Legislature(2017 - 2018)BELTZ 105 (TSBldg)

03/27/2018 01:30 PM LABOR & COMMERCE

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01:33:38 PM Start
01:34:13 PM SB119
02:38:31 PM Adjourn
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ Bills Previously Heard/Scheduled: TELECONFERENCED
Moved CSSB 119(L&C) Out of Committee
                    ALASKA STATE LEGISLATURE                                                                                  
          SENATE LABOR AND COMMERCE STANDING COMMITTEE                                                                        
                         March 27, 2018                                                                                         
                           1:33 p.m.                                                                                            
MEMBERS PRESENT                                                                                                               
Senator Mia Costello, Chair                                                                                                     
Senator Kevin Meyer, Vice Chair                                                                                                 
Senator Gary Stevens                                                                                                            
Senator Berta Gardner                                                                                                           
Senator Peter Micciche                                                                                                          
MEMBERS ABSENT                                                                                                                
All members present                                                                                                             
COMMITTEE CALENDAR                                                                                                            
SENATE BILL NO. 119                                                                                                             
"An Act relating to disclosure  of health care services and price                                                               
information;  relating  to  health  care  insurers;  relating  to                                                               
availability  of payment  information  and  estimates of  out-of-                                                               
pocket expenses;  relating to an  incentive program  for electing                                                               
to receive health  care services for less than  the average price                                                               
paid;  relating   to  filing  and  reporting   requirements;  and                                                               
providing for an effective date."                                                                                               
     - MOVED CSSB 119(L&C) OUT OF COMMITTEE                                                                                     
PREVIOUS COMMITTEE ACTION                                                                                                     
BILL: SB 119                                                                                                                  
SHORT TITLE: HEALTH CARE COSTS: DISCLOSURE;INSURERS;                                                                            
SPONSOR(s): SENATOR(s) HUGHES                                                                                                   
04/24/17       (S)       READ THE FIRST TIME - REFERRALS                                                                        
04/24/17       (S)       L&C, FIN                                                                                               
02/27/18       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
02/27/18       (S)       Heard & Held                                                                                           
02/27/18       (S)       MINUTE(L&C)                                                                                            
02/27/18       (S)       L&C AT 5:00 PM BELTZ 105 (TSBldg)                                                                      
02/27/18       (S)       -- Public Testimony --                                                                                 
03/19/18       (S)       L&C AT 6:00 PM BELTZ 105 (TSBldg)                                                                      
03/19/18       (S)       Heard & Held                                                                                           
03/19/18       (S)       MINUTE(L&C)                                                                                            
03/27/18       (S)       L&C AT 1:30 PM BELTZ 105 (TSBldg)                                                                      
WITNESS REGISTER                                                                                                              
NATASHA MCCLANAHAN, Staff                                                                                                       
Senator Mia Costello                                                                                                            
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Reviewed changes between version U and                                                                    
version R of SB 119.                                                                                                            
SENATOR SHELLEY HUGHES                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Sponsor of SB 119.                                                                                        
BUDDY WHITT, Staff                                                                                                              
Senator Shelley Hughes                                                                                                          
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided the sectional analysis for version                                                               
R of SB 119.                                                                                                                    
ELISE SORUM-BIRK, Intern                                                                                                        
Senator Bill Wielechowski                                                                                                       
Alaska State Legislature                                                                                                        
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Provided information on SB 119.                                                                           
SARA CHAMBERS, Division Manager                                                                                                 
Corporations, Business, and Professional Licensing (CBPL)                                                                       
Department of Commerce, Community and Economic Development                                                                      
Juneau, Alaska                                                                                                                  
POSITION STATEMENT: Testified that the Board of Pharmacy offered                                                              
no position on incorporating SB 209 into SB 119.                                                                                
JOEL ALLUMBAUGH, Visiting Fellow                                                                                                
Foundation for Government Accountability                                                                                        
Naples, Florida                                                                                                                 
POSITION STATEMENT: Testified in support of SB 119.                                                                           
RICHARD HOLT, Chair                                                                                                             
Board of Pharmacy                                                                                                               
Eagle River, Alaska                                                                                                             
POSITION STATEMENT: Raised concerns about SB 119.                                                                             
ACTION NARRATIVE                                                                                                              
1:33:38 PM                                                                                                                    
CHAIR MIA COSTELLO called the  Senate Labor and Commerce Standing                                                             
Committee meeting  to order at 1:33  p.m. Present at the  call to                                                               
order  were  Senators  Gardner,   Stevens,  Micciche,  and  Chair                                                               
Costello. Senator Meyer arrived soon thereafter.                                                                                
         SB 119-HEALTH CARE COSTS: DISCLOSURE;INSURERS;                                                                     
1:34:13 PM                                                                                                                    
CHAIR COSTELLO  announced the consideration  of SB 119  and noted                                                               
the proposed committee substitute (CS).                                                                                         
1:34:39 PM                                                                                                                    
SENATOR  MICCICHE  moved  to  adopt   the  work  draft  committee                                                               
substitute (CS) for  SB 119, labeled 30-LS0403\R,  as the working                                                               
1:34:56 PM                                                                                                                    
CHAIR COSTELLO objected for an explanation of the changes.                                                                      
1:35:09 PM                                                                                                                    
NATASHA  MCCLANAHAN, Staff,  Senator Mia  Costello, Alaska  State                                                               
Legislature, Juneau,  Alaska, reviewed the  following explanation                                                               
of changes from version U to version R of SB 119:                                                                               
        • Bill title revised to include new items in the                                                                        
          legislation pertaining to pharmacies' disclosure                                                                      
          of cost information.                                                                                                  
        • Changes AS 08.80.297, adding that pharmacies must                                                                     
          disclose pharmacy retail price and consumer's                                                                         
          cost sharing price when filling a prescription.                                                                       
        • Adds a new section to AS 08.80, directing that                                                                        
          pharmacists  in the  State  must, unless  directed                                                                    
          otherwise by  the consumer,  charge the  lesser of                                                                    
          the two  prices between the pharmacy  retail price                                                                    
          and the consumer cost sharing price.                                                                                  
        • Stipulates  that    pharmacies    must    retain                                                                      
          prescription and customer cost information for a                                                                      
          period of at least two years.                                                                                         
        • A new subsection is added directing the                                                                               
          department to  inform the  public that  a provider                                                                    
          who chose  to pay the  maximum penalty in  lieu of                                                                    
          disclosing their prices, was  in violation of this                                                                    
        • Sections 8 and 9 of version U are removed and a                                                                       
          new section  is added requiring the  Department of                                                                    
          Administration  to  conduct  an  analysis  of  the                                                                    
          possible  impacts to  the state  of Alaska  and to                                                                    
          employees   under   managed   plans   should   the                                                                    
          Department   adopt   the    requirements   of   AS                                                                    
          18.23.400,   AS  18.23.405,   and  AS   21.96.200-                                                                    
1:36:47 PM                                                                                                                    
SENATOR SHELLEY HUGHES, Alaska State Legislature, Juneau,                                                                       
Alaska, sponsor of SB 119, offered to have Mr. Witt go through                                                                  
the sectional.                                                                                                                  
1:37:08 PM                                                                                                                    
BUDDY  WHITT,   Staff,  Senator  Shelley  Hughes,   Alaska  State                                                               
Legislature,  Juneau, Alaska,  advised that  the CS  incorporates                                                               
legislation  by Senator  Wielechowski  regarding pharmacists.  He                                                               
highlighted the following changes in version R of SB 119:                                                                       
      Sec. 2, Page 1, line 12  Page 2, Line 2 Adds that a                                                                       
        pharmacist must disclose retail and cost sharing                                                                        
     information when requested.                                                                                                
        Sec. 3, Page 2, Line 3  Page 3, Line 4 Amends AS                                                                        
    08.80.297   by   adding   new   subsections   regarding                                                                     
     disclosure of prescription drug pricing to consumers.                                                                      
        b. Pharmacists shall charge the lower of the two                                                                        
          prices of a prescription  drugs between the retail                                                                    
          prices  and  the  consumers  cost  sharing  price,                                                                    
          unless otherwise directed by the consumer.                                                                            
        c. The pharmacist must inform the consumer if the                                                                       
          retail  price is  lower  that  the consumers  cost                                                                    
          sharing price.                                                                                                        
        d. Pharmacies must post a notice that the consumer                                                                      
          may,   at  the   point   of   sale,  request   the                                                                    
          pharmacists retail price of a prescription.                                                                           
        e. No contract or agreement may prohibit a pharmacy                                                                     
          from complying with this section.                                                                                     
        f. Definitions used in this section.                                                                                    
1:39:32 PM                                                                                                                    
SENATOR STEVENS noted  that on the top  of page 2 of  the bill it                                                               
says, "pharmacy  retail price" and "consumer's  cost sharing." He                                                               
asked  if  that  should  be "price"  instead  of  "cost  sharing"                                                               
because the  explanation of changes  says, "cost  sharing price."                                                               
He asked if  pharmacists only deal with two  prices, the consumer                                                               
cost sharing price and the retail price.                                                                                        
MR. WHITT  said his understanding  is there are only  two prices.                                                               
One is the  price the pharmacy charges on a  retail basis and the                                                               
other is the copay that an insured person would pay.                                                                            
SENATOR STEVENS  asked him to  look into whether the  language at                                                               
the top of page 2 should say "consumer cost sharing price."                                                                     
1:41:12 PM                                                                                                                    
At ease                                                                                                                         
1:41:41 PM                                                                                                                    
CHAIR COSTELLO reconvened  the meeting. She pointed  out that the                                                               
definition of cost sharing is on page 2, line 17.                                                                               
1:42:07 PM                                                                                                                    
SENATOR MEYER joined the committee.                                                                                             
CHAIR  COSTELLO  asked  Senator  Stevens  if  he  wanted  further                                                               
SENATOR STEVENS said not if the chair is happy.                                                                                 
1:42:32 PM                                                                                                                    
SENATOR GARDNER  said it seems the  price is set by  the retailer                                                               
and the  cost sharing has to  do with the insurance,  so it's not                                                               
really a  price. She asked  the impact  of this provision  on the                                                               
pharmacist.   They  aren't   reimbursed  sometimes   through  the                                                               
insurance process  for the actual  price they paid. She  asked if                                                               
this provision  of requiring  the pharmacy to  sell at  the lower                                                               
price hurts the bottom line.                                                                                                    
MR. WHITT deferred to Senator Wielechowski staff.                                                                               
SENATOR GARDNER said she'd hold the question.                                                                                   
1:44:16 PM                                                                                                                    
MR. WHITT continued the sectional analysis for SB 119.                                                                          
     Sec. 4,  Page 3,  Lines 5    10  AS 08.80.305  is added                                                                    
     instructing pharmacists  to maintain pricing  and sales                                                                    
     information for no less than two years.                                                                                    
     Sec. 5  and Sec.  6, Page  3, Lines 11    24  These two                                                                    
     sections  amend AS  08.80.460  to  exempt violators  of                                                                    
     this  section from  the maximum  penalty of  a class  B                                                                    
     misdemeanor and  includes them  in the  civil penalties                                                                    
     assessed for violation of the section.                                                                                     
MR. WHITT  said pharmacists face  severe penalties  for violating                                                               
certain  provisions  in  Chapter  80.   They  did  not  want  the                                                               
situation of not  providing a piece of paper  stating someone may                                                               
request the  retail price to  be a  violation that resulted  in a                                                               
class  B  misdemeanor.  The  language is  to  clarify  that  this                                                               
section  alone  would  not  result  in a  maximum  penalty  if  a                                                               
pharmacist were in violation.                                                                                                   
SENATOR HUGHES said  in lieu of paying a  penalty, the pharmacist                                                               
would have the option to refund the difference to the consumer.                                                                 
MR. WHITT said he  would skip to subsection (g) on  page 5 to the                                                               
next substantive change.                                                                                                        
     Sec. 8,  Page 4, Line  8   Page 7,  Line 31 Adds  a new                                                                    
     section to Title 18 for  health care services and price                                                                    
        g. Allows the department to disclose to the public                                                                      
          that the  health care provider  or facility  is in                                                                    
          violation of  this section  should they  choose to                                                                    
          pay the  maximum penalty in lieu  of providing the                                                                    
          requested information.                                                                                                
MR.  WHITT  explained that  if  a  provider  chooses to  pay  the                                                               
penalty in  lieu of  providing price information  for the  top 25                                                               
health  care  services,  the  Department  of  Health  and  Social                                                               
Services (DHSS) does  have the ability to list the  fact that the                                                               
provider is in violation of the requirement to disclose prices.                                                                 
CHAIR COSTELLO asked if the penalty is $2,500.                                                                                  
MR. WHITT said that's correct.                                                                                                  
MR. WHITT  said the rest of  the bill is unchanged  until Section                                                               
13,  page 13.  This  addresses concerns  that  the Department  of                                                               
Administration (DOA)  voiced that implementing such  major policy                                                               
changes without  the ability  to thoroughly  vet them  might have                                                               
unintended consequences.                                                                                                        
     Sec.  13, Page  13,  Lines  6    16  The Department  of                                                                    
     Administration  shall   perform  an  analysis   of  the                                                                    
     possible  impacts to  the state  of Alaska  and to  the                                                                    
     employees  under managed  plans  should the  Department                                                                    
     adopt the  requirements of  AS 18.23.400,  AS 18.23.405                                                                    
     and AS 21.96.200  AS 21.96.300.                                                                                            
1:49:14 PM                                                                                                                    
SENATOR HUGHES said the department  was interested in the concept                                                               
and  what other  states  have  done and  whether  it might  bring                                                               
savings. For example, just for  the retiree health care per year,                                                               
it is about $650 million. They  were also willing to implement it                                                               
if it's a  benefit to the state. That language  isn't in the bill                                                               
currently, but future committees might  want to include that. She                                                               
is  pleased about  the  report back.  It's a  step  in the  right                                                               
MR. WHITT said the CS makes no changes after Section 13.                                                                        
1:50:48 PM                                                                                                                    
SENATOR STEVENS said that the  pharmacist must keep the record of                                                               
prescriptions for  two years. He  asked how onerous this  will be                                                               
for the pharmacist.                                                                                                             
MR.  WHITT said  as the  sponsor  mentioned, Section  3 asks  the                                                               
pharmacy to keep  the information on hand, so they  can refund if                                                               
they charged  too much. The  price is the  price at the  point of                                                               
sale. Retail prices  may vary, but the contracted  rates with the                                                               
insurance company are set for a period of time.                                                                                 
SENATOR STEVENS  clarified they have  not received  feedback from                                                               
pharmacists that this would be difficult to do.                                                                                 
MR. WHITT  said the sponsor's office  has not heard that  it will                                                               
be onerous.                                                                                                                     
1:53:39 PM                                                                                                                    
SENATOR GARDNER said she believes  it might be fairly complicated                                                               
to figure  out the steps  on each order.  She would like  to hear                                                               
from pharmacists about what this might entail.                                                                                  
MR. WHITT said  this is retail, not  wholesale. His understanding                                                               
is that information and the  consumer cost sharing price are kept                                                               
on file and readily available.                                                                                                  
SENATOR HUGHES  said she appreciates  the question.  This changes                                                               
things, but they are trying not  to make this onerous. The retail                                                               
price is set every day of the  year. For the most part the retail                                                               
price will be readily available [through the software used].                                                                    
1:56:26 PM                                                                                                                    
SENATOR MEYER  asked if this  pertains to physician  providers in                                                               
Alaska only.  He asked if  telehealth outside the state  would be                                                               
MR. WHITT said he would  get clarification, but his understanding                                                               
is every health  care provider licensed in Alaska  would be privy                                                               
to the policy.                                                                                                                  
SENATOR  MEYER asked  if each  physician in  a multiple-physician                                                               
practice would need to post prices.                                                                                             
MR. WHITT  said he  would need  to check and  follow up  with the                                                               
SENATOR   MEYER   asked   if  physician   assistants   or   nurse                                                               
practitioners working  with physicians would need  to post prices                                                               
as well.                                                                                                                        
1:59:41 PM                                                                                                                    
At ease                                                                                                                         
2:00:53 PM                                                                                                                    
CHAIR COSTELLO reconvened the meeting.                                                                                          
2:01:03 PM                                                                                                                    
MR.  WHITT said  his assumption  is that  the bill  addresses all                                                               
providers and  all health care  facilities. He read  the language                                                               
in Section 8  pages 4 and 5. It's purposefully  broad language to                                                               
capture as much information as possible.                                                                                        
SENATOR  HUGHES added  that a  primary care  clinic that  has the                                                               
same price  list for all  the providers  would need to  have just                                                               
one list.                                                                                                                       
SENATOR MEYER asked  if they also put the prices  on their or the                                                               
department's website.                                                                                                           
MR. WHITT said in Section 8 language  on page 4, says that a list                                                               
is turned in to DHSS for posting  on the website and is posted in                                                               
a  reception area  of  the  facility and  on  a  website, if  the                                                               
facility has a website.                                                                                                         
SENATOR MEYER  commented that the  onus is for the  department to                                                               
put it on the website, not the doctor's office.                                                                                 
MR. WHITT restated that the  provider facility must post the list                                                               
on a website if the provider has a website.                                                                                     
2:04:24 PM                                                                                                                    
SENATOR  MICCICHE said  section 8,  page 7,  has a  definition of                                                               
health care facility and health care provider.                                                                                  
2:04:44 PM                                                                                                                    
CHAIR  COSTELLO   removed  her  objection;  finding   no  further                                                               
objection, version R was adopted.                                                                                               
2:05:25 PM                                                                                                                    
ELISE  SORUM-BIRK,  Intern,  Senator  Bill  Wielechowski,  Alaska                                                               
State Legislature,  Juneau, Alaska, said generally  this would be                                                               
a benefit to pharmacists.                                                                                                       
SENATOR GARDNER  asked if she  has discussed this  provision with                                                               
MS.  SORUM-BIRK  said they  have  one  letter from  a  pharmacist                                                               
organization. They support the idea  of the bill but are hesitant                                                               
that the onus  is on the pharmacist. They would  rather it be put                                                               
on the pharmacy benefit manager.                                                                                                
SENATOR GARDNER said she would like  to hear from a pharmacist or                                                               
someone who could tell how this would apply.                                                                                    
CHAIR COSTELLO said no pharmacists were signed in to testify.                                                                   
SENATOR  GARDNER reiterated  that  she would  like  to hear  from                                                               
2:08:35 PM                                                                                                                    
At ease                                                                                                                         
2:09:25 PM                                                                                                                    
CHAIR COSTELLO reconvened the meeting.                                                                                          
2:09:30 PM                                                                                                                    
MS. SORUM-BIRK said  subsection (e) on page 2, line  14, would be                                                               
beneficial  to pharmacists  because  they often  now  have a  gag                                                               
order in  contracts. Without that  gag order, they would  be able                                                               
to talk more openly about pricing to the consumer.                                                                              
CHAIR COSTELLO asked if the  administration has a position on the                                                               
2:11:30 PM                                                                                                                    
SARA  CHAMBERS,  Division  Manager, Corporations,  Business,  and                                                               
Professional Licensing (CBPL),  Department of Commerce, Community                                                               
and Economic Development (DCCED),  Juneau, Alaska, said the Board                                                               
of  Pharmacy looked  at SB  209,  Senator Wielechowski's  initial                                                               
bill,  but declined  to offer  a position.  The thought  from the                                                               
board  is  it's  not  dramatically  different.  The  division  is                                                               
reaching out  to the board  to ensure the  chair is aware  of the                                                               
changes in the bill.                                                                                                            
CHAIR COSTELLO  asked if  she foresees  the fiscal  note changing                                                               
from zero.                                                                                                                      
MS. CHAMBERS said CBPL hasn't  submitted a fiscal note and hasn't                                                               
done the analysis on this bill at this time.                                                                                    
2:13:33 PM                                                                                                                    
CHAIR COSTELLO turned to public testimony.                                                                                      
2:13:51 PM                                                                                                                    
JOEL  ALLUMBAUGH,  Visiting  Fellow,  Foundation  for  Government                                                               
Accountability, Naples, Florida, testified  in support of SB 119.                                                               
He said the foundation is a  nonpartisan think tank. He also owns                                                               
and operates  an employee  benefits business.  He lives  with the                                                               
regulatory choices  made. The foundation  has been  interested in                                                               
aligning  patient incentives  with meaningful  transparency as  a                                                               
simple  way  to lower  health  care  spending. They  support  the                                                               
efforts  of  SB 119.  What  is  common  across states  is  widely                                                               
variable  costs with  no  tie to  quality.  Shopping alone  won't                                                               
solve the  problem, but it is  part of the low  hanging fruit. He                                                               
asked  them  to  imagine  the possible  savings  to  patients  by                                                               
choosing lower-cost  services and to  think of the impact  of the                                                               
delivery service  as providers respond  to incentives,  just like                                                               
patients do.  He gave  an example of  how implementing  a similar                                                               
program for  New Hampshire  state employees  lowered costs  for a                                                               
certain treatment.                                                                                                              
2:18:59 PM                                                                                                                    
RICHARD  HOLT, Chair,  Board of  Pharmacy,  Eagle River,  Alaska,                                                               
said he  wanted to  give his personal  perspective as  a licensed                                                               
pharmacist.  The first  big impact  of  the committee  substitute                                                               
would be  providing consumers  with cost  sharing data.  He won't                                                               
know  the copay  until he  enters all  the information  about the                                                               
prescription into  the computer system.  Until he sends  all that                                                               
information via  computer to the  insurance company he  will have                                                               
no idea what  the consumer will pay or if  it is covered. Second,                                                               
there is  the retail or  cash price  and a consumer  cost sharing                                                               
defined in  the bill.  Another price  is through  discount cards,                                                               
which also  affect prices. It doesn't  look like they are  a part                                                               
of  this   process,  but  many   patients  use   discount  cards,                                                               
especially those who do not have insurance.                                                                                     
MR. HOLT said Senator Gardner  had excellent points about Section                                                               
3 and the  onus on pharmacists. To have to  manually look up each                                                               
claim  when  processing  hundreds  of  prescriptions  a  day  and                                                               
thinking  about  clinical  concerns,  is onerous.  He  is  not  a                                                               
computer  programmer,  but it  is  not  user friendly.  Regarding                                                               
posting  notices,  patients don't  pay  attention.  He asked  why                                                               
there is  an onus imposed  on in-state pharmacies  versus out-of-                                                               
state pharmacies.                                                                                                               
2:25:15 PM                                                                                                                    
SENATOR  STEVENS   asked  him  to   reflect  on  Section   4  and                                                               
maintaining costs for two years.                                                                                                
MR. HOLT  said it won't  be a  large burden because  most records                                                               
are electronic.                                                                                                                 
2:26:12 PM                                                                                                                    
At ease                                                                                                                         
2:27:34 PM                                                                                                                    
CHAIR COSTELLO  reconvened the meeting.  Finding no one  else who                                                               
wanted to comment, she closed public testimony on SB 119.                                                                       
2:28:03 PM                                                                                                                    
MR. WHITT said he and the  sponsor appreciate Mr. Holt giving his                                                               
view of the  bill. He pointed out that the  sponsor did meet with                                                               
every  stakeholder  they could  think  of.  He will  respect  Mr.                                                               
Holt's view on the bill.                                                                                                        
MR. WHITT said that Section 3  of the bill doesn't change the way                                                               
a prescription is  filled. The bill assumes  that everything that                                                               
happens  is  after  the  prescription is  filled.  It  is  simply                                                               
letting the consumer  know if one of the two  prices is lower, so                                                               
the consumer can make a  purchasing decision. They are asking for                                                               
transparency  and  information for  consumers  when  they fill  a                                                               
prescription. Second,  the bill  does not require  pharmacists to                                                               
give information about cost over the phone.                                                                                     
2:30:42 PM                                                                                                                    
SENATOR GARDNER  said subsection  (b) says, "A  pharmacist shall,                                                               
unless directed otherwise  by the consumer charge  a consumer the                                                               
applicable cost sharing or the  current pharmacy retail price for                                                               
a  prescription  medicine,  whichever  is  less."  That  means  a                                                               
pharmacist must figure out for  every prescription which is less,                                                               
so  they  must  complete  the submission  through  the  insurance                                                               
company for that  calculation and check the other  price. That is                                                               
a lot of work.                                                                                                                  
SENATOR HUGHES  said she  is willing  to work  with Mr.  Holt and                                                               
others. Her experience is once  pharmacists bring up her name the                                                               
information is available instantly. It  is the point of sale, not                                                               
phone   requests.  Her   understanding  is   that  software   can                                                               
accommodate  that.  She wants  to  allow  consumers to  have  the                                                               
information they  need and ensure  consumers are  not overcharged                                                               
and also make it the least amount of work for pharmacists.                                                                      
2:32:57 PM                                                                                                                    
SENATOR GARDNER said  she appreciates that. She  wants to support                                                               
that, but even  if someone gets the same  prescription filled all                                                               
the time,  pharmacists have  to check the  price every  time with                                                               
insurance  companies.  Sometimes  people  are  not  employed  any                                                               
longer or filling prescriptions early.  It's another step that is                                                               
rather  laborious. It's  a concern  and pharmacists  not here  to                                                               
speak about it.                                                                                                                 
2:34:08 PM                                                                                                                    
SENATOR MICCICHE asked  if there could be  an interstate commerce                                                               
problem with subsection (e) in Section 3.                                                                                       
MR. WHITT said  based on his research, legislation  like this has                                                               
been  passed in  Connecticut, Georgia,  North Dakota,  Louisiana,                                                               
and  is in  committee  in  Massachusetts. As  it  relates to  the                                                               
federal commerce  clause, this would  be a policy that  the state                                                               
would  enact for  pharmacists who  are licensed  in the  state of                                                               
Alaska. Those  concerns have been  addressed in other  states and                                                               
Legislative Legal hasn't expressed concern with that section.                                                                   
SENATOR  MICCICHE  said  he's not  convinced  even  though  other                                                               
states  have passed  similar legislation.  He didn't  know how  a                                                               
state  could  legislate  an out-of-state  supplier  contract.  It                                                               
seems problematic and an important consideration.                                                                               
CHAIR COSTELLO  said the  bill has a  Finance referral  and those                                                               
concerns can be brought up there.                                                                                               
SENATOR  MICCICHE said  he would  request  hearing from  affected                                                               
parties in Finance.                                                                                                             
2:37:51 PM                                                                                                                    
SENATOR MEYER moved to report the  CS for SB 119, version R, from                                                               
committee  with individual  recommendations  and attached  fiscal                                                               
2:38:05 PM                                                                                                                    
CHAIR COSTELLO  found no objection  and CSSB 119(L&C)  moved from                                                               
the Senate Labor and Commerce Standing Committee.                                                                               
2:38:31 PM                                                                                                                    
There being  no further  business to  come before  the committee,                                                               
Chair Costello  adjourned the Senate Labor  and Commerce Standing                                                               
Committee meeting at 2:38 p.m.                                                                                                  

Document Name Date/Time Subjects
CSSB 119 Version R.PDF SL&C 3/27/2018 1:30:00 PM
SB 119
CSSB 119 Explanation of Changes Ver. U to R.pdf SL&C 3/27/2018 1:30:00 PM
SB 119
CSSB 119 Version R - Sectional Analysis.pdf SL&C 3/27/2018 1:30:00 PM
SB 119