIVE MEARS moved to report CSHB 144, Version 34-
LS0780\N, Wallace, 4/1/25, out of committee with individual
recommendations and the accompanying fiscal notes. There being
no objection, CSHB 144 (HSS) was reported out of the House
Health and Social Services Standing Committee.
5:01:16 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:01 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 96 Combined Testimony 04.08.25.pdf |
HHSS 4/8/2025 3:15:00 PM |
HB 96 |
| HB 144 Combined Testimony as of 4.7.25.pdf |
HHSS 4/8/2025 3:15:00 PM |
HB 144 |
| HB 144 Amendment N.2.pdf |
HHSS 4/8/2025 3:15:00 PM |
HB 144 |
| HB 96 Amendment I.1.pdf |
HHSS 4/8/2025 3:15:00 PM |
HB 96 |
| HB 96 Amendment I.2.pdf |
HHSS 4/8/2025 3:15:00 PM |
HB 96 |