Legislature(2025 - 2026)BELTZ 105 (TSBldg)
03/26/2025 01:30 PM Senate LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| SB132 | |
| SB133 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 132 | TELECONFERENCED | |
| += | SB 133 | TELECONFERENCED | |
SB 133-INSURANCE; PRIOR AUTHORIZATIONS
1:50:11 PM
CHAIR BJORKMAN reconvened the meeting and announced the
consideration of SENATE BILL NO. 133 "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."
1:50:44 PM
KONRAD JACKSON, Staff, Senator Jesse Bjorkman, Alaska State
Legislature, Juneau, Alaska, presented a brief recap of SB 133,
on behalf of the Senate Labor and Commerce Standing Committee,
Senator Bjorkman, Chair. He stated that SB 133 sets clear rules
for the prior authorization process in healthcare. The bill
requires insurers to follow set timelines, improve communication
with providers, and use secure electronic systems to protect
patient privacy and speed up approvals. SB 133 gives the
Division of Insurance authority to oversee and enforce
compliance.
1:52:44 PM
CHAIR BJORKMAN announced invited testimony on SB 133.
1:53:00 PM
JARED KOSIN, President, Alaska Hospital and Healthcare
Association (AHHA) Anchorage, Alaska, testified by invitation on
SB 133. He paraphrased the following statement:
[Original punctuation provided.]
Prior authorization is a review process commonly used
by insurers that essentially requires healthcare
providers to obtain express authorization to provide a
specific treatment or procedure for their patients.
While prior authorization can be useful for reviewing
the appropriateness of medical care, it can also cause
significant delays in necessary, urgent patient
treatment.
We hear story after story about time-consuming
appeals, endless paperwork, lack of consistency and
transparency, and needless interruptions to treatment
when patients are at their most vulnerable. This has
contributed to a contentious relationship between
providers and insurers in Alaska and across the
country.
1:54:42 PM
MR. KOSIN continued with his testimony:
SB 133 is the result of this collaborative effort. The
bill has the strong backing of Alaska's hospitals
through AHHA, physicians via the Alaska State Medical
Association, and the state's major health insurers.
The bill prioritizes system automation and injects a
new level of transparency for prior authorization,
including policies, peer review and appeals,
enforcement, and accountability.
SB 133 also includes the following reforms that will
have an immediate and positive impact on patients:
• Faster turnaround times for prior authorization
decisions from five working days to 72 hours
• Long-term approval for treatment plans concerning
chronic conditions
• Automatic approval for key therapies for Stage
Four Advanced Metastatic Cancer
• A clear process for requesting exceptions to step
therapy requirements
Finally, AHHA is proud of the work that went into SB
133 and is grateful to Senator Bjorkman for bringing
this legislation forward. This bill exemplifies
effective, stakeholder-driven reform that will create
lasting improvements in patient care. We strongly
support SB 133 and urge the committee to swiftly
consider and pass this bill.
1:56:31 PM
CHAIR BJORKMAN stated that SB 133 grants automatic prior
authorization for individuals with chronic conditions while
shortening authorization timelines for other services. He asked
what factors may be considered to eliminate waiting times
entirely for those other treatments, rather than requiring one
to three days.
1:57:22 PM
MR. KOSIN replied that SB 133 focuses on modernizing the prior
authorization process by requiring insurers to use integrated
online portals instead of outdated methods like faxing. By
prioritizing automation and transparency, many authorizations
are expected to be processed instantly, with faster turnaround
times overallsometimes with no wait time at all, even though
the law allows up to 72 hours.
1:59:15 PM
GARY STRANNIGAN, Vice President, Congressional/Legislative
Affairs, Premera Blue Cross Blue Shield of Alaska, Anchorage,
Alaska, testified by invitation on SB 133:
[Original punctuation provided.]
Thank you for sponsoring SB 133, Prior Authorization.
Premera Blue Cross Blue Shield of Alaska engaged
extensively in the efforts to negotiate a workable
bill on this topic, and we commend SB 133 to you
At Premera, we feel that efforts to promote the
affordability of our products are key to continuing to
be able to provide care for our customers. This is
because affordability has become the highest bar a
person must clear, in order to gain access to health
insurance and health care services.
Prior authorization is a key component of
affordability, in that it helps carriers verify that
their members are getting the right care, at the right
time, in the right setting and at the right price. It
is well-publicized that some carriers have been
exceedingly aggressive in this space, using prior
authorization in as much as 20 percent of all claims.
At Premera the number is about 2 percent. So we
wanted to be sure that the compromise in front of you
maintained the ability of health plans to use prior
authorization, but with some reasonable sideboards as
well as incentives that will help plans modernize and
improve their prior authorization systems so that
these systems optimally serve providers, patients and
plans alike.
Our vision is that most prior authorizations will be
approved instantaneously improving the care for our
members as well as their experience. However, this is
impossible if the prior authorization request is
initiated with a fax. We think this bill will help
incentivize the adoption of electronic prior
authorizations by providers, and for those providers
that cling to their fax machines, we trust that
eventually the improvements in the prior authorization
system performance will be impossible to resist.
We would never suggest that HB 133 is perfect, but we
commend it to you as it represents a set of reasonable
compromises made by all parties.
We would also commend the process by which this
legislation was crafted: considerable work among
stakeholders involving lots of back and forth; give
and take. There are too many controversial proposals
of which this can't be said, so it is particularly
deserving to be called out here.
2:02:41 PM
HEATHER CARPENTER, Deputy Director, Division of Insurance,
Anchorage, Alaska, presented updates regarding SB 133. She
stated that the Division worked collaboratively with hospitals,
insurers, and other stakeholders to craft SB 133, aiming to
avoid the problems seen with prior authorization last year. The
process was widely supported, and one insurer even suggested the
bill could serve as a national model for legislation.
2:03:53 PM
CHAIR BJORKMAN opened public testimony on SB 133.
2:04:28 PM
LUCY LAUBE, Manager, State Government Relations, National
Psoriasis Foundation, Alexandria, Virginia, testified in support
of SB 133. She highlighted the bill's therapy protection
provision, which addresses step therapy, when insurers require
patients to try and fail on cheaper drugs before covering the
medication prescribed by their doctor. She argued this practice
harms patients with chronic conditions like psoriasis or
psoriatic arthritis, sometimes causing irreversible damage and
higher long-term costs. Studies show 92 percent of patients
report negative health impacts from such delays, and the
practice costs the U.S. health system an estimated $93.3 billion
annually. She said similar protections have already been adopted
federally and in over 36 states.
2:07:15 PM
BRUCE RICHARDS, Director, Government Affairs, Central Peninsula
Hospital, Soldotna, Alaska, testified in support of SB 133 and
stated that this legislation was developed collaboratively with
all stakeholders and represents a true compromise. The goal is
to put patients first by reducing harmful delays in prior
authorization, which can prevent timely access to needed
treatments. He said by setting clear timelines, requiring
evidence-based decisions, and modernizing outdated processes
like faxing, the bill aims to ensure faster, more transparent
approvals, lessen administrative burdens, and prevent patients
such as those with cancer or chronic pain from suffering
unnecessary delays in care.
2:10:03 PM
KATIE CAPOZZI, President, Alaska Chamber of Commerce, Anchorage,
Alaska, testified in support of SB 133 and stated that the
Chamber has formally endorsed a compromise approach to prior
authorization reform, recognizing the ongoing challenges members
and providers face in navigating healthcare utilization. Over
the past year, hospitals, insurers, and regulators collaborated
to create practical solutions, which culminated in SB 133. She
said the key elements of SB 133 include faster decision
turnaround times, extended approvals for chronic condition
treatments, automatic approval of essential cancer therapies,
and a clear process for step therapy exceptions. Backed by
hospitals, physicians, and major insurers, the bill advances
automation, transparency, and accountability in prior
authorization practices.
2:11:58 PM
SENATOR BJORKMAN held public testimony open on SB 133.
2:12:06 PM
CHAIR BJORKMAN held SB 133 in committee.
2:12:19 PM
There being no further business to come before the committee,
Chair Bjorkman adjourned the Senate Labor and Commerce Standing
Committee meeting at 2:12 p.m.