Legislature(2025 - 2026)DAVIS 106
05/13/2025 03:15 PM House HEALTH & SOCIAL SERVICES
Note: the audio ![]()
and video ![]()
recordings are distinct records and are obtained from different sources. As such there may be key differences between the two. The audio recordings are captured by our records offices as the official record of the meeting and will have more accurate timestamps. Use the icons to switch between them.
| Audio | Topic |
|---|---|
| Start | |
| SJR16|| HJR17 | |
| HB147 | |
| HB149 | |
| SJR15 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 147 | TELECONFERENCED | |
| + | SJR 15 | TELECONFERENCED | |
| + | HB 149 | TELECONFERENCED | |
| + | SB 134 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| + | SJR 16 | TELECONFERENCED | |
| += | HJR 17 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
May 13, 2025
3:22 p.m.
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
SENATE JOINT RESOLUTION NO. 16
Urging the United States Congress to pass the Ensuring Lasting
Smiles Act; and urging lawmakers to advocate for policies that
guarantee equitable access to vital healthcare.
- MOVED SJR 16 OUT OF COMMITTEE
HOUSE JOINT RESOLUTION NO. 17
Urging the United States Congress to pass the Ensuring Lasting
Smiles Act; and urging lawmakers to advocate for policies that
guarantee equitable access to vital healthcare.
- HEARD & HELD
HOUSE BILL NO. 147
"An Act relating to the practice of naturopathy."
- HEARD & HELD
HOUSE BILL NO. 149
"An Act relating to pharmacy benefits managers; relating to
third-party administrators; and providing for an effective
date."
- HEARD & HELD
CS FOR SENATE JOINT RESOLUTION NO. 15(HSS)
Calling on the state's congressional delegation to oppose cuts
to federal spending on Medicaid.
- MOVED CSSJR 15(HSS) OUT OF COMMITTEE
PREVIOUS COMMITTEE ACTION
BILL: SJR 16
SHORT TITLE: FEDERAL ENSURING LASTING SMILES ACT
SPONSOR(s): SENATOR(s) GRAY-JACKSON
04/02/25 (S) READ THE FIRST TIME - REFERRALS
04/02/25 (S) HSS
04/10/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/10/25 (S) Heard & Held
04/10/25 (S) MINUTE(HSS)
04/22/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/22/25 (S) Moved SJR 16 Out of Committee
04/22/25 (S) MINUTE(HSS)
05/05/25 (S) HSS RPT 4DP 1NR
05/05/25 (S) DP: DUNBAR, CLAMAN, TOBIN, GIESSEL
05/05/25 (S) NR: HUGHES
05/12/25 (S) TRANSMITTED TO (H)
05/12/25 (S) VERSION: SJR 16
05/13/25 (H) HSS AT 3:15 PM DAVIS 106
BILL: HJR 17
SHORT TITLE: FEDERAL ENSURING LASTING SMILES ACT
SPONSOR(s): REPRESENTATIVE(s) GALVIN
04/09/25 (H) READ THE FIRST TIME - REFERRALS
04/09/25 (H) HSS
05/06/25 (H) HSS AT 3:15 PM DAVIS 106
05/06/25 (H) Heard & Held
05/06/25 (H) MINUTE(HSS)
05/13/25 (H) HSS AT 3:15 PM DAVIS 106
BILL: HB 147
SHORT TITLE: PRACTICE OF NATUROPATHY
SPONSOR(s): REPRESENTATIVE(s) PRAX
03/21/25 (H) READ THE FIRST TIME - REFERRALS
03/21/25 (H) HSS, L&C, FIN
04/15/25 (H) HSS AT 3:15 PM DAVIS 106
04/15/25 (H) -- MEETING CANCELED --
04/22/25 (H) HSS AT 3:15 PM DAVIS 106
04/22/25 (H) Heard & Held
04/22/25 (H) MINUTE(HSS)
05/13/25 (H) HSS AT 3:15 PM DAVIS 106
BILL: HB 149
SHORT TITLE: PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN
SPONSOR(s): LABOR & COMMERCE
03/21/25 (H) READ THE FIRST TIME - REFERRALS
03/21/25 (H) L&C, HSS
03/26/25 (H) L&C AT 3:15 PM BARNES 124
03/26/25 (H) <Bill Hearing Canceled>
03/31/25 (H) L&C AT 3:15 PM BARNES 124
03/31/25 (H) Heard & Held
03/31/25 (H) MINUTE(L&C)
05/05/25 (H) L&C AT 3:15 PM BARNES 124
05/05/25 (H) Moved HB 149 Out of Committee
05/05/25 (H) MINUTE(L&C)
05/07/25 (H) L&C RPT 3DP 3NR
05/07/25 (H) DP: BURKE, CARRICK, HALL
05/07/25 (H) NR: COULOMBE, SADDLER, NELSON
05/13/25 (H) HSS AT 3:15 PM DAVIS 106
BILL: SJR 15
SHORT TITLE: OPPOSE MEDICAID CUTS
SPONSOR(s): HEALTH & SOCIAL SERVICES
03/19/25 (S) READ THE FIRST TIME - REFERRALS
03/19/25 (S) HSS
03/20/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/20/25 (S) <Bill Hearing Canceled>
03/25/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/25/25 (S) Heard & Held
03/25/25 (S) MINUTE(HSS)
03/27/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/27/25 (S) Heard & Held
03/27/25 (S) MINUTE(HSS)
04/01/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/01/25 (S) Moved CSSJR 15(HSS) Out of Committee
04/01/25 (S) MINUTE(HSS)
04/07/25 (S) HSS RPT CS 3DP 1DNP SAME TITLE
04/07/25 (S) DP: GIESSEL, CLAMAN, TOBIN
04/07/25 (S) DNP: HUGHES
05/08/25 (H) HSS AT 3:15 PM DAVIS 106
05/08/25 (H) <Bill Hearing Canceled>
05/09/25 (S) TRANSMITTED TO (H)
05/09/25 (S) VERSION: CSSJR 15(HSS)
05/10/25 (H) READ THE FIRST TIME - REFERRALS
05/10/25 (H) HSS
05/13/25 (H) HSS AT 3:15 PM DAVIS 106
WITNESS REGISTER
SENATOR ELVI GRAY-JACKSON
Alaska State Legislature
Juneau Alaska
POSITION STATEMENT: As prime sponsor, presented SJR 16.
AMBER FIGUEROA, DO, representing self
Fairbanks, Alaska
POSITION STATEMENT: Testified during the hearing on HB 147.
SEAN HIGGINS, MD
No Address Provided
POSITION STATEMENT: Had his written testimony read by Gene
Therriault during the hearing on HB 147.
COURTNEY BOWERS, ND
Vermont Naturopathic Doctors
Burlington, Vermont
POSITION STATEMENT: Testified during the hearing on HB 147.
NATALIE WIGGINS, ND
Alaska Association of Naturopathic Doctors
Anchorage, Alaska
POSITION STATEMENT: Testified during the hearing on HB 147.
SYLVAN ROBB, Director
Division of Corporations, Business, and Professional Licensing
Department of Commerce, Community and Economic Development
Juneau, Alaska
POSITION STATEMENT: Answered questions during the hearing on HB
147.
HEATHER CARPENTER, Deputy Director
Division of Insurance
Department of Commerce, Community & Economic Development
Juneau, Alaska
POSITION STATEMENT: Provided information during the hearing on
HB 149.
SETH TAGARIAN, Staff
Senator Forrest Dunbar
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: On behalf of Senator Dunbar, prime sponsor,
presented CSSJR 15(HSS).
ACTION NARRATIVE
3:22:35 PM
CHAIR GENEVIEVE MINA called the House Health and Social Services
Standing Committee meeting to order at 3:22 p.m.
Representatives Schwanke, Ruffridge, Mears, Gray, Fields, Prax,
and Mina were present at the call to order.
SJR 16-FEDERAL ENSURING LASTING SMILES ACT
HJR 17-FEDERAL ENSURING LASTING SMILES ACT
3:23:14 PM
CHAIR MINA announced that the first order of business would be
SENATE JOINT RESOLUTION NO. 16, Urging the United States
Congress to pass the Ensuring Lasting Smiles Act; and urging
lawmakers to advocate for policies that guarantee equitable
access to vital healthcare and HOUSE JOINT RESOLUTION NO. 17,
Urging the United States Congress to pass the Ensuring Lasting
Smiles Act; and urging lawmakers to advocate for policies that
guarantee equitable access to vital healthcare.
3:23:39 PM
SENATOR ELVI GRAY-JACKSON, Alaska State Legislature, as prime
sponsor, presented SJR 16. She thanked the committee for
supporting the resolution. She stated that the resolution will
provide support for those with [congenital] anomalies,
referencing both the costs of care for such conditions and
witness testimony during earlier committee sessions.
3:24:58 PM
REPRESENTATIVE MEARS moved to report SJR 16 out of committee
with individual recommendations and the accompanying fiscal
notes. There being no objection, SJR 16 was reported out of the
House Health and Social Services Standing Committee.
3:25:16 PM
The committee took an at-ease from 3:25pm to 3:27pm
HB 147-PRACTICE OF NATUROPATHY
3:27:27 PM
CHAIR MINA announced that the next order of business would be
HOUSE BILL NO. 147, "An Act relating to the practice of
naturopathy."
CHAIR MINA opened public testimony on HB 147.
3:27:56 PM
AMBER FIGUEROA, DO, representing self, stated that her younger
sister was diagnosed with colon cancer and died at 42, leaving
behind three children. Her sister's primary care provider was a
naturopath who attributed her anemia to a heavy period. When
her sister sought help through traditional medicine during an
emergency room visit, she was told to follow up with her primary
care provider, whom Dr. Figueroa said did not know how to
navigate her into the Western medicine system to have various
procedures related to the cancer performed. According to
Figueroa DO, by the time her sister's cancer was found, it had
metastasized into her liver and abdomen. Dr. Figueroa stated
that while her testimony was not related to whether or not to
prescribe naturopathy, it highlighted two points: those who
seek naturopathy are not looking for prescription medication;
and she does not prescribe these remedies not because she
doesn't think that they work, but because she is not trained in
naturopathy, as she is a licensed family physician. To
illustrate her second point, she stated that despite having over
twenty years of training in pharmacology, she is constantly
looking up new medicines and consulting her colleague
pharmacologist on them, as pharmacology is "a huge and changing
world, even for those of us who have extensive education in it."
She stated that if naturopaths wanted to prescribe traditional
medicine, they should be trained in Western medicine, as there
exist several paths of them to attain the relevant credentials.
She acknowledged that while there is a healthcare provider
shortage, she does not think naturopaths offer a solution to
said shortage. She attributed this belief to losing someone
whom she says was untrained in the medical profession, and she
doesn't wish the same on anyone.
3:30:18 PM
SEAN HIGGINS, MD, had his written testimony regarding HB 147
read by Gene Therriault, as follows:
Good afternoon, my name is Sean Higgins, I am an ER
physician working in Alaska Regional Hospital. Before
becoming an Alaskan, I worked in several medical
communities in Washington State, where licensed
naturopaths were permitted to work with a broad scope
of practice.
As an ER doctor, I am seeing more and more patients
come in for things that should be managed by a primary
care provider. These include medication refills,
antibiotics for urinary tract infections, management
of chronic ... conditions such as diabetes and high
blood pressure. During a typical shift, I estimate
that around 30 percent of the patients I see in the ER
are for primary care related medical concerns, not
emergencies.
This not only equates to expensive and uncertain bills
for the patient, but is putting a huge strain on our
staffing and resources in the emergency room. Our
wait times have increased tremendously and patients
with emergencies are not always getting the prompt
attention they need. The shortage of primary care
providers ... forces emergency medicine doctors to
practice on the fringes or even outside our scope of
expertise. Patients receiving primary care in the ER
from providers who are not trained in primary care
receive a disservice. The lack of consistency and
follow-up they receive in this scenario is not in
alignment with ... the goals and principles of primary
care. This is all detrimental to the patient and to
Alaska.
Allowing naturopathic doctors to practice to the
extent of their training will increase the amount of
primary care providers in Alaska. It will give
patients more access to primary care, thus relieving
the pressure on emergency rooms. I have many working
professional relationships with naturopathic providers
from Alaska and Washington. As you've heard
previously, pharmaceutical curriculum at four-year
doctoral programs for naturopathic medicine is
comparable, or maybe even identical, to the courses I
took at the UVA medical school for allopathic doctors.
These providers use the same textbooks and study
programs ... for their license exams as I did. I've
previously witnessed naturopathic colleagues manage
prescriptive medication safely and effectively to
promote primary care in Washington patients. I'm
baffled that here in Alaska, naturopathic providers
need to refer their patients to a PA [physician
assistant] or a nurse practitioner for medication
management when I know that naturopathic doctors have
more rigorous and lengthy training. This situation
defies logic.
In my experience, naturopathic doctors are thoughtful,
deliberate, and forward thinking. By allowing
naturopathic doctors to practice to the full extent of
their training, you are helping Alaskans receive the
primary and preventative care they need, keeping them
healthier and out of the emergency room.
Thank You.
3:34:06 PM
COURTNEY BOWERS, ND, Vermont Naturopathic Doctors, stated that
Vermont and Alaska were similar in that both suffer from a
shortage of primary care providers. In response to this
shortage, the Vermont State Legislature passed a law allowing
naturopaths to prescribe medication according to their training.
Prior to this action, naturopaths had a limited formulary. With
the new bill, naturopathic doctors are required to pass an
additional board examination that consists of their first 100
prescriptions or first year of prescriptions to be reviewed by a
supervising licensed medical provider in good standing, licensed
naturopathic doctor, or naturopathic doctor with at least five
years of prescribing experience under full prescription
authority. She drew upon her own experience of the
certification process for illustration purposes. According to
her testimony, the passage of the bill did not correspond to an
increase in complaints to medical doctors regarding
prescriptions, which she attested to as the appointed advisor to
her state's Office of Professional Regulation, which oversees
her profession. She continued, stating that she has not had a
problem finding a physician that oversees prescription review.
She said that the bill had been incredibly successful in
providing primary care to patients, as services allowed by the
bill provided a means by which patients could be matched to
appropriate medication and for naturopathic doctors to practice
to their fullest scope of expertise.
3:36:59 PM
NATALIE WIGGINS, ND, Alaska Association of Naturopathic Doctors,
began her testimony by expressing her condolences to Dr.
Figueroa over the death of her sister. She expressed her
concerns with testimonies like Dr. Figueroa, as there is a
misnomer between someone who is a licensed naturopathic doctor
and someone who refers to themselves as a naturopath. The
difference between the two is that naturopaths do not have much
in the way of rigorous course of study or oversight and that
naturopathic doctors by contrast are trained primarily as
primary care providers. This gives the latter the knowledge and
experience to navigate the healthcare system, make careful
diagnoses, and thus prescribe medication. She further went on
to say that prescribing authority is not a "Western medicine
modality, but it is a primary care modality." Thus, due to this
modality, and that licensed naturopathic doctors are trained in
pharmacology in ways like MDs, the concerns raised by Dr.
Figueroa testimony would not apply to this bill
DR. WIGGINS stated that another misnomer in discussions
surrounding the prescribing authority of naturopathic doctors
that nurse practitioners (NPs) are trained in Western medicine
and naturopaths are not. Further, there are various
similarities between NP training and naturopathic training,
especially because neither requires the completion of a
residency and that in Alaska, nurse practitioners have a very
broad scope of practice without a required residency. She
continued, saying that both Alaska nurse practitioners and NDs
have faced similar opposition from "a very selective, small
group of MDs in the state that have a loud voice" over the
practices of each respective group. She further stated that the
views are not representative of the medical paradigm within
Alaska and that the situation has resulted in a "nonsensical
turf war" between both naturopathic doctors and MDs and has
taken from efforts to address the needs of patients in Alaska.
She expressed support for the expansion of prescribing authority
within the bill, stating that it was simply an update to
existing law that reflected the scope of training for
naturopathic doctors. Drawing on her comparison between the
opposition faced by NPs and NDs from "some of the select MD
community," Dr. Wiggins stated that when the former group asked
for similar authorities 24 years prior it resulted in NPs now
serving an important role in the health care system in Alaska.
Thus, indicating the evidence presented by both Dr. Higgins and
Dr. Bowers, as well as her own work experience in Arizona, Dr.
Wiggins stated that naturopathic doctors could serve a similar
role.
3:42:09 PM
CHAIR MINA, after ascertaining that no one else wished to
testify, closed public testimony on HB 147.
3:42:31 PM
REPRESENTATIVE GRAY commented that since the state currently has
a shortage of primary care providers, "rather than having these
turf wars and saying, you know, that this particular provider is
better than that particular provider," many Alaskans would
prefer to see a naturopath and that their four year course of
training was adequate for the authorities the bill would provide
them. Thus, he supported HB 147.
3:43:21 PM
REPRESENTATIVE PRAX, as prime sponsor of HB 147, asked to hear a
question indicated by Representative Mears for Dr. Bowers.
3:43:41 PM
REPRESENTATIVE MEARS asked Dr. Bowers a question pertaining to a
state agency providing oversight in Vermont.
DR. BOWERS responded that the agency that provided that was the
Office of Professional Regulation under the authority of the
Vermont Secretary of State that oversees many professions, as it
provides licenses to said professions when appropriate. The way
these professions are managed leans towards an advisor model, as
the secretary of state overseeing said office appoints various
people from those professions to a committee dealing with
complaints and concerns over public safety specific to their
profession. Dr. Bowers herself has been serving on the board
for three years and has not had one complaint regarding a
prescribing situation.
REPRESENTATIVE MEARS asked Dr. Bowers a follow-up question
pertaining to how much of a parallel current State Boards of
Medicine, Midwives, and Nurse Practitioners would be to the
board Dr. Bowers is describing or if the board Dr. Bowers is
describing includes other professions.
DR. BOWERS answered that there are parallels between board
structures in both states, that this structure is provided by
the State of Vermont, and that she serves on said board as an
appointed volunteer. She currently serves alone on the board,
though others could serve on it later should resources be
allocated by the legislature.
3:47:33 PM
REPRESENTATIVE PRAX asked if Rob Sylvan was present and if she
could explain how naturopathic doctor prescribing authority
could work with a supervisory board.
3:48:01 PM
SYLVAN ROBB, Director, Division of Corporations, Business, and
Professional Licensing, Department of Commerce, Community and
Economic Development, stated that naturopathy is a profession
not regulated by the board but rather is regulated by the
division. In response to a follow-up question, she explained
that such a complaint against naturopaths would be investigated
by division affiliated, certified investigators, and the
division would assign an appropriate course of disciplinary
action should a violation be found. If such action required
naturopathic knowledge, the board would engage with a naturopath
to determine specific disciplinary action.
3:49:57 PM
CHAIR MINA asked Ms. Robb which other professions receive
similar regulatory oversight from the division rather than their
own board.
MS. ROBB answered that there are several professions under
similar oversight, including acupuncturist, behavioral
analysist, dietitians, nutritionists, athletic trainers,
audiologists, and speech language pathologists.
CHAIR MINA asked Ms. Robb if any of the professions she
mentioned in her answer to Representative Mears' original
question have prescribing authority.
MS. ROBB answered they do not.
3:51:09 PM
REPRESENTATIVE MEARS asked Ms. Robb how the disciplinary process
for professions overseen directly by the division would work.
MS. ROBB answered that there was no specific individual assigned
to each case because of a need to avoid conflicts of interest
with each induvial case. Beyond those concerns, the division
would then look for someone with expertise in a specific subject
matter regarding the case. As an example, since the bill in
question concerns the prescribing authority of naturopathic
doctors, investigators assigned to a case regarding a complaint
against a naturopathic doctor would have expertise in
pharmacology.
REPRESENTATIVE MEARS, in follow-up, asked Ms. Robb how such
expertise would be determined, and if a process for doing so is
already in place or would need to be created.
MS. ROBB replied that such records are maintained by the
licensing agency and that investigators are referred to
individual cases by other professionals within the licensing
agency's database.
3:53:32 PM
REPRESENTATIVE PRAX, regarding testimony of Dr. Figueroa,
expressed his condolences to Dr. Figueroa, stating that both he
and his wife were "shopping around" for primary care providers
when his wife became interested in naturopathic medicine. They
were able to find someone that was best suited to both of their
needs, he emphasized there can be, in both naturopathic and the
"licensed medical" profession, a great deal of variability when
it comes to professional ethics. Representative Prax stated
that he hopes that the passage of HB 147 provides a "better
guideline" for practitioners and that the public would have a
greater sense of trust in someone who has been certified in
contrast to someone who hasn't been certified. In doing so, he
argued that the state medical profession would be able to "get
over some of what really are turf wars in many of these cases"
and thus help the public access primary care.
3:55:48 PM
REPRESENTATIVE GRAY, speaking of the concerns raised by
Representative Mears regarding oversight, stated that he had
several questions as to why a separate board could not have
oversight over naturopathic doctors. He elaborated, stating
that various medical boards don't want to have oversight of
naturopathic professionals. Further, he stated that there are
currently not enough naturopathic doctors in the state for the
creation of a separate board to be created for naturopathy. He
stated that by passing HB 147, the state would be able to
attract more qualified naturopaths, and a board could thus be
created later. At such a point, the legislation surrounding
naturopathy could be revisited in the future.
3:56:51 PM
CHAIR MINA asked Ms. Robb to confirm that naturopathic doctors
were currently being regulated through the Division of
Corporations, Business, and Professional Licensing
MS. ROBB responded that it is correct.
CHAIR MINA asked how many complaints there had been against
naturopathic doctors since naturopathic the profession has been
under regulatory oversight.
MS. ROBB answered that she did not have a specific number of
complaints made against naturopathic doctors since they were
under such regulatory oversight but could give accurate figures
for the past several fiscal years, which could be sent to Chair
Mina later.
CHAIR MINA asked for the specific number of complaints for the
past fiscal year.
MS. ROBB stated that she would provide that information.
3:57:53 PM
REPRESENTATIVE SCHWANKE expressed support for the bill, stating
that there were some good comments made. She thanked
Representative Gray for pointing out that there aren't that many
naturopathic doctors in Alaska, and that HB 147 offered the
state "an opportunity to move forward in a positive manner."
She further expressed support for the physician oversight, exam
requirements, and the continuing education provisions in the
bill, that similar provisions existed in other states with no
complaints, and that many of the state's residents have had
positive interactions with naturopaths, herself included, siting
her personal experience where her medical provider recommended
exploratory surgery when a naturopath did not think this was
necessary.
3:59:39 PM
CHAIR MINA noted that she had received an amendment from
Representative Prax.
3:59:53 PM
REPRESENTATIVE PRAX said he did not want to offer the amendment
now.
4:00:09 PM
CHAIR MINA announced that HB 147 was held over.
HB 149-PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN
4:00:18 PM
CHAIR MINA announced that the final order of business would be
HOUSE BILL NO. 149, "An Act relating to pharmacy benefits
managers; relating to third-party administrators; and providing
an effective date."
4:01:02 PM
REPRESENTATIVE FIELDS, as prime sponsor, presented HB 149 by
reading the sponsor statement [in the committee file], which
read as follows [original punctuation provided]:
House Bill 149 will require Third-Party Administrators
(TPAs) and Pharmacy Benefits Managers (PBMs) to be
licensed in the state of Alaska and outlines a
licensing fee that reflects the Division of
Insurance's cost of managing said licensure.
Currently, the state requires only registration for
these entities. Registration provides a basic level of
verification; in contrast, licensure is a legally
mandated process granting the right to practice a
profession. Moving to licensure gives the Division of
Insurance the same authority over TPAs and PBMs that
they hold over any other licensed business entity.
Insurers continue to out-source many core functions to
external entities such as PBMs and TPAs, with staff
managing vendor contracts instead of performing those
functions internally. Since TPAs and PBMs operate as
separate business entities, they are not regulated as
an insurer under a Certificate of Authority (COA) nor
a firm under a license. This shift has created
pathways to circumvent Alaska insurance code, thereby
increasing division staff time dedicated to clarifying
legal questions from TPAs. If a TPA or a PBM is not an
insurance carrier with a COA, they should be a license
holder with a license.
Last year the Alaska State Legislature passed House
Bill 226 that pertained to PBM business practices.
During the committee process, language incorporating
PBMs into the examination of insurers' statutes from
AS 21.06.120 AS 21.06.160 was not addressed. HB 149
addresses this omission to ensure the division is
meeting the intent of the legislature in regulating
PBMs, including conducting Market Conduct Exams when
concerning business practices occur. In addition, the
legislation certifies that PBMs are treated the same
as insurance agencies, by making them responsible for
the cost of these exams.
Please join me in supporting HB 149 to allow the
Division of Insurance to regulate Third-Party
Administrators and Pharmacy Benefit Managers as
licensees in the state of Alaska.
4:02:08 PM
REPRESENTATIVE RUFFRIDGE noted that House Bill 226 had been
sponsored by Representative Sumner.
4:02:25 PM
REPRESENTATIVE GRAY asked to hear from the administration.
4:02:43 PM
HEATHER CARPENTER, Deputy Director, Division of Insurance,
Department of Commerce, Community & Economic Development, stated
that HB 149 was a "clean-up" bill. She explained that when the
legislature had considered the implementation of House Bill 226,
a loophole was found where pharmacy benefits managers (PBMs)
could push back if the State of Alaska were conducting a market
conduct exam in response to patterns it found concerning.
Enacting HB 149 would move third-party administrators (TPAs) and
PBMs to full licensure and would require PBMs to pay for the
cost of the market conduct exam should they be under
investigation. Such categorization would provide regulatory
clarity to both TPAs and PBMs since there exists a different
regulatory scheme if such entities are registered as opposed to
if they were licensed.
REPRESENTITIVE GRAY expressed support for HB 149.
4:04:32 PM
CHAIR MINA opened public testimony on HB 149. After
ascertaining there was no one who wished to testify, she closed
public testimony.
4:05:16 PM
CHAIR MINA announced that HB 149 was held over.
SJR 15-OPPOSE MEDICAID CUTS
4:05:20 PM
CHAIR MINA announced that the final order of business would be
CS FOR SENATE JOINT RESOLUTION NO. 15(HSS), Calling on the
state's congressional delegation to oppose cuts to federal
spending on Medicaid.
4:05:44 PM
SETH TAGARIAN, Staff, Senator Forrest Dunbar, on behalf of
Senator Dunbar, prime sponsor, gave the sponsor statement for
CSSJR 15(HSS) [in the committee file], which read as follows
[original punctuation provided]:
Senate Joint Resolution 15 calls on Alaska's
congressional delegation to oppose proposed federal
cuts to Medicaid. More than 250,000 Alaskansincluding
children, seniors, people with disabilities, and low-
income adultsrely on Medicaid and the Children's
Health Insurance Program (CHIP) for essential health
services. These cuts would be devastating to our
families, communities, and economy.
Rural and remote communities depend on Medicaid at
higher rates due to a shortage of providers, expensive
travel, and limited access to employer-sponsored
insurance. Medicaid is also a cornerstone of Alaska's
Tribal health system and supports nearly 100,000
children and covers almost 40 percent of births
annually.
Federal Medicaid funding represents more than $2
billion each year, 78 percent of the program's cost in
our state. Slashing this funding would force Alaska to
consider drastic reductions in coverage, benefits, or
provider payments, putting lives and livelihoods at
risk. Beyond direct health care impacts, Medicaid
sustains a vital segment of Alaska's economy. It
supports high-quality union jobs, strengthens small
businesses by providing health care coverage to
workers, and ensures that seniors and individuals with
disabilities can remain in their homes and communities
with dignity.
Proposed federal cutsnearly $880 billion over 10
yearswould endanger these benefits. SJR 15 urges our
congressional delegation to protect the health and
economic security of Alaskans by rejecting these cuts.
4:07:41 PM
The committee took an at-ease from 4:07 p.m. to 4:08 p.m.
4:08:14 PM
CHAIR MINA opened public testimony on CSSJR 15(HSS). After
ascertaining that there was no one who wished to testify, she
closed public testimony.
4:08:43 PM
CHAIR MINA noted there had been a meeting regarding cuts to
Medicaid and stated it was clear that many Alaskans are
benefactors to Medicaid. She thanked Senator Dunbar for putting
forward this resolution.
4:09:13 PM
REPRESENTATIVE MEARS moved to report CSSJR 15(HSS) out of
committee with individual recommendations and the accompanying
fiscal notes. There being no objection, CSSJR 15(HSS) was
reported out of the House Health and Social Services Standing
Committee.
4:09:50 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 4:10 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB149-DCCED-DOI-03-21-25.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 149 |
| HB 149 - Sectional Analysis v.A.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 149 |
| HB 149 Combined Bill Packet 05.12.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 149 |
| HB 149 - Sponsor Statement v.A.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 149 |
| HB0149A.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 149 |
| SJR 15 Fiscal Note LEG SESS 3.19.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
SJR 15 |
| SJR 15 Sponsor Statement Version I 4.7.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
SJR 15 |
| SJR 15 Supporting Letters Recieved as of 4.7.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
SJR 15 |
| SJR 15 Combined Bill Packet 05.12.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
SJR 14 |
| SJR 15 Version I 4.7.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
SJR 15 |
| HB 147 Amendment #1 G.1.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 147 |
| HB 147 LOS 04.18.25.pdf |
HHSS 5/13/2025 3:15:00 PM |
HB 147 |