Legislature(2015 - 2016)BELTZ 105 (TSBldg)

02/04/2016 01:30 PM Senate LABOR & COMMERCE

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* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
*+ SB 104 PERSON W/DISABILITY SAVINGS ACCOUNTS TELECONFERENCED
Heard & Held
*+ SB 141 E-CIGS: SALE TO AND POSSESSION BY MINOR TELECONFERENCED
Heard & Held
*+ SB 142 INSURANCE FOR ANTI-CANCER MEDICATION TELECONFERENCED
Heard & Held
*+ SB 158 REAL ESTATE BROKER LICENSURE REQS TELECONFERENCED
Scheduled but Not Heard
+ Bills Previously Heard/Scheduled: TELECONFERENCED
+= SB 69 BD OF CHIROPRACTIC EXAMINERS; PRACTICE TELECONFERENCED
Moved CSSB 69(L&C) Out of Committee
+= HB 12 MORTGAGE LENDING AND LOAN ORIGINATORS TELECONFERENCED
Moved SCS CSHB 12(L&C) Out of Committee
+= SB 125 LEGISLATIVE MEMBERS OF AGDC BOARD TELECONFERENCED
Moved CSSB 125(L&C) Out of Committee
+= SB 148 EMPLOYER REPORT OF WORKPLACE INJURY/DEATH TELECONFERENCED
Moved CSSB 148(L&C) Out of Committee
-- Public Testimony --
          SB 142-INSURANCE FOR ANTI-CANCER MEDICATION                                                                       
                                                                                                                                
1:54:14 PM                                                                                                                    
CHAIR COSTELLO announced the consideration of SB 142.                                                                           
                                                                                                                                
KARI   NORE,  Staff,   Senator   Cathy   Giessel,  Alaska   State                                                               
Legislature,  introduced  SB  142   on  behalf  of  the  sponsor,                                                               
speaking to the following sponsor statement:                                                                                    
                                                                                                                                
     SB 142  would ensure  that both intravenous  and orally                                                                    
     administered cancer  treatments are treated  fairly and                                                                    
     are  equally available  to  consumers. Patients  should                                                                    
     not be  prohibited from receiving cancer  treatment due                                                                    
     to high  insurance costs. Currently  intravenous cancer                                                                    
     treatment  co-pays are  much  less  expensive than  the                                                                    
     oral cancer treatments, and are  not always the easiest                                                                    
     option for patients.                                                                                                       
                                                                                                                                
     This   bill   also   prevents  increasing   costs   for                                                                    
     intravenous  or injected  chemotherapy that  is covered                                                                    
     under the  policy or plan or  by reclassifying benefits                                                                    
     with  respect  to  anti-cancer medications.  This  bill                                                                    
     asks for parity, or fairness,  to the consumer, as they                                                                    
     choose the treatment option that is right for them.                                                                        
                                                                                                                                
     I  urge you  to  support this  bill  that will  require                                                                    
     equal insurance  coverage for  anti-cancer medications,                                                                    
        both those administered intravenously and those                                                                         
     administered orally.                                                                                                       
                                                                                                                                
1:56:05 PM                                                                                                                    
JEANNE   MUNGLE,   Deputy   Director,  Division   of   Insurance,                                                               
Department  of  Commerce,   Community  and  Economic  Development                                                               
(DCCED),  stated  that  SB  142  seeks  to  reduce  out-of-pocket                                                               
expenses for consumers utilizing  healthcare insurance plans that                                                               
provide  coverage for  anti-cancer medications.  Section 1  would                                                               
level the  playing field in  terms of cost. Currently,  40 states                                                               
have enacted similar legislation.                                                                                               
                                                                                                                                
She related that the division is  working with the sponsor to add                                                               
language that  would not prohibit  cost-sharing rates  that could                                                               
occur  between network  and  out-of-network  providers. The  bill                                                               
would have  zero fiscal impact  on the Division of  Insurance and                                                               
would  be  a good  measure  from  the standpoint  of  eliminating                                                               
surprise billings for consumers.                                                                                                
                                                                                                                                
1:57:42 PM                                                                                                                    
SENATOR MEYER asked if there was any opposition to the bill.                                                                    
                                                                                                                                
MS. MUNGLE answered the division is not aware of any opposition.                                                                
                                                                                                                                
MS. NORE added  that Premera Blue Cross Blue  Shield supports the                                                               
bill and she is not aware of any opposition.                                                                                    
                                                                                                                                
CHAIR COSTELLO asked if the  administration has a position on the                                                               
bill.                                                                                                                           
                                                                                                                                
MS. MUNGLE  offered her belief  that the general opinion  is that                                                               
it is a good bill.                                                                                                              
                                                                                                                                
CHAIR COSTELLO asked  if the administration is in  support of the                                                               
bill.                                                                                                                           
                                                                                                                                
MS. MUNGLE  replied "generally  I believe  we would  support that                                                               
measure."                                                                                                                       
                                                                                                                                
CHAIR COSTELLO opened public testimony on SB 142.                                                                               
                                                                                                                                
1:59:13 PM                                                                                                                    
ERIC HANSEN,  representing himself, Juneau, Alaska,  testified in                                                               
support  of  SB 142.  He  related  that  four  years ago  he  was                                                               
diagnosed  with multiple  myeloma,  as a  result  of exposure  to                                                               
Agent Orange.  It is incurable  but treatable. He said  this bill                                                               
seems trivial  in light of the  budget crisis, but it  can make a                                                               
life-changing difference for many patients.                                                                                     
                                                                                                                                
The  pill he  takes  now  costs $10,000  per  month,  and the  20                                                               
percent co-pay  is beyond his  reach. A less effective  drug that                                                               
has to  be infused  has a $30  co-pay. But not  only does  it not                                                               
work as  well, it also  has more  side effects. He  discussed the                                                               
different options for cancer treatment  and described SB 142 as a                                                               
way to  get everybody on the  same page, working for  the benefit                                                               
of  the   patient  to  make  treatments   equally  available  and                                                               
affordable. This  would take one  huge problem off the  table, he                                                               
said.                                                                                                                           
                                                                                                                                
SENATOR STEVENS asked  if he was exposed to Agent  Orange when he                                                               
was in the military.                                                                                                            
                                                                                                                                
MR. HANSON answered yes; he  received significant exposure in the                                                               
highlands of Vietnam. The first  symptoms appeared about 20 years                                                               
ago and became full blown about four years ago.                                                                                 
                                                                                                                                
SENATOR STEVENS asked if the  Veterans Administration has been of                                                               
assistance.                                                                                                                     
                                                                                                                                
MR.  HANSON replied  yes and  they're good  when they've  finally                                                               
lined up, but it's a slow, cumbersome process.                                                                                  
                                                                                                                                
SENATOR STEVENS thanked Mr. Hansen for his service.                                                                             
                                                                                                                                
CHAIR COSTELLO  thanked Mr.  Hansen for  his service  and Senator                                                               
Giessel for introducing the legislation.                                                                                        
                                                                                                                                
2:07:49 PM                                                                                                                    
DR.  LATHA SUBRAMANIAN,  MD,  Denali  Oncology Group,  Anchorage,                                                               
Alaska,  testified in  strong support  of SB  142. She  explained                                                               
that  Denali  Oncology  Group  represents  all  the  medical  and                                                               
radiation  oncologists in  Alaska  and  the nurse  practitioners.                                                               
They are the Alaska chapter  for the American Society of Clinical                                                               
Oncology. Their  mission is  to advocate  for their  patients and                                                               
ensure that  any Alaskan that  has cancer will have  equal access                                                               
to the most effective therapy for his/her cancer in Alaska.                                                                     
                                                                                                                                
DR.  SUBRAMANIAN said  she couldn't  say it  any better  than the                                                               
previous  testifier.   In  the  last  several   years  tremendous                                                               
progress  has been  made  in the  care of  cancer  and there  are                                                               
several new  drugs for many  kinds of cancer,  including multiple                                                               
myeloma.  Sometimes  the most  effective  treatment  is taken  by                                                               
mouth and there  isn't an intravenous substitute.  The problem is                                                               
that even  if a  patient has health  insurance, they  often can't                                                               
afford  the prescribed  oral drug  because their  policy includes                                                               
deductibles,  co-pays,  co-insurance   and  various  formularies.                                                               
Patients that can't afford a drug, simply don't take it.                                                                        
                                                                                                                                
DR.  SUBRAMANIAN urged  the committee  to pass  SB 142  to ensure                                                               
equal, affordable access for cancer  patients so they can get the                                                               
best treatment available regardless of the method of delivery.                                                                  
                                                                                                                                
2:11:43 PM                                                                                                                    
ROD GORDON, Pharmacist, Great  Land Infusion Pharmacy, Anchorage,                                                               
Alaska,  testified in  support  of  SB 142.  He  said  this is  a                                                               
specialty  pharmacy that  focuses on  infusion therapy,  but also                                                               
provides  support  for patients  who  need  oral medications.  In                                                               
addition to what has already  been said about barriers to access,                                                               
an  unforeseen consequence  of  high co-pays  is  that it  forces                                                               
patients to resort  to an out-of-state specialty  pharmacy to get                                                               
a  competitive  co-pay.  This prevents  immediate  access  and  a                                                               
personal  face-to-face  interaction  with  a  specialty  oncology                                                               
pharmacy provider.                                                                                                              
                                                                                                                                
2:13:50 PM                                                                                                                    
THEA ZAJAC,  Director, Government Affairs, Leukemia  and Lymphoma                                                               
Society, California, testified in support  of SB 142. She thanked                                                               
the sponsor for introducing the  bill and stressed its importance                                                               
for people living  with blood cancers in Alaska.  She said cancer                                                               
treatment  is  changing rapidly  and  this  legislation is  about                                                               
catching  up the  insurance industry  with  the modernization  of                                                               
treatments.  She said  she has  worked on  this issue  in several                                                               
states  and has  seen the  positive  impact it  has on  patients'                                                               
lives.                                                                                                                          
                                                                                                                                
2:15:09 PM                                                                                                                    
LINDSEY  TRISCHLER,  Advocate  Associate,  International  Myeloma                                                               
Foundation (IMF),  Washington, D.C.,  testified in support  of SB
142.  IMF  is the  largest  and  oldest foundation  dedicated  to                                                               
improving  the quality  of life  of myeloma  patients. They  work                                                               
collaboratively with  organizations and  individuals representing                                                               
patients  in  Alaska  to  focus on  equal  access  to  treatments                                                               
regardless of  how it's administered. Treatment  decisions should                                                               
be based on  what is the most effective, not  what the patient is                                                               
able  to afford.  She  echoed Mr.  Hansen's  testimony about  the                                                               
difficulty  and complication  of  myeloma  cancer treatments  and                                                               
emphasized that it is highly  treatable given the advancements in                                                               
drug development.  The different  treatment options  have enabled                                                               
patients to live longer, but  remissions are not always permanent                                                               
so  additional  treatment  options  are essential.  Thus,  it  is                                                               
critical  that  all cancer  patients  have  equal access  to  all                                                               
treatments, not just the ones covered on an affordable rate.                                                                    
                                                                                                                                
2:18:24 PM                                                                                                                    
SHEILA  STICKEL,  West  Coast Field  Director,  National  Patient                                                               
Advocate  Foundation (NPAF),  Seattle,  Washington, testified  in                                                               
support of SB 142. She said  SB 142 would ensure coverage for all                                                               
oral  cancer medications  that are  equal to  the traditional  IV                                                               
therapies.  Nearly 30  percent of  the new  cancer therapies  are                                                               
oral but insurance doesn't always cover  them at the same rate as                                                               
intravenous  drugs. There  are a  host of  very good  reasons for                                                               
patients to have  access to oral therapies but  those in critical                                                               
need of  oral cancer medication often  have prescription policies                                                               
that  cost thousands  of  dollars each  month.  This can  exhaust                                                               
financial resources  and force  difficult decisions.  By ensuring                                                               
there is  parity between the  types of cancer  treatments, Alaska                                                               
will take  the needed  step of ensuring  patients have  access to                                                               
the treatment that their physician prescribed.                                                                                  
                                                                                                                                
Forty states  and the  District of  Columbia have  already passed                                                               
oral parity  laws. SB 142  would make  it easier for  patients in                                                               
Alaska to afford oral cancer medications.                                                                                       
                                                                                                                                
2:21:52 PM                                                                                                                    
DR.  MARY  STEWART,  Oncologist, Alaska  Oncology  &  Hematology,                                                               
Anchorage, Alaska, testified  in support of SB 142.  She said she                                                               
has practiced in  Alaska since 1985 and is amazed  at the options                                                               
for cancer  treatment that are  available today. "Oral  drugs are                                                               
simply  amazing"  but  they're  all expensive.  It's  clear  that                                                               
something  has to  be done  nationally  to affect  pharmaceutical                                                               
pricing, but "you and I can't  do anything about that," she said.                                                               
However, it is possible to  positively affect people in Alaska by                                                               
giving them access to medications.                                                                                              
                                                                                                                                
2:23:22 PM                                                                                                                    
EMILY  NENON,  Director,  Government Relations,  American  Cancer                                                               
Society, Anchorage, Alaska,  testified in support of  SB 142. She                                                               
said she works  on cancer research funding issues  at the federal                                                               
level and  at the  American Cancer Society.  She said  there have                                                               
been  tremendous strides  in the  area of  cancer treatments  and                                                               
over one-quarter  of the anti-cancer  treatments in  the research                                                               
pipeline  are  in  oral  form. This  bill  is  about  modernizing                                                               
statutes  and   getting  equitable  coverage  between   oral  and                                                               
intravenous anti-cancer medications.                                                                                            
                                                                                                                                
2:24:50 PM                                                                                                                    
SENATOR COSTELLO closed public testimony.                                                                                       
                                                                                                                                
CHAIR GIESSEL offered  a conceptual amendment on page  2, line 4.                                                               
Insert:  "Nothing in  this  section shall  prohibit  a plan  from                                                               
requiring different  cost sharing rates  for in network  and out-                                                               
of-network  pharmacies."  The  language was  recommended  by  the                                                               
Division of Insurance.                                                                                                          
                                                                                                                                
Renumber the subsequent subsection.                                                                                             
                                                                                                                                
She said she would have a committee substitute prepared.                                                                        
                                                                                                                                
CHAIR COSTELLO held SB 142 in committee awaiting the CS.                                                                        

Document Name Date/Time Subjects
CS Draft SB 69 Ver. H.pdf SL&C 2/4/2016 1:30:00 PM
SB 69
CS HB 12 (L&C) ver. N.pdf SL&C 2/4/2016 1:30:00 PM
HB 12
CS SB 125 ver. W.pdf SL&C 2/4/2016 1:30:00 PM
SB 125
CS SB 148 ver. W.pdf SL&C 2/4/2016 1:30:00 PM
SB 148
SB 142.PDF SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Sponsor Statement.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Fiscal Note.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Sectional Analysis.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Francesca Oral Anti-Cancer Therapies.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Letter of Support LLS.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Letter of Support Melanoma Fundation.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Letter of Support Myeloma Foundation.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Oral Chemo Therapy National Map.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - Oral Therapy Cost Study Summary Journal of Health Economics.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 142 - State Fiscal Impact Studies Summary.pdf SL&C 2/4/2016 1:30:00 PM
SB 142
SB 141.PDF SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - Sponsor Statement.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - Sectional Analysis.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - E-cigs NCSL Legisbrief.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - E-Cigarettes Poison the Airways.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - DH&SS E-cigs Bulletin.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - AK Dispatch E-Cigs.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 141 - Fiscal Note.pdf SL&C 2/4/2016 1:30:00 PM
SB 141
SB 158.PDF SL&C 2/4/2016 1:30:00 PM
SB 158
Senate Bill 158 - Alaska Real Estate Commission Letter.pdf SL&C 2/4/2016 1:30:00 PM
SB 158 - Fiscal Note.pdf SL&C 2/4/2016 1:30:00 PM
SB 158
SB 158 - Comparative Education Experience Other States.pdf SL&C 2/4/2016 1:30:00 PM
SB 158
Senate Bill 158 - Alaska Real Estate Commission Letter 2.pdf SL&C 2/4/2016 1:30:00 PM
SB 104.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Sponsor Statement.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Sectional Analysis.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Fiscal Note DCCED.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Fiscal Note DOR.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - ABLE Act Background Info.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Gov Cncl Disabilities Fact Sheet.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 104 - Gov Cncl on Disabilities Powerpoint Reference.pdf SL&C 2/4/2016 1:30:00 PM
SB 104
SB 158 - Sponsor Statement.pdf SL&C 2/4/2016 1:30:00 PM
SB 158