Legislature(2025 - 2026)BUTROVICH 205
04/03/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| SB122 | |
| SB134 | |
| Confirmation Hearing(s): State Medical Board | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | SB 122 | TELECONFERENCED | |
| += | SB 134 | TELECONFERENCED | |
| += | SB 45 | TELECONFERENCED | |
| += | SB 88 | TELECONFERENCED | |
ALASKA STATE LEGISLATURE
SENATE HEALTH AND SOCIAL SERVICES STANDING COMMITTEE
April 3, 2025
3:46 p.m.
MEMBERS PRESENT
Senator Forrest Dunbar, Chair
Senator Cathy Giessel, Vice Chair
Senator Matt Claman
Senator Löki Tobin
Senator Shelley Hughes
MEMBERS ABSENT
All members present
COMMITTEE CALENDAR
CONFIRMATION HEARING(S):
State Medical Board
Samantha Smith - Anchorage
- CONFIRMATION ADVANCED
SENATE BILL NO. 122
"An Act relating to insurance; establishing standards for health
insurance provider networks; and providing for an effective
date."
- MOVED CSSB 122(HSS) OUT OF COMMITTEE
SENATE BILL NO. 134
"An Act relating to pharmacy benefits managers; relating to
third-party administrators; and providing for an effective
date."
- HEARD & HELD
PREVIOUS COMMITTEE ACTION
BILL: SB 122
SHORT TITLE: HEALTH INSURANCE NETWORK STANDARDS
SPONSOR(s): SENATOR(s) GIESSEL BY REQUEST
03/05/25 (S) READ THE FIRST TIME - REFERRALS
03/05/25 (S) HSS, L&C
03/11/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/11/25 (S) Heard & Held
03/11/25 (S) MINUTE(HSS)
03/20/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/20/25 (S) <Bill Hearing Canceled>
03/27/25 (S) HSS AT 3:30 PM BUTROVICH 205
03/27/25 (S) Heard & Held
03/27/25 (S) MINUTE(HSS)
04/01/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/01/25 (S) <Bill Hearing Canceled>
04/03/25 (S) HSS AT 3:30 PM BUTROVICH 205
BILL: SB 134
SHORT TITLE: PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN
SPONSOR(s): SENATOR(s) GIESSEL
03/18/25 (S) READ THE FIRST TIME - REFERRALS
03/18/25 (S) HSS, L&C
04/01/25 (S) HSS AT 3:30 PM BUTROVICH 205
04/01/25 (S) Heard & Held
04/01/25 (S) MINUTE(HSS)
04/03/25 (S) HSS AT 3:30 PM BUTROVICH 205
WITNESS REGISTER
HEATHER CARPENTER, Director
Division of Insurance
Department of Commerce, Community and
Economic Development (DCCED)
Juneau, Alaska
POSITION STATEMENT: Answered questions about SB 122.
JERRFERY DAVIS, Principal
Weston Group Consulting
Wenatchee, Washington
POSITION STATEMENT: Answered questions concerning SB 122.
BRENDA SNYDER, Director
State Government Affairs, CVS Health
Tacoma, Washington
POSITION STATEMENT: Testified in opposition to SB 122.
STEVE COMPTON, MD, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to SB 122.
BRANDY SEIGNEMARTIN, Executive Director
Alaska Pharmacy Association
Eagle River, Alaska
POSITION STATEMENT: Testified in support of SB 134.
BETSY DOUDS-PACVAN, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to the appointment
of Ms. Smith to the State Medical Board.
JENNIFER FAYETTE, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to the appointment
of Ms. Smith to the State Medical Board.
SAMANTHA SMITH, Governor's Appointee, Medical Board
Anchorage, Alaska
POSITION STATEMENT: Testified as the governor's appointee to the
State Medical Board.
CANDACE HICKEL, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in opposition to the appointment
of Ms. Smith.
DONALD GENE HUDSON, DO, representing self
Anchorage, Alaska
POSITION STATEMENT: Testified in support of the appointment of
Ms. Smith to the State Medical Board.
ACTION NARRATIVE
3:46:10 PM
CHAIR DUNBAR called the Senate Health and Social Services
Standing Committee meeting to order at 3:46 p.m. Present at the
call to order were Senators Hughes, Claman, Tobin, Giessel, and
Chair Dunbar.
SB 122-HEALTH INSURANCE NETWORK STANDARDS
3:47:29 PM
CHAIR DUNBAR announced the consideration of SENATE BILL NO. 122
"An Act relating to insurance; establishing standards for health
insurance provider networks; and providing for an effective
date."
3:48:03 PM
CHAIR DUNBAR invited the sponsor to give a recap of SB 122.
3:48:09 PM
SENATOR GIESSEL recapped the purpose of SB 122 stating it is a
consumer protection bill. SB 122 would require insurance
companies to maintain adequate provider networks in their
policies.
3:49:14 PM
CHAIR DUNBAR said the committee would hear two amendments.
3:49:27 PM
CHAIR DUNBAR solicited a motion.
3:49:29 PM
SENATOR GIESSEL moved to adopt Amendment 1, work order 34-
LS0281\N.1.
4-LS0281\N.1
Wallace
3/25/25
A M E N D M E N T 1
OFFERED IN THE SENATE BY SENATOR GIESSEL
TO: SB 122
Page 1, lines 5 - 10:
Delete all material and insert:
"Sec. 21.07.035. Minimum provider network
standards. (a) A health care insurer shall take the
network requirements of this section into account when
calculating the benefits of, or other contractual
requirements applicable to, a covered person's health
care insurance policy that, as determined by the
director,
(1) requires the covered person to use a
limited network of health care providers, as defined
in regulation by the director; or
(2) creates a substantial financial or
other incentive or disincentive for the covered person
to use a limited network of health care providers."
3:49:32 PM
CHAIR DUNBAR objected for purposes of discussion.
3:49:40 PM
SENATOR GIESSEL explained that in the original SB 122, section
21.05.035 emphasizes its core purpose as consumer protection by
establishing minimum provider network standards. The bill
directs the Division of Insurance to assess network adequacy,
clarifying that insurers must consider network breadth when
calculating benefits. She said the director will evaluate
whether networks are so narrow or low-cost that consumers may be
misled or lack meaningful choice and will weigh whether
consumers are fully informed when selecting between limited,
lower-cost networks and broader, higher-cost options.
3:51:47 PM
SENATOR HUGHES asked for clarification on why Amendment 1 is
needed if 90 percent of providers are required to be in-network.
3:52:06 PM
SENATOR GIESSEL responded that the example is used to illustrate
the risk that insurers may intentionally offer extremely narrow
networks to attract consumers seeking low premiums. SB 122 is
intended as a safeguard to prevent consumers from unknowingly
choosing low-cost plans that later limit access to needed
specialists, resulting in inadequate coverage when medical needs
arise.
3:53:35 PM
SENATOR HUGHES reiterated that she doesn't understand the need
based on large percentages in SB 122. She requested the Division
of Insurance Director speak to the committee for further
understanding.
3:54:09 PM
HEATHER CARPENTER, Director, Division of Insurance, Department
of Commerce, Community and Economic Development (DCCED), Juneau,
Alaska, answered questions about SB 122. She introduced herself.
SENATOR HUGHES asked whether she sees the amendment as
necessary.
3:54:53 PM
MS. CARPENTER replied that how Senator Giessel described it is
probably accurate. She said Alaska doesn't have a narrow network
and she doesn't know if it would apply to someone who doesn't
have privileges at a hospital because of how the networks look.
3:55:37 PM
SENATOR HUGHES asked whether the amendment would hurt the
consumer.
3:55:47 PM
MS. CARPENTER answered that she doesn't think it will hurt the
consumer. She stated she agrees with Senator Giessel that
consumers need to be more informed.
3:56:10 PM
CHAIR DUNBAR removed his objection. He found no further
objection and Amendment 1 (N.1) was adopted.
3:56:25 PM
CHAIR DUNBAR solicited a motion.
3:56:31 PM
SENATOR CLAMAN moved to adopt Amendment 2, work order 34-
LS0281\N.2.
34-LS0281\N.2
Wallace
4/1/25
A M E N D M E N T 2
OFFERED IN THE SENATE BY SENATOR CLAMAN
TO:SB 122
Page 3, line 3:
Delete "85"
Insert "70"
Page 3, line 7:
Delete "85"
Insert "70"
Page 3, line 10:
Delete "90"
Insert "75"
Page 3, line 14:
Delete "90"
Insert "75"
Page 3, line 18:
Delete "95"
Insert "80"
Page 3, line 22:
Delete "95"
Insert "80"
3:56:36 PM
CHAIR DUNBAR objected for purposes of discussion.
3:56:43 PM
SENATOR CLAMAN described Amendment 2 stating it reduces the
required provider network coverage percentages in all six
regions by 15 percent, such as lowering 85 percent to 70 percent
and 90 percent to 75 percent, while maintaining the bill's
consumer protections and making the requirements more acceptable
to insurers.
3:57:39 PM
JERRFERY DAVIS, Principal, Weston Group Consulting, Wenatchee,
Washington, answered questions concerning SB 122. He stated that
the revised percentages are intended to preserve the bill's
consumer protection goals and apply only to narrow network plan
designs, particularly those with little or no out-of-network
coverage. He said in cases where consumers may be drawn to
lower-cost plans without fully understanding network
limitations, SB 122 requires insurers offering such plans to
meet specified network adequacy percentages, which are believed
to still fulfill the bill's original intent.
3:59:27 PM
CHAIR DUNBAR removed his objection. He found no further
objection and Amendment 2 (N.2) was adopted.
3:59:45 PM
CHAIR DUNBAR opened public testimony on SB 122.
4:00:33 PM
At ease.
4:00:49 PM
CHAIR DUNBAR reconvened the meeting and resumed public
testimony.
4:01:03 PM
BRENDA SNYDER, Director, State Government Affairs, CVS Health,
Tacoma, Washington, testified in opposition to SB 122. She
explained that health carriers offer employers and plan sponsors
various cost-saving tools, including network design, to balance
access, cost, and quality while improving outcomes and
controlling expenses. She said carriers already must meet ACA
and CMS network adequacy standards, overseen by the Alaska
Division of Insurance, and have expanded provider networks
significantly in recent years. She argued that the bill's
proposed changes to network adequacy percentages would disrupt
this balance, weaken quality safeguards, increase provider
leverage in negotiations, raise costs and out-of-pocket
expenses, and potentially put patient safety at risk.
4:03:33 PM
STEVE COMPTON, MD, representing self, Anchorage, Alaska,
testified in opposition to SB 122. He emphasized that Alaska
already suffers from severe provider shortages across multiple
specialties, including pulmonology, endocrinology, cardiology,
pediatric neurosurgery, and primary care, forcing some patients
to leave the state for care. He argued that insurers' cost-
control strategies often reduce access to care, that there is
currently no clear standard for network adequacy, and that
consumer protections are lacking, particularly in light of
statements by a dominant out-of-state insurer indicating plans
to implement a new network strategy in Alaska.
4:07:00 PM
CHAIR DUNBAR closed public testimony on SB 122.
4:07:13 PM
SENATOR HUGHES asked why SB 122 references Medicare Advantage,
noting that it is not available in Alaska and primarily serves
individuals over age 65. She asked whether the reference is
merely to identify a list of specialties and, if so, how
pediatric care would be accounted for.
4:07:57 PM
SENATOR GIESSEL suggested that Mr. Davis answer the question.
4:08:14 PM
MR. DAVIS replied that the reference is to a list of specialties
and acknowledged the point brought up about pediatrics.
4:08:32 PM
SENATOR HUGHES asked whether this is something that needs to be
fixed.
MR. DAVIS replied that adding pediatrics would be a good
addition but it's referencing a list not products.
4:08:50 PM
SENATOR HUGHES stated that the amendment improves SB 122 but
remains concerned that it adds another layer of network adequacy
requirements beyond those already mandated by the Affordable
Care Act. She questioned the use of percentage-based standards
rather than provider-to-population ratios. She stated that she
is worried that the thresholds may still be too high given
Alaska's limited specialists, and cautioned that mandated
percentages could increase provider leverage, raise health care
costs, and discourage insurer participation, ultimately reducing
competition and harming consumers.
4:11:00 PM
CHAIR DUNBAR solicited the will of the committee.
4:11:03 PM
SENATOR GIESSEL moved to report SB 122, work order 34-LS0281\N,
as amended, from committee with individual recommendations and
attached fiscal note(s).
4:11:19 PM
CHAIR DUNBAR found no objection and CSSB 122(HSS) was reported
from the Senate Health and Social Services Standing Committee.
4:11:32 PM
At ease.
SB 134-PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN
4:13:14 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of SENATE BILL NO. 134 "An Act relating to
pharmacy benefits managers; relating to third-party
administrators; and providing for an effective date."
4:13:32 PM
CHAIR DUNBAR opened public testimony on SB 134.
4:13:59 PM
BRANDY SEIGNEMARTIN, Executive Director, Alaska Pharmacy
Association, Eagle River, Alaska, testified in support of SB
134. She stated that licensing pharmacy benefit managers and
third-party administrators is a necessary, common-sense step to
give the Division of Insurance proper oversight and enforcement
authority. While recent legislation improved transparency and
accountability, licensure is needed to ensure compliance, align
with standard practice.
4:15:11 PM
CHAIR DUNBAR closed public testimony on SB 134.
4:15:15 PM
CHAIR DUNBAR held SB 134 in committee.
4:15:24 PM
At ease.
^CONFIRMATION HEARING(S): STATE MEDICAL BOARD
CONFIRMATION HEARING(S): STATE MEDICAL BOARD
4:16:46 PM
CHAIR DUNBAR reconvened the meeting and announced the
consideration of the governor's appointee Samantha Smith to the
State Medical Board.
4:17:29 PM
CHAIR DUNBAR opened public testimony on the appointment of Ms.
Smith to the State Medical Board.
4:17:50 PM
BETSY DOUDS-PACVAN, representing self, Anchorage, Alaska,
testified in opposition to the appointment of Ms. Smith to the
State Medical Board. She expressed strong concern about
appointing Ms. Smith as the physician assistant representative
on the State Medical Board. She cited her limited practical
experience, narrow and atypical work background, and lack of
experience working with other PAs in Alaska. She stated that Ms.
Smith lacks sufficient understanding of Alaska's medical
practice environment and the profession's history in the state.
She recommended against confirming Ms. Smith's appointment as
it's premature for her career.
4:21:07 PM
JENNIFER FAYETTE, representing self, Anchorage, Alaska,
testified in opposition to the appointment of Ms. Smith to the
State Medical Board. She stated that Ms. Smith has the
willingness to serve but lacks sufficient clinical breadth,
experience in diverse Alaskan practice settings and professional
judgment to represent PAs in Alaska.
4:23:35 PM
At ease.
4:45:53 PM
CHAIR DUNBAR reconvened the meeting and invited Ms. Smith to
testify as the governor's appointee to the State Medical Board.
4:46:15 PM
SAMANTHA SMITH, Governor's Appointee, State Medical Board,
Anchorage, Alaska, testified as the governor's appointee to the
State Medical Board. She outlined her education and work
history. She stated that while Alaskans are hardworking, she has
observed patients being mistreated by the medical community,
leading to a loss of trust in the health care system. She cited
the common refrain, she has heard from her patients, "I'm sick
and tired of being sick and tired.She said this motivated her
to seek a role on the medical board, believing Alaskans deserve
high-quality care and confidence in their medical providers.
4:48:53 PM
SENATOR TOBIN explained that the State Medical Board oversees
licensure, continuing education, DEA registration, scope of
practice, and disciplinary matters. She asked about Ms. Smith's
experience with and understanding of this oversight. She also
asked about her familiarity with expectations for providers in
areas not reflected in her résumé, including DEA registration
and prescriptive authority.
4:49:56 PM
MS. SMITH responded that she lacks direct oversight experience
but believes her status as a newer provider gives her
familiarity with current laws and licensure processes. She said
she understands regulatory requirements through her practice and
experience working under others, emphasizing patient safety. She
described her understanding of the licensure process, including
how applications with potential red flags are reviewed and
investigated, and stated she would contact prior employers,
programs, boards, and applicants when concerns arise. She
explained that she does not hold DEA registration because her
practice focuses on non-pharmaceutical treatments and does not
involve prescribing pain medications.
4:55:04 PM
CHAIR DUNBAR returned to public testimony.
4:55:23 PM
CANDACE HICKEL, representing self, Anchorage, Alaska, testified
in opposition to the appointment of Ms. Smith. She stated that
there are more than 25 letters opposing Ms. Smith's appointment.
Common themes in the letters were that Ms. Smith's clinical
practice does not reflect how PAs practice in Alaska. She said
Ms. Smith is unwilling to work with local PA organizations, and
she lacks sufficient clinical experience. She noted that Ms.
Smith has only four years of experience in a highly specialized
fieldregenerative medicinethat is not representative of PA
practice in Alaska. She said Ms. Smith does not have the
experience working in rural settings, and raised concerns about
an apparent HIPAA violation suggesting an inability to maintain
required confidentiality.
4:57:12 PM
SENATOR CLAMAN asked whether most physician assistants have a
DEA license.
4:57:35 PM
MS. HICKEL replied yes, and identified concern in Ms. Smith's
testimony with her injecting medication without having a DEA
license.
4:58:05 PM
DONALD GENE HUDSON, DO, representing self, Anchorage, Alaska,
testified in support of the appointment of Ms. Smith to the
State Medical Board. He stated that over his many years in
medicine, he has seen both good and poor providers. After
reviewing Ms. Smith's charts quarterly, discussing cases with
her, and working with her for two years, he explained that her
practice does not require a DEA or narcotics license, only a
state license. He meets Ms. Smith every other week to discuss
patient care.
5:00:50 PM
CHAIR DUNBAR asked where Dr. Hudson was from.
DR. HUDSON replied Anchorage.
5:01:04 PM
SENATOR TOBIN asked how many PAs he collaborates with.
MR. HUDSON replied that he currently collaborates with five. He
said two PAs are part time and he said is an alternate for a PA
on Hilcorp.
5:02:20 PM
SENATOR TOBIN asked whether he invoiced the PAs for the
collaborating agreement.
5:02:29 PM
DR. HUDSON answered no except, one clinic pays when he shows up.
5:02:49 PM
CHAIR DUNBAR closed public testimony on the appointment of MS.
Smith to the State Medical Board.
5:03:13 PM
SENATOR CLAMAN asked Ms. Smith whether she has worked in the
emergency room during her practice history.
5:03:28 PM
MS. SMITH replied that she has not worked in an emergency room
but has trained with emergency medicine.
5:03:39 PM
SENATOR CLAMAN asked whether she has worked in a medical family
practice clinic.
MS. SMITH answered that she is currently working in family
medicine within functional medicine.
5:03:55 PM
SENATOR CLAMAN asked whether there is a medical doctor that
provides supervision in the clinic where Ms. Smith works.
MS. SMITH replied that the medical doctor is Dr. Hudson. She
said he isn't in the clinic daily but is available by phone day
or night.
5:04:26 PM
CHAIR DUNBAR asked whether there were any further questions.
5:04:31 PM
SENATOR TOBIN asked if Ms. Smith has worked in a federally
qualified health clinic.
5:04:46 PM
MS. SMITH replied no.
5:04:53 PM
SENATOR TOBIN asked whether Ms. Smith was familiar with
federally qualified health clinics, as 67 percent of PAs work in
those type of facilities.
5:05:13 PM
MS. SMITH asked for the question to be repeated.
CHAIR TOBIN repeated the question.
5:05:31 PM
MS. SMITH replied that she is not familiar with the specific
operations of a federally qualified health clinic but noted that
all PAs follow the same regulations and statutes.
5:05:58 PM
SENATOR HUGHES said that in Ms. Smith's opening remarks she
referenced quality. She asked how the quality of care in Alaska
compares to the East Coast.
5:06:26 PM
MS. SMITH replied that medical care on the East Coast is among
the best in the nation, while Alaska's quality does not match
that level. She was disappointed upon moving to Alaska,
expecting higher standards due to the state's close ties with
Washington and hardworking population. Her concerns were based
not only on patient reports but also on national trends and
statistics, such as the 2023 Commonwealth Fund rankings, where
Alaska placed 39th overall and last in prevention and treatment.
Alarmed by these findings, she volunteered for the medical board
to help improve patient care in Alaska.
5:09:27 PM
SENATOR HUGHES asked whether Ms. Smith attributes Alaska's
lower-quality scores to the providers and, if so, how she plans
to improve provider quality through her role on the board.
5:09:57 PM
MS. SMITH answered that improving provider quality starts with
ensuring that only qualified individuals receive licensure,
noting she never received a phone call about potential issues on
her own application despite guidance that she should have. She
said research shows providers with academic or clinical
probation may have higher risk of complications. She emphasized
monitoring current licensed physicians and PAs to ensure they
follow regulations, prevent patient harm, and fairly address
complaints, noting the limited availability of medical
malpractice attorneys in Alaska.
5:12:17 PM
CHAIR DUNBAR stated that in accordance with AS 39.05.080, the
Senate Health and Social Services Standing Committee reviewed
the following and recommends the appointment be forwarded to a
joint session for consideration:
State Medical Board
Samantha Smith - Anchorage
He reminded members that signing the report(s) regarding
appointments to boards and commissions in no way reflects
individual members' approval or disapproval of the appointees;
the nominations are merely forwarded to the full legislature for
confirmation or rejection.
5:12:54 PM
There being no further business to come before the committee,
Chair Dunbar adjourned the Senate Health and Social Services
Standing Committee meeting at 5:12 p.m.
| Document Name | Date/Time | Subjects |
|---|---|---|
| SB 134 Supporting Document PBM License Registration Tracking NAIC 04.02.25.pdf |
SHSS 4/3/2025 3:30:00 PM |
SB 134 |
| SJR 15 Fiscal Note LEG SESS 3.19.25.pdf |
SHSS 4/3/2025 3:30:00 PM |
SJR 15 |
| SB 134 DOI Response to SHSS 4.3.25.pdf |
SHSS 4/3/2025 3:30:00 PM |
SB 134 |
| SB 122 Amendment N.1 3.25.25 (002).pdf |
SHSS 4/3/2025 3:30:00 PM |
SB 122 |
| SB 122 Amendment N.2 4.2.25.pdf |
SHSS 4/3/2025 3:30:00 PM |
SB 122 |