Legislature(2015 - 2016)BARNES 124
04/06/2016 03:15 PM House LABOR & COMMERCE
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| Audio | Topic |
|---|---|
| Start | |
| HB372 | |
| HB234 | |
| SB148 | |
| SB142 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 234 | TELECONFERENCED | |
| + | SB 148 | TELECONFERENCED | |
| + | SB 142 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 372 | TELECONFERENCED | |
SB 142-INSURANCE FOR ANTI-CANCER MEDICATION
4:36:36 PM
CHAIR OLSON announced that the final order of business would be
CS FOR SENATE BILL NO. 142(L&C) am, "An Act relating to
insurance coverage for anti-cancer medications."
4:37:09 PM
REPRESENTATIVE HUGHES moved to adopt Amendment 1, labeled 29-
LS1133\W.A.1, Wallace, 4/5/16, which read:
Page 1, line 1, following "medications":
Insert "; and providing for an effective date"
Page 2, following line 14:
Insert a new bill section to read:
"* Sec. 3. This Act takes effect January 1, 2017."
CHAIR OLSON objected for discussion purposes.
4:37:21 PM
KARI NORE, Staff, Senator Cathy Giessel, Alaska State
Legislature, advised that Amendment 1 changes the effective date
of the bill, as requested by the PREMERA health insurance
company, in order to ensure it can completely implement this
change and not affect premiums or accrue additional costs.
4:38:02 PM
CHAIR OLSON removed his objection to Amendment 1.
4:38:18 PM
REPRESENTATIVE LEDOUX objected to Amendment 1 for discussion
purposes. She said she was aware there are certain times a
cancer patient is prescribed medication, which is paid for, but
then receives it in another form and it is not paid for. She
expressed her preference for the legislation to be effective
immediately instead of January 1, 2017.
MS. NORE advised that PREMERA's fiscal year 2016 filing must be
submitted by May 6, 2015. There is concern that the proposed
legislation, as written, would cause PREMERA to amend its
filings, causing a fiscal impact to consumers.
CHAIR OLSON commented that initially all of the contracts come
up on January 1; therefore, there are already contracts in place
that are good until December 31.
MS. NORE added that the bill only applies to new and renewed
plans, and would not affect plans currently in place.
REPRESENTATIVE LEDOUX surmised that if the bill were passed in
April [2016], PREMERA would have three weeks to respond.
MS. NORE pointed out that the sponsor wishes to avoid putting
any additional burden on consumers, especially since the bill
only applies to renewed plans. Ms. Nore further explained that
SB 142 seeks to ensure that both intravenously and orally
administered cancer treatments are treated fairly and are
equally available to consumers. She said currently, there is a
disparity between what patients pay for intravenous cancer
treatments versus oral, because oral treatments are billed as
prescriptions, and there is no deductible to meet. However,
intravenous treatments are often billed as medical benefits, of
which there is a deductible to reach, and after which the
consumer no longer pays. Thus, although oral cancer treatment
is much cheaper for administration costs, it ends up being more
expensive. Also, certain cancer treatments are only available
in the oral option; therefore, patients should not be forced to
pay higher premiums simply because treatment is only available
in the oral form. In addition, the bill also prevents the re-
classification of benefits or increasing costs, with respect to
both intravenous and oral cancer treatments.
4:43:05 PM
REPRESENTATIVE LEDOUX relayed her personal experience with
typhoid oral and inoculation vaccines: inoculations are
reimbursed by insurance and oral vaccines are not. She
questioned why the bill is limited to cancer treatments as there
are probably many drugs that can be taken orally or
intravenously.
MS. NORE answered that the sponsor chose to focus on cancer
medications, and deferred to the director of the Division of
Insurance at DCCED.
CHAIR OLSON opened public testimony.
4:44:56 PM
EMILY NENON, Alaska Government Relations Director, American
Cancer Society/Cancer Action Network, advised that 40 states
have adopted this measure. She described it as a modernization
of Alaska's insurance statutes due to the tremendous changes in
cancer research making many options available in an oral form as
opposed to infusion. Ms. Nenon stated that the issue is not
just about whether a physician prescribed chemo in the pill or
the infusion form, but that some chemo treatments are only
available in the oral form; in fact, approximately 25 percent of
the new treatments in the research pipeline for cancer are oral.
She pointed out that oral medications often have fewer side
effects and the ease of administration is a huge issue,
particularly with the geographic challenges of Alaska. Ms.
Nenon expressed her organization's support for the bill.
4:46:39 PM
ERIC HANSEN, International Myeloma Foundation, advised he is an
advocate for patients - and is also a patient - as four years
ago he was diagnosed with Multiple Myeloma caused by exposure to
Agent Orange. Multiple Myeloma is incurable, but treatable by
chemo, and he noted that research breakthroughs have made some
insurance procedures obsolete; for example, the pharmacy benefit
for many conditions is insufficient, when applied to cancer
medications. He opined that the issue for most patients is not
so much the needles and the toxicity of chemo, but rather
[medical] access, especially in Alaska. For example, in Juneau
there is only one nurse who can administer chemo, as it is a
highly specialized procedure. There are few places in the
entire state where a person can be infused with chemo and some
patients need to be infused twice per week. The pills that are
now available target cancers, unlike chemo fluids, which "just
kill everything." Mr. Hansen characterized cancer treatment
pills as "a godsend," because patients do not have to adhere to
the administrator's availability or spend four hours to receive
an infusion. Further, a patient's veins can collapse. Mr.
Hansen said he has been taking one pill per day for three years
to treat his cancer, although he may have to eventually return
to infusion chemo pending further research. He noted the
difficulties for those who live far from infusion treatment
facilities and urged for this "insurance glitch" to be resolved,
and restated his support for the bill.
REPRESENTATIVE LEDOUX asked Mr. Hansen's view of changing the
effective date from immediately to January 1.
MR. HANSEN, speaking as a patient, said he would like to make
the effective date tomorrow because someone who cannot afford
the copay will have to go somewhere for treatment. He
acknowledged that the insurance companies have to establish
paperwork, but sooner is better for patients.
REPRESENTATIVE COLVER described Mr. Hansen's testimony as
compelling, and inquired about the cost for Mr. Hansen's copay.
MR. HANSEN replied that he qualifies for Medicare; however, if
he were younger, his copay would be $2,000 per month. He said
he would have had to go back to the hospital and the chemo
fluids, although now all cancer medications cost about the same
because they are all unique and targeted.
4:54:33 PM
KIMBERLY THEIS, Advocacy Manager, Leukemia & Lymphoma Society,
echoed the sentiments that have been shared, and said that the
Leukemia & Lymphoma Society believes this is a vital solution
intended to ensure that patients can reliably and consistently
expect fair coverage for cancer treatments even when the
treatments come in the form of a pill. She said the society is
hopeful that the lawmakers in Alaska will embrace this bill
because it helps to offer meaningful improvements in access to
care.
CHAIR OLSON announced public testimony would remain open.
[SB 142 was held over.]