Legislature(2025 - 2026)BUTROVICH 205
03/20/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB90 | |
| SB88 | |
| SB121 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 122 | TELECONFERENCED | |
| += | SB 90 | TELECONFERENCED | |
| += | SB 88 | TELECONFERENCED | |
| += | SB 121 | TELECONFERENCED | |
| += | SJR 15 | TELECONFERENCED | |
SB 121-HEALTH INSURANCE ALLOWABLE CHARGES
4:13:29 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 121
"An Act relating to settlement of health insurance claims;
relating to allowable charges for health care services or
supplies; and providing for an effective date."
4:13:56 PM
SENATOR GIESSEL, District E, speaking as sponsor stated her
staff would give a recap of SB 121.
4:14:07 PM
JANE CONWAY, Staff, Senator Cathy Giessel, Alaska State
Legislature, Juneau, Alaska, offered a recap of SB 121. She
stated that the legislation would require out-of-network claims
to be reimbursed at the 75th percentile, with a minimum payment
set at 450 percent of the Medicare rate. Insurers would have to
calculate allowable charges using statewide data from a 12-month
period and reimburse all providers billing the same CPT code at
the same rate. She said SB 121 also mandates periodic audits to
ensure insurer compliance with these requirements and Title 21.
4:15:20 PM
SENATOR CLAMAN asked whether SB 121 applies only to insurers'
dealings with out-of-network providers and does not address in-
network rates.
4:15:41 PM
MS. CONWAY replied that is correct.
SENATOR CLAMAN asked whether insurance companies negotiate in-
network rates directly with providers. he also asked for
confirmation that SB 121 would not limit their ability to
differentiate between a physician assistant and a physician for
the same service.
4:16:15 PM
MS. CONWAY replied that the insurer could contract with
providers within a network and hash out an agreed upon rate. She
said doing so is separate from the 75th percentile out-of-
network.
4:16:46 PM
CHAIR DUNBAR opened public testimony on SB 121.
4:17:39 PM
NADJA HIPSZER, representing self, Fairbanks, Alaska, testified
in opposition to SB 121. She warned that SB 121 will raise costs
for a shrinking pool of fully insured employers and individuals
while failing to address Alaska's underlying health care
challenges. She argued that SB 121 revives policies, like the
80th percentile rule, that previously inflated costs, and noted
that providers face the same economic pressures as other
businesses without guaranteed prices. She said that if provider
subsidies are necessary, pressures should be shared by all
Alaskans, not just commercial insurance payers.
4:20:06 PM
ELI POWELL, Orthopedic Surgeon, representing self, Fairbanks,
Alaska, testified in support of SB 121. He argued that the bill
protects patients and consumers by preserving leverage for
providers in negotiations with insurers. Most Alaska providers
have been in-network for years, but without the ability to go
out-of-network, insurers could drive rates down to near-Medicare
levels despite rising labor costs. He stated there is no
evidence that the 80th percentile rule increased costs and noted
that premiums have risen even as reimbursements have remained
flat. She maintained that physicians are not the cause of rising
health care costs and warned that, without SB 121, many
practices could fail, making it difficult to sustain health care
access in Alaska.
4:22:27 PM
SENATOR CLAMAN asked if Mr. Powell was in support or in
opposition of SB 121.
CHAIR DUNBAR stated his belief that Mr. Powell was in support.
4:23:01 PM
AMBER MICHAEL, representing self, Anchorage, Alaska, testified
in support of SB 121. She stated that unstable reimbursement
rates allow insurers to push payments down, making it difficult
for providers to sustain their practices and threatening patient
access to care. In Alaska, where access is already limited, this
instability can force providers to reduce services, close, or
leave the state. She argued that SB 121 is essential to
establish fair, predictable reimbursement and prevent further
erosion of the healthcare system.
4:24:46 PM
LISA JACKSON, representing self, Anchorage, Alaska, testified in
support of SB 121. She shared her experience as an owner of a
private clinic accepting Medicare and Medicaid, but rising costs
and declining reimbursement made it financially unsustainable.
She warned that further reimbursement cuts for nurse
practitioners will force more clinic closures, shifting primary
care to emergency rooms and driving up overall health care
costs.
4:28:02 PM
SENATOR CLAMAN announced that Mr. Powell supports SB 121.
4:28:29 PM
TARAH SWEENY, DPT, Progressive Physical Therapy, Anchorage,
Alaska, testified in support of SB 121. She agreed with the
other testifiers and stated additional challenges of owning a
physical therapy practice, including difficulty recruiting and
retaining therapists due to rising labor costs, administrative
burdens, and declining reimbursement rates. These pressures
limit her ability to offer competitive compensation and provide
timely care, worsening existing provider shortages and reducing
access for Medicare and Medicaid patients. She said SB 121 would
help by establishing clear, fair reimbursement standards that
protect both providers and patients and support continued access
to care.
4:31:41 PM
BRENDA SNYDER, Director, State Government Affairs, CVS Health,
Tacoma, Washington, testified in opposition to SB 121. She
argued that SB 121 would increase health care costs for Alaskans
without improving access by reinstating percentile-based
reimbursement that previously drove unsustainable out-of-network
expenses. She stated that the repeal of the 80th percentile rule
and reliance on the federal No Surprises Act created a fair,
market-based system that lowered premiums and out-of-pocket
costs while still allowing providers to appeal payments. She
warned that SB 121's 75th percentile payment floor would
significantly raise consumer cost sharing and premiums and urged
lawmakers to oppose the bill.
4:34:01 PM
JENNIFER CANET, Practice Manager, Peak Neurology and Sleep
Medicine, Willow, Alaska, testified in support of SB 121. She
said after seeking an increase following ten years without
reimbursement, the payer instead proposed lower rates across all
billing codes. Meanwhile, operating costs and employee
expectations have risen, including a more than 20 percent
increase in the cost of providing employee health benefits. She
said providers now have little negotiating power, making it
difficult to continue serving patients with complex and chronic
conditions.
4:35:46 PM
KATIE CAPOZZI, President, Alaska Chamber of Commerce, Anchorage,
Alaska, testified in opposition to SB 121. She argued that
reinstating a similar 75th percentile mandate through SB 121
would increase premiums for approximately 118,000 Alaskans and
undo recent, data-driven health care reforms. She emphasized
that sustainable health care solutions require collaboration
among stakeholders and said SB 121 was developed without that
collaborative process.
4:38:37 PM
WHITNEY WILLCUT, representing self, Eagle River, Alaska,
testified in support of SB 121. She said Certified Registered
Nurse Anesthetist (CRNA)'s make up about half of the state's
anesthesia providers and are often the sole anesthesia
professionals in critical access hospitals, delivering care
comparable in quality to physician colleagues. She warned that
lower reimbursement for Advanced Practice Registered Nurse
(APRN)'s threatens small practices and hospitals and stressed
that equal pay for equal work is necessary to maintain access to
care statewide.
4:40:22 PM
STEVEN SIVILS, DO, representing self, Anchorage, Alaska,
testified in support of SB 121. He stated that he agrees with
the previous supportive testifiers and added that its hard to
recruit people to come to Alaska with the changes to insurance
reimbursement. He said SB 121 provides transparency, fairness
and stability.
4:42:10 PM
NICHIA ESTEVEZ, Practice Administrator, Valley Medical Care,
Juneau, Alaska, testified in support of SB 121. She explained
the struggles Valley Medical Care has been facing and agreed
with other testifiers that the loss of the 80th percentile
equals loss of negotiating power with insurance. She stated that
it's not sustainable.
4:44:39 PM
STEVE COMPTON, MD, representing self, Anchorage, Alaska,
testified in support of SB 121. He argued that Alaska's health
care payment system is dominated by an out-of-state insurer with
excessive market power. He described the 80th percentile
standard as a consumer protection created to address insurance
abuses and warned that eliminating such protections reduces
access to care by forcing providers out of the market.
4:48:06 PM
CHRISTINE SAGAN, Owner, Vitae Integrative Medical Center,
Anchorage, Alaska, testified in support of SB 121. She said her
experience shows that declining and inconsistent reimbursement
rates are financially destabilizing providers and reducing
patient access to care in Alaska. She argued that SB 121 would
establish fair, transparent reimbursement standards through a
statewide payment floor and regular audits, preventing insurers
from imposing unsustainable terms. She warned that without SB
121, rising costs and falling reimbursements will force more
clinics to close, worsening Alaska's health care crisis.
4:50:07 PM
DAVID JAMISON, Owner, Talkabout Inc., Fairbanks, Alaska,
testified in support of SB 121. He said since the repeal of the
80th percentile rule, insurers have relied on undefined regional
benchmarks based on lower-cost states, which do not reflect
Alaska's operating realities. He argued that insurers now
control reimbursement without bearing the cost of workforce
development, making it difficult for providers to compete
nationally and sustain services in Alaska.
4:52:30 PM
TERESA LYON, representing self, Fairbanks, Alaska, testified in
support of SB 121. She said that she is an advanced practice
registered nurse who owns a psychiatric mental health practice
with three clinics and 20 employees, created to train new
clinicians and meet growing demand for outpatient services. She
described a fragile reimbursement system that led to layoffs of
most clinical staff, long waitlists, and significant disruption
from insurer actions, including midyear termination of in-
network status that harmed patients. She stated that SB 121
would stabilize reimbursement, help rebuild services, and
protect access to mental health care across Alaska.
4:55:55 PM
GARY STRANNIGAN, Vice President, Congressional and Legislative
Affairs, Primera Blue Cross and Shield, Everett, Washington,
testified in opposition to SB 121. He argued that affordability
is the primary barrier to accessing health insurance and care in
Alaska and that prior percentile reimbursement rules
significantly worsened affordability. He warned that SB 121
would raise costs across all insurance markets, including self-
insured plans, and estimated it would increase premiums for a
family of four by about $5,000 in 2026. He concluded that SB 121
would set an artificial payment floor, fuel healthcare
inflation, and make care less affordable without providing
corresponding consumer benefits.
4:58:19 PM
CHAIR DUNBAR asked him to repeat who would experience the $5,000
increase and under what circumstances.
4:58:29 PM
MR. STRANNIGAN replied that a family of four in the Affordable
Care Act (ACA) market would have an increase of $5,000 in 2026.
4:58:36 PM
CHAIR DUNBAR asked whether a family of four saw a $5,000
decrease in their premium when the 80TH percentile rule was
repealed.
4:58:52 PM
MR. STRANNIGAN replied that two rate filings produced reductions
of about 4 percent and 6 percent in the individual market,
creating roughly 10 percent downward pressure, but rising
healthcare costs offset those reductions and premiums still
increased over the past two years. He said he expects this trend
to reverse in 2026, with filings submitted to the insurance
department in June.
4:59:49 PM
SENATOR CLAMAN asked whether premiums increased overall during
the past two years and whether, due to the repeal of the 80th
percentile rule, those increases were smaller than they would
have been if the rule had remained in place.
5:00:19 PM
MR. STRANNIGAN replied that is correct.
5:00:28 PM
SENATOR CLAMAN asked how inflation is factored into the
increase.
5:00:37 PM
MR. STRANNIGAN replied that inflation is factored into cost
trend assumptions using medical inflation, which is based on
service utilization and unit costs rather than general consumer
inflation.
5:01:21 PM
SENATOR CLAMAN asked for confirmation that it is Mr.
Strannigan's testimony that, despite inflationary cost
pressures, the 2025 rate filings would reflect an overall
reduction in premiums.
5:01:43 PM
MR. STRANNIGAN replied yes.
5:02:00 PM
APRIL ERICKSON, representing self, Kodiak, Alaska, testified in
support of SB 121. She said the bill affects all advanced
practice registered nurses, with impact on anesthesia care.
CRNAs provide most anesthesia services statewide, yet insurers
reimburse them at only 85 percent of physician rates for the
same services. SB 121 would ensure equal pay for equal work,
supporting workforce retention and access to anesthesia care
across Alaska.
5:04:24 PM
NOAH LAUFER, Co-Owner, Medical Park Family Care, Anchorage,
Alaska, testified in support of SB 121. He stated that his
practice sees about 35,000 patient visits annually, including
Medicare and Medicaid patients, despite long-standing flat
reimbursement rates. He said even though his practice has served
the community for over 50 years, financial instability and lack
of control over reimbursement make ownership unsustainable and
deters future successors. He said reduced specialist
availability since the repeal of the 80th percentile rule has
increased wait times and forced more out-of-state referrals,
raising costs and harming patient care.
5:07:35 PM
TIM MULLEN, Chief Executive Officer (CEO), Ortho Alaska,
Anchorage, Alaska, testified in support of SB 121. He stated he
has worked in healthcare for over 30 years and removing the 80th
percentile rule eliminates a key consumer protection based on
outdated data. Rising costs have not led to higher rates,
showing the repeal hasn't lowered premiums. He warned that
Alaska's unique market risks long-term damage if rates are
pushed too low.
5:10:12 PM
JOHN MCDONAGH, President, Alaska Heart and Vascular Institute,
Anchorage, Alaska, testified in support of SB 121. He echoed
comments of others and said primary care in Alaska is struggling
without protections like the 80th percentile rule, threatening
recruitment, retention, and access to care. Most independent
providers operate alone, and clinicians are not driving price
increases. He said major cost drivers are pharmaceuticals and
medical devices, not hardworking clinicians.
5:12:00 PM
JENNA SCHMIDT, MD, representing self, Juneau, Alaska, testified
in support of SB 121. She criticized nonprofit insurers for high
executive pay while holding providers "ransom" with premiums.
Despite the 80th percentile repeal, premiums have risen and
reimbursements declined. She said she supports SB 121 to restore
provider bargaining power and preserve patient choice.
5:14:03 PM
GENE QUINN, Chief Executive Officer (CE), Envoy Integrated
Health, Anchorage, Alaska, testified in support of SB 121. He
noted that the 80th percentile had minimal impact on costs and
premiums continued to rise. He emphasized that reducing
healthcare costs requires collaboration with insurers on value,
based care and accountable care organizations. He said he
supports SB 121 for rebuilding trust with physicians and
improving healthcare quality and access in Alaska.
5:16:50 PM
WADE ERICKSON, MD, Medical Network of Alaska, Wasilla, Alaska,
testified in support of SB 121. He agreed with Dr. Quinn's
testimony and reported that their insurance premiums rose 56
percent and 17 percent over two years, while reimbursements
increased only 2 percent over seven years. A proposed 17 percent
fee reduction is unsustainable, forcing consideration of going
out-of-network. Such cuts would stress practices, leading to
reduced services, staff, and access for Medicare, Medicaid, and
self-paying patients.
5:19:50 PM
SENATOR GIESSEL asked for confirmation that she correctly heard
his premiums increased 56 percent last year and 17 percent this
year.
5:20:11 PM
MR. ERICKSON replied that is correct.
5:20:13 PM
SENATOR GIESSEL asked whether she also heard correctly that over
the past year reimbursements increased by only 2 percent, and
are now being offered a 17 percent reduction.
5:20:35 PM
MR. ERICKSON replied that reimbursements have increased only 2
percent since 2018, with no opportunity to renegotiate during
that period.
5:21:06 PM
GLORIA JUENEMAN, Chief Revenue Officer, Alaska Heart and
Vascular Institute, Anchorage, Alaska, testified in support of
SB 121. She stated that the bill promotes provider
sustainability while protecting Alaskans' care, ensuring fair
negotiations with insurers whose rates often fall below actual
costs, including recent Medicare cuts.
5:22:40 PM
CAMILLA SULAK, MD, representing self, Anchorage, Alaska,
testified in support of SB 121. She stated that the bill will
protect providers and increase transparency, noting that since
the 80th percentile rule was repealed, medical bills have risen
sharply. This threatens outpatient specialty and primary care,
likely increasing patient visits and overcrowding in emergency
departments.
5:24:23 PM
At ease.
5:28:52 PM
CHAIR DUNBAR reconvened the meeting.
5:29:28 PM
Chair Dunbar closed public testimony and held SB 121 in
committee.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 90 Backup-50 States Age of Mental Health Consent 3.13.25.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Backup-01.31.24 AFSP Suicide Data United States.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Backup-SFIN 3.5.25 MESA High-Cost Reciepients.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Backup-SHSS 4.11.24 DOH Presentation BH Roadmap.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Backup-Joint HSS 2.13.17 Opioid Use Disorder.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Sectional, Version A.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 90 Backup-10.24.23 Axios Fatal U.S. Pediatric Opioid Poisonings.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 90 |
| SB 121 Letters of Support 3.18.25.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 121 |
| Alaska SB 121 Comment Letter Premera.pdf |
SHSS 3/20/2025 3:30:00 PM |
SB 121 |