04/03/2025 03:15 PM House HEALTH & SOCIAL SERVICES
| Audio | Topic |
|---|---|
| Start | |
| HB52 | |
| HB144 | |
| Adjourn |
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 52 | TELECONFERENCED | |
| *+ | HB 144 | TELECONFERENCED | |
| *+ | HB 151 | TELECONFERENCED | |
| + | TELECONFERENCED |
ALASKA STATE LEGISLATURE
HOUSE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 3, 2025
3:20 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. 52
"An Act relating to the rights of minors undergoing evaluation
or inpatient treatment at psychiatric hospitals; relating to the
use of seclusion or restraint of minors at psychiatric
hospitals; relating to a report published by the Department of
Health; relating to inspections by the Department of Health of
certain psychiatric hospitals; and providing for an effective
date."
- HEARD & HELD
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."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: HB 52
SHORT TITLE: MINORS & PSYCHIATRIC HOSPITALS
SPONSOR(s): REPRESENTATIVE(s) DIBERT
01/22/25 (H) READ THE FIRST TIME - REFERRALS
01/22/25 (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)
04/03/25 (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
WITNESS REGISTER
REPRESENTATIVE MAXINE DIBERT
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 52.
MATTIE HULL, Staff
Representative Maxine Dibert
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Dibert, prime
sponsor, answered questions regarding HB 52.
KIM SWISHER, Deputy Director
Office of Children's Services
Department of Family and Community Service
Anchorage, Alaska
POSITION STATEMENT: Answered questions regarding HB 52.
ROBERT NAVE, Division Operations Manager
Division of Health Care Services
Department of Health
Anchorage, Alaska
POSITION STATEMENT: Answered questions regarding HB 52.
SETH GREEN, MD
Behavioral Health Clinical Supervisor
Aleutian Pribilof Islands Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 52.
REPRESENTATIVE JUSTIN RUFFRIDGE
Alaska State Legislature
Juneau, Alaska
POSITION STATEMENT: As prime sponsor, presented HB 144.
BUD SEXTON, Staff
Representative Justin Ruffridge
Juneau, Alaska
POSITION STATEMENT: On behalf of Representative Ruffridge,
prime sponsor, answered questions regarding HB 144.
JARED KOSIN, President and CEO
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Answered questions regarding HB 144.
JARED KOSIN
President and CEO
Alaska Hospital and Healthcare Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 144.
GARY STRANNIGAN, Vice President
Congressional and Legislative Affairs
Premera Blue Cross Blue Shield of Alaska
Everett, Washington
POSITION STATEMENT: Testified in support of HB 144.
PAM VENTGEN, Executive Director
Alaska State Medical Association
Anchorage, Alaska
POSITION STATEMENT: Testified in support of HB 144.
ACTION NARRATIVE
3:20:21 PM
CHAIR GENEVIEVE MINA called the House Health and Social Services
Standing Committee meeting to order at 3:20 p.m.
Representatives Prax, Gray, Mears, Ruffridge, Schwanke, and Mina
were present at the call to order. Representative Fields
arrived as the meeting was in progress.
HB 52-MINORS & PSYCHIATRIC HOSPITALS
3:21:01 PM
CHAIR MINA announced that the first order of business would be
HOUSE BILL NO. 52, "An Act relating to the rights of minors
undergoing evaluation or inpatient treatment at psychiatric
hospitals; relating to the use of seclusion or restraint of
minors at psychiatric hospitals; relating to a report published
by the Department of Health; relating to inspections by the
Department of Health of certain psychiatric hospitals; and
providing for an effective date." [Before the committee,
adopted as a working document on 3/25/25, was the proposed
committee substitute (CS) for HB 52, Version 34-LS0399\N,
Radford, 3/24/25 ("Version N").]
3:21:25 PM
REPRESENTATIVE MAXINE DIBERT, Alaska State Legislature, as prime
sponsor, provided a brief recap of HB 52, Version N. She
explained that Version N would include three straightforward
reforms: expand rights of parents to communicate with their
children receiving care; require unannounced thorough
inspections by state public health officials twice annually; and
ensure that facilities are transparent about their use of
physical and chemical restraints and seclusion.
3:25:00 PM
MATTIE HULL, Staff, Representative Maxine Dibert, on behalf of
Representative Dibert, prime sponsor, answered questions
regarding HB 52, Version N, from the previous hearing on the
bill. He said that Version N would not be duplicative, but
expansive, of current patients' rights while in psychiatric
treatment facilities. He said that 35 students would be
interviewed from two different facilities twice a year. He
added that inspections under HB 52, Version N, would be
unannounced to ensure the authenticity of their results.
3:28:41 PM
REPRESENTATIVE GRAY asked about medications that are being used
as both restraints and medications and how that would affect the
need for substance use to be reported.
MR. HULL responded that chemical restraints are drugs used on a
patient for discipline or convenience but not required to treat
medical systems. He added that he would be willing to clarify
this distinction through an amendment to Version N.
REPRESENTATIVE GRAY expressed a concern that Version N would
allow facilities to do something and not report it, such as
overprescribing a drug that a child already takes.
3:32:23 PM
KIM SWISHER, Deputy Director, Office of Children's Services
(OCS), Department of Family and Community Service (DFCS),
responded that she may not be the best to answer the question
from Representative Gray.
3:32:48 PM
ROBERT NAVE, Division Operations Manager, Division of Health
Care Services (DHCS), Department of Health (DOH), responded that
there should be a record of all drug administration at the
facility.
3:33:28 PM
REPRESENTATIVE RUFFRIDGE asked what current inspections of these
facilities look like and if unannounced inspections, under HB
52, Version N, would replace current inspections.
MR. HULL responded that all hospital inspections are
unannounced, according to Medicaid standards. However,
hospitals are allowed to contract out private agencies to
conduct these inspections. He does not know the frequency of
current inspections.
MR. NAVE added that the unannounced inspections under the
proposed legislation would be in addition to current inspections
of the facilities.
REPRESENTATIVE RUFFRIDGE asked again if current inspections are
unannounced.
MR. NAVE responded that that is correct.
REPRESENTATIVE RUFFRIDGE asked when the last time the
psychiatric facilities underwent inspections.
MR. NAVE responded that he does not have the last date of the
inspections.
REPRESENTATIVE RUFFRIDGE asked about the frequency of current
inspections.
MR. HULL responded that the inspections occur at least annually.
REPRESENTATIVE RUFFRIDGE asked about the safety of interviewers
if they are required to conduct interviews alone.
MR. HULL responded that he would work to clear up that concern.
3:37:50 PM
REPRESENTATIVE FIELDS said that the mistreatment of children in
hospitals has cost the state much more money than it would cost
to keep these vulnerable patients safe.
3:38:55 PM
REPRESENTATIVE SCHWANKE asked about who would approve
communication between patients and their families.
MR. HULL responded that treatment plans are not always overseen
by a physician but by other high-level staff, who could approve
of this communication.
REPRESENTATIVE SCHWANKE asked for clearer language regarding who
can approve communications.
CHAIR MINA explained that the original language of the bill
seemed too restrictive.
3:41:33 PM
MR. NAVE said that less restrictive language would include
mental health clinicians, psychiatrists, and other healthcare
professionals.
REPRESENTATIVE SCHWANKE expressed concern regarding a broad
range of individuals being allowed to approve or deny
communications.
3:42:38 PM
CHAIR MINA asked if Version N would have more restrictive rights
for minors, limiting length of video calls with families.
MR. HULL responded that the proposed legislation would not set a
maximum number of communications per week but would set a
minimum of one hour per week.
3:44:38 PM
REPRESENTATIVE GRAY asked what the facility is responsible for
if a patient does not want to spend one hour in communication
with their family.
REPRESENTATIVE DIBERT responded that she is not sure how that
situation would look and she would have to investigate that
question more deeply.
3:47:07 PM
MS. SWISHER responded that currently, if a youth does not want
to speak with their family, then the facility does not force it.
3:47:41 PM
REPRESENTATIVE GRAY emphasized that he does not want a facility
to be able to say communication did not happen because the child
did not want to, whether the child truly said that or not.
3:48:43 PM
REPRESENTATIVE RUFFRIDGE emphasized that HB 52, Version N, would
give the right, not the requirement, of a child to have
communication with their guardian. He suggested also giving
parents and guardians the right to communicate with their
children in psychiatric facilities.
MR. HULL responded that the rights of parents are also very
important and he would like to encourage parents to reach out to
their children in psychiatric facilities.
3:50:57 PM
REPRESENTATIVE GRAY emphasized cases of nonverbal children, who
may not be able to ask for the opportunity to communicate with
their guardian.
3:51:57 PM
CHAIR MINA returned to her question regarding restrictions that
HB 52 would place on the rights to communicate that currently
exist under psychiatric rights law.
MR. HULL responded that the language Chair Mina referred to is
present in both current statute on psychiatric rights and HB 52,
Version N.
CHAIR MINA asked if providers currently have the ability to
restrict the number of calls made by a psychiatric patient.
3:53:49 PM
MR. NAVE responded that facilities can put some limits on access
to communication.
3:54:21 PM
REPRESENTATIVE FIELDS agreed that language regarding limits on
communication should be amended.
3:54:33 PM
REPRESENTATIVE GRAY said that he disagrees and said that
children in psychiatric hospitals should not have unlimited
access to phone calls.
3:55:17 PM
CHAIR MINA said that if facilities can already restrict access
to communication, the proposed legislation would not need to
further restrict access.
3:56:00 PM
REPRESENTATIVE FIELDS said that existing language in Version N
could be misconstrued and further limit access to communication.
3:56:33 PM
MR. HULL said that Version N of HB 52 would set a floor, not a
maximum, of communication.
3:57:18 PM
SETH GREEN, MD, Behavioral Health Clinical Supervisor, Aleutian
Pribilof Islands Association, advised that cutting off
communication and connections to home increases loneliness for
children in psychiatric facilities. He said that having access
to communication increases the long-term benefits of psychiatric
treatment. He added that he supports unannounced and unexpected
inspections of psychiatric facilities. He emphasized that
reducing the use of restraint is essential for positive outcomes
of psychiatric treatment.
4:01:03 PM
REPRESENTATIVE PRAX asked if the Aleutian Pribilof Islands
Association provides residential or out-patient care.
DR. GREEN responded that they only provide out-patient care.
4:02:05 PM
REPRESENTATIVE PRAX asked if psychiatric facilities are
currently inspected annually with their license renewals.
MR. NAVE responded that that is correct.
REPRESENTATIVE PRAX asked if that inspection is announced or
unannounced.
MR. NAVE said that it is an unannounced inspection.
REPRESENTATIVE PRAX asked if, under HB 52, Version N, there
would be three unannounced inspections per year.
MR. NAVE responded that is correct.
REPRESENTATIVE PRAX asked if the accrediting agency also
performs inspections and, if so, whether they are unannounced,
as well.
MR. NAVE responded that those inspections are also unannounced.
REPRESENTATIVE PRAX asked if DOH reviews the results of the
accrediting agency's inspections.
MR. NAVE responded that DOH does review the findings.
4:04:28 PM
REPRESENTATIVE GRAY described his experience with unannounced
inspections at the hospital he worked at. He explained that
although inspections were unannounced, they occurred within a
predictable timeline, allowing the hospital to prepare in
advance for the inspection. He asked whether the proposed
legislation should include random unannounced inspections to
prevent this ability to prepare.
MR. NAVE responded that the additional inspections under Version
N would fall outside of the predictable timeline that currently
exists.
4:06:30 PM
CHAIR MINA asked if there are any gaps in data collection
currently being missed that would be included under the reports
required under HB 52, Version N.
MR. HULL responded that the inspections would only inspect the
in-state populations, even though the majority of Alaska
children in psychiatric hospitals are sent to out-of-state
facilities.
4:08:08 PM
MS. SWISHER responded that current reporting captures youth at
both in-state and out-of-state facilities. She said she is
unaware of any gaps in current data reporting.
CHAIR MINA asked if the annual report, under Version N, would
reference the children in out-of-state facilities.
MS. SWISHER responded that the annual report would encompass the
reporting that already exists, regarding both children at in-
state and out-of-state facilities.
CHAIR MINA asked if there is an existing report in DFCS related
to children that are sent out of state.
MS. SWISHER responded that there is an existing quarterly
report.
4:10:18 PM
REPRESENTATIVE GRAY asked what would prevent the state from
doing unannounced visits to out-of-state facilities where Alaska
children are residing.
MR. HULL responded that he is not entirely sure but could help
to find that information.
MS. SWISHER responded that OCS occasionally does perform
unannounced visits to out-of-state facilities, and she is not
sure of any non-budgetary restrictions.
REPRESENTATIVE GRAY asked if Ms. Swisher goes to Utah.
MS. SWISHER responded that OCS does transfer children to out-of-
state facilities when necessary.
4:13:01 PM
REPRESENTATIVE SCHWANKE asked what the benefit would be from
posting annual reports of facilities online.
MR. HULL responded that HB 52 would ensure transparency as well
as the anonymity of the patients.
REPRESENTATIVE SCHWANKE expressed concern regarding publishing
the full report online.
4:15:38 PM
MR. HULL responded that psychiatric facilities have increasingly
used medications improperly and that the state needs to protect
children from this abuse. He said that full transparency is
essential in this endeavor.
4:17:09 PM
REPRESENTATIVE RUFFRIDGE asked who is responsible for the
deficiencies found in these facilities. He asked about
accreditation agencies' responsibility.
MR. HULL responded that he would love to see more federal
oversight of these facilities. He said that many states are
increasing protections for the children in their psychiatric
facilities.
MR. NAVE responded there are multiple layers of oversight and
jurisdiction over these facilities. He said that each layer has
different jurisdiction and different focuses.
4:21:03 PM
REPRESENTATIVE PRAX said that he is concerned about over-
reporting.
MR. NAVE responded that the State of Alaska has a very broad
definition of restraint, which he does not want to further
restrict. He said that he would rather see more than less
reporting.
REPRESENTATIVE PRAX asked if there are any Health Insurance
Portability and Accountability Act (HIPAA) restrictions to be
concerned about when reporting.
MR. NAVE responded that any reports published online would be
de-identified.
REPRESENTATIVE PRAX asked if there is a problem with reporting
to the state if a child is not in the custody of the state.
MR. NAVE answered that that would not be a HIPAA violation.
4:24:47 PM
REPRESENTATIVE GRAY named some of the main drugs used as
restraints in psychiatric facilities and expressed his concerns
regarding the more addictive substances. He said he wants to
know if addictive substances are being used as restraints when
there are other options for restraint.
REPRESENTATIVE SCHWANKE responded that she does not question the
need for the report, especially to families and to the
legislature. She said she wonders if publishing the report
online would create more problems and questions for DOH.
4:27:45 PM
REPRESENTATIVE PRAX considered whether the House Health and
Social Services Standing Committee should be required to read
the report.
[HB 52, Version N, was held over.]
HB 144-INSURANCE; PRIOR AUTHORIZATIONS
4:28:40 PM
CHAIR MINA announced that the next 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."
4:28:50 PM
REPRESENTATIVE MEARS moved to adopt the proposed committee
substitute (CS) for HB 144, Version 34-LS0780\N, Wallace,
4/1/25, as the working document.
CHAIR MINA objected for the purpose of discussion.
4:29:25 PM
REPRESENTATIVE JUSTIN RUFFRIDGE, Alaska State Legislature, as
prime sponsor, presented HB 144. He said this issue has been
addressed in previous legislatures and addresses the issue of
prior authorization.
4:31:34 PM
BUD SEXTON, Staff, Representative Justin Ruffridge, on behalf of
Representative Ruffridge, prime sponsor, presented HB 144. He
described the process of prior authorization, which must be
reasonable and efficient. He said that under, HB 144, prior
authorization would be required within 72 hours for a standard
request and within 24 hours for an expedited request. He said
that HB 144 would benefit patients, especially those with
chronic conditions.
4:36:09 PM
REPRESENTATIVE FIELDS asked about HB 144 automatically renewing
coverage for those with chronic illnesses for an additional
year, rather than "additional periods," which would be more
subject to the medical condition at hand.
4:37:13 PM
JARED KOSIN, President and CEO, Alaska Hospital and Healthcare
Association, responded that the Division of Insurance interprets
the language of HB 144 as allowing renewals into perpetuity.
4:38:11 PM
REPRESENTATIVE FIELDS responded that he would like to hear
confirmation on this matter from Legislative Legal Services.
4:38:25 PM
MR. SEXTON continued the presentation of HB 144. On behalf of
Representative Ruffridge, prime sponsor, he read the sectional
analysis of HB 144 [hard copy included in the committee file].
Section 1. AS 21.07.080 is amended to make conforming
changes, preserving the original intent by citing AS
21.07.005-21.07.090 (the original chapter contents).
Section 2. AS 21.07 is amended by adding a new
section: Article 2. Prior Authorization.
Sec 21.07.100. Prior authorization requests.
(a) Requires that each health care insurer offering a
health plan, after January 1, 2027, shall designate a
prior authorization process that is reasonable,
efficient, and minimizes the administrative burden on
health care providers and facilities and that complies
with the standards for medical care and prescription
drugs.
(b) Requires that if a health care provider submits a
prior authorization request, the health care insurer
shall make a determination and notify the provider
within:
a. 72-hours after receiving a standard request
submitted by a method other than facsimile;
b. 72-hours, excluding weekends, after receiving a
standard request submitted by facsimile; or
c. 24-hours after receiving an expedited request.
(c) Provides, that when a prior authorization request
is submitted that does not contain the information
necessary to make a determination, the health care
insurer shall request specific additional information
within:
a. One calendar day after receiving an expedited
request;
b. Three calendar days after receiving a standard
request.
(d) Allows an insurer, in making a determination, that
if the submitted information is not sufficient to make
a determination the insurer may request additional
information with a due date of not less than five (5)
working days nor more than fourteen (14) working days.
(e) Mandates that after the submission of the prior
authorization request, the provider shall receive
confirmation that the request has been received with a
date and time of the receipt.
(f) Provides a prior authorization request is
considered approved if the health care insurer fails
to provide a written denial, approval or request for
additional information within the time specified
above.
Sec. 21.07.110.
(a) Provides that a health care insurer shall make its
most current prior authorization standards available,
on the health care insurer's website including
information or document needed to make a
determination. If the health care insurer provides a
portal, the prior authorization standards shall be
available on the portal.
(b) Provides that a health care insurer's prior
authorization standards must include prior
authorization requirements used by the insurer and by
the insurer's utilization review organization. The
requirements must be based on peer-reviewed, evidence-
based clinical review criteria and be consistently
applied by all sources.
(c) Provides that if the prior authorization standards
published by the health care insurer differ from those
published by their utilization review organization,
the standard most favorable to the covered person
shall be used.
(d) Provides that a health care insurer shall indicate
on its website, for each service subject to prior
authorization,
(1) Whether a standardized electronic prior
authorization request transaction is available; and
(2) The date the prior authorization requirement
became effective and was published on their website.
(e) Provides that if the prior authorization
requirement is terminated, the health care insurer
shall indicate on its website the date the requirement
was removed.
Sec. 21.07.120. Peer review of prior authorization
requests.
(a) Provides that an insurer shall establish a process
for the health care provider to request a clinical
peer review of a prior authorization request.
(b) The peer reviewer must have relevant clinical
expertise in the specialty area or be an equivalent
specialty of the provider submitting the prior
authorization request.
(c) Provides that a heath care insurer shall provide
to the health care provider upon request, the
qualifications of a peer reviewer issuing an adverse
decision.
Sec. 21.07.130. Period of validity of prior
authorization.
(a) Requires that a prior authorization request, for a
chronic condition, must be valid for not less than
twelve (12) months while the covered person is covered
by the insurer's policy. Also addresses how the prior
authorization may be renewed.
(b) Provides that, except for (a) above, a prior
authorization request shall be valid for ninety (90)
calendar days or a duration that is clinically
appropriate, whichever is longer.
Sec. 21.07.140. Adverse determinations.
Provides that if a health care insurer makes an
adverse determination, the insurer shall notify the
covered person and their health care provider and
provide each
(1) A clear explanation of the adverse determination,
(2) A statement of the covered person's right of
appeal; and
(3) Instructions on how to file the appeal.
Sec. 21.07.150. Prior authorization application
programming interface. States that each insurer shall
maintain a prior authorization application programming
interface that automates the prior authorization
process for providers to determine whether a prior
authorization is required for medical care, identify
prior authorization information and documentation
requirements, and facilitate the exchange of prior
authorization requests and determinations from its
electronic health records or practice management
system. The application programming interface must be
consistent with the technical standards and
implementation dates established in the Centers for
Medicare and Medicaid Services rules on
interoperability and patient access.
Sec 21.07.160. Step therapy restrictions and
exception.
(a) Requires that an insurer that provides coverage
under a policy for the treatment of Stage 4 advanced
metastatic cancer shall not limit or exclude coverage
for a drug that is approved by the Federal Drug
Administration (FDA) and that is on the insurer's
prescription drug formulary by mandating that a
covered person with Stage 4 advanced metastatic cancer
undergo step therapy.
(b) Provides that if coverage of a prescription drug
for treatment of any medical condition is restricted
by the insurer, or their utilization review
organization because of a step therapy protocol, the
health care insurer or utilization review organization
must provide a covered person, and his/her provider,
with access to a clear, convenient, and readily
accessible process to request a step therapy exception
determination.
(c) A step therapy exception determination shall be
granted if the covered person has tried the step
therapy required prescription drugs while under a
current or previous health insurance policy.
(d) The insurer, or utilization review organization,
may request relevant documentation from the covered
person or provider to support the exception request.
(e) States that this section shall not be construed to
prevent:
(1) An insurer, or utilization review organization,
from requiring a covered person to try a generic
equivalent or other brand name drug prior to providing
coverage for the requested prescription drug; or
(2) A provider from prescribing a prescription drug he
or she determines is medically appropriate.
Sec 21.07.170. Annual report.
Health care insurers shall submit annual reports, on a
form prescribed by the director, detailing their
adherence to AS 21.07.100 through AS 21.07.180.
Sec 21.07.180. Compliance and enforcement
(a) Requires that the director shall monitor
compliance with the provision of AS 21.07.100 AS
21.07.180.
(b) States that the examination of an insurer's prior
authorization practices shall be consistent with AS
21.06.120 through AS 21.06.230. Examinations shall be
performed at least every two years
(c) Provides that if an insurer is found to be non-
compliant with the provisions of AS 21.07.100 through
AS 21.07.180, the director may impose penalties
including fines for each instance of non-compliance,
orders to rectify deficiencies within a specified time
frame or for suspension or revocation of the insurer's
certificate of authority for persistent or severe
violations.
(d) Provides that the director shall adopt regulations
establishing penalties for noncompliance.
Section 3. Sec 21.07.250 is amended to
Add definitions for:
(15) Chronic Condition
(16) Covered person
(17) Expedited request
(18) Prior Authorization
(19) Standard request
(20) Step-therapy protocol
(21) Utilization review organization
Section 4. The uncodified laws of the State of Alaksa
are amended by adding a new section to read:
Transition Regulations providing that the director may
adopt regulations necessary to implement this Act.
Section 5. Provides that Section 4 takes effect
immediately.
Section 6. Provides that except as provided in Sec 5,
this act takes effects on January 1, 2027.
4:43:24 PM
REPRESENTATIVE FIELDS, [referring to page 5, line 16, in Section
2 of HB 144], pointed to the language "Adverse determinations"
and asked if it would be necessary to add "answered by a human"
to add clarity.
4:44:12 PM
REPRESENTATIVE RUFFRIDGE responded that some other sections of
HB 144 detail how to avoid an adverse determination. He said
that there are options before a telephone conversation with a
human would be necessary.
4:45:48 PM
REPRESENTATIVE FIELDS asked why stage 4 metastatic breast
cancer, as opposed to other types or stages of cancer, is
distinguished in HB 144.
REPRESENTATIVE RUFFRIDGE responded with an explanation of step
therapy. He said that stage 4 metastatic breast cancer is not
exclusive under HB 144.
4:48:18 PM
CHAIR MINA removed her objection to the motion to adopt the
proposed CS for HB 144, Version 34-LS0780\N, Wallace, 4/1/25, as
the working document. There being no further objection, Version
N was before the committee.
4:48:43 PM
CHAIR MINA announced invited testimony.
4:48:51 PM
MR. KOSIN begin his invited testimony on HB 144, Version N, by
explaining that at stage 4 of any cancer, one typically starts
exploring trials and alternative treatments. He said that the
Alaska Hospital and Healthcare Association strongly supports HB
144 and the effort to reform prior authorization. He said that
HB 144, Version N, would address the delays in urgent care
needed by patients and would have an immediate, positive impact
on patients. He emphasized the importance of transparency that
would be added to prior authorization under the proposed
legislation.
4:53:25 PM
GARY STRANNIGAN, Vice President, Congressional and Legislative
Affairs, Premera Blue Cross Blue Shield of Alaska, began his
invited testimony in support of HB 144, Version N. He said that
prior authorization is an important component to making
healthcare affordable. He said he thinks the proposed
legislation would improve prior authorization and increase its
efficiency by increasing automation of the process.
4:56:21 PM
PAM VENTGEN, Executive Director, Alaska State Medical
Association, began her invited testimony in support of HB 144,
Version N. She said that the Alaska State Medical Association
strongly supports the proposed legislation. She said that the
process of prior authorization has become cumbersome and harmful
to patients, but HB 144, Version N, would address those issues
very well.
4:58:31 PM
REPRESENTATIVE GRAY raised concern that HB 144, Version N, would
not actually reduce costs.
REPRESENTATIVE RUFFRIDGE responded that in states that have
passed similar legislation, there have been direct correlations
to reduce costs. He added that HB 144, Version N, would
simplify the process of prior authorization and the number of
employees required to complete the process.
REPRESENTATIVE GRAY explained that often, due to drug
advertising, patients will ask a physician to prescribe
specific, name-brand drugs, rather than the generic drug of the
same kind. He said that doing so requires prior authorization,
even in situations where physicians may not have the time to
process a prior authorization. He asked for feedback on these
cases.
REPRESENTATIVE RUFFRIDGE responded that prior authorization does
help with cost containment and that HB 144, Version N, would
improve the ability to provide step therapy, as well as help
uphold patient safety.
REPRESENTATIVE GRAY suggested that one way to expand access to
care and lower costs would be to allow pharmacists to prescribe
medications.
REPRESENTATIVE RUFFRIDGE responded that pharmacists are awesome,
and he supports Representative Gray's support of their work.
[HB 144, Version N, was held over.]
5:09:48 PM
ADJOURNMENT
There being no further business before the committee, the House
Health and Social Services Standing Committee meeting was
adjourned at 5:09 p.m.