SB 134-PHARMACY BENEFITS MANAGER;3RD PARTY ADMIN  4:23:14 PM CHAIR MINA announced that the first order of business would be SENATE BILL NO. 134, "An Act relating to pharmacy benefits managers; relating to third-party administrators; and providing for an effective date." 4:23:42 PM JANE ROHR, Staff, Senator Cathy Giessel, Alaska State Legislature, presented SB 134 on behalf of Senator Giessel, prime sponsor. She stated that pharmacy benefit managers and third-party administrators do business as intermediaries "between insurance companies and pharmacies or consumers." Some responsibilities include the negotiation of medication prices and the processing of claims. She continued: Current statute requires these entities to be registered, which only allows for a basic level of recognition. The purpose of this bill is to require transparency and accountability for third-party administrators and pharmacy benefit managers operating in the state of Alaska, by requiring them to be licensed and subject to oversight by the Division of Insurance. MS. ROHR, in conclusion, offered to answered questions. 4:24:31 PM CHAIR MINA noted those available for questions and entertained amendments. 4:24:47 PM REPRESENTATIVE RUFFRIDGE moved to adopt Amendment 1 to SB 134, labeled 34-LS0461\A.2, Wallace, 5/14/25, which read as follows: Page 16, following line 13: Insert a new bill section to read:  "* Sec. 32. AS 21.36.520(a) is amended to read: (a) An insurer providing a health care insurance policy or its pharmacy benefits manager may not (1) interfere with a covered person's right to choose a pharmacy or provider; (2) interfere with a covered person's right of access to a clinician-administered drug; (3) interfere with the right of a pharmacy or pharmacist to participate as a network pharmacy; (4) reimburse a pharmacy or pharmacist an amount less than the amount the pharmacy benefits manager reimburses an affiliate for providing the same pharmacy services, calculated on a per-unit basis using the same generic product identifier or generic code number; (5) impose a reduction in reimbursement for pharmacy services because of the person's choice among pharmacies that have agreed to participate in the plan according to the terms offered by the insurer or its pharmacy benefits manager; (6) use a covered person's pharmacy services data collected under the provision of claims processing services for the purpose of soliciting, marketing, or referring the person to an affiliate of the pharmacy benefits manager; (7) prohibit or limit a pharmacy from mailing, shipping, or delivering drugs to a patient as an ancillary service; however, the insurer or its pharmacy benefits manager (A) is not required to reimburse a delivery fee charged by a pharmacy unless the fee is specified in the contract between the pharmacy benefits manager and the pharmacy; (B) may not require a patient signature as proof of delivery of a mailed or shipped drug if the pharmacy (i) maintains a mailing or shipping log signed by a representative of the pharmacy or keeps a record of each notification of delivery provided by the United States mail or a package delivery service; and (ii) is responsible for the cost of mailing, shipping, or delivering a replacement for a drug that was mailed or shipped but not received by the covered person; (8) prohibit or limit a network pharmacy from informing an insured person of the difference between the out-of-pocket cost to the covered person to purchase a drug, medical device, or supply using the covered person's pharmacy benefits and the pharmacy's usual and customary charge for the drug, medical device, or supply; (9) conduct or participate in spread pricing in the state; (10) assess, charge, or collect a form of remuneration that passes from a pharmacy or a pharmacist in a pharmacy network to the pharmacy benefits manager, including claim processing fees, performance-based fees, network participation fees, or accreditation fees; (11) reverse and resubmit the claim of a pharmacy more than 90 days after the date the claim was first adjudicated, and may not reverse and resubmit the claim of a pharmacy unless the insurer or pharmacy benefits manager (A) provides prior written notification to the pharmacy; (B) has just cause; (C) first attempts to reconcile the claim with the pharmacy; and (D) provides to the pharmacy, at the time of the reversal and resubmittal, a written description that includes details of and justification for the reversal and resubmittal;  (12) prohibit or limit a pharmacy from  collecting a fee from a covered person for a service  or product not covered by the covered person's health  care insurance policy." Renumber the following bill sections accordingly. CHAIR MINA objected for the purpose of discussion. REPRESENTATIVE RUFFRIDGE explained that there have been reports of contracts or policies that do not allow a pharmacy to collect a fee for additional services, such as delivery or adherence packing, without risking termination of contract. The language that would be added by adopting Amendment 1 would remedy that. CHAIR MINA removed her objection. 4:26:10 PM REPRESENTATIVE GRAY objected. He asked who would pay. REPRESENTATIVE RUFFRIDGE clarified that Amendment 1 allows for a service that is not already covered under the plan; therefore the fee would be charged to the patient. In response to follow- up questions from Representative Gray, Representative Ruffridge noted that he, as a pharmacist, regularly mails prescriptions to patients in remote areas or when items are difficult to obtain from different locations. He noted that Amendment 1 would allow a pharmacy to offer delivery service. 4:28:55 PM REPRESENTATIVE GRAY removed his objection. There being no further objection, Amendment 1 was adopted. 4:29:15 PM REPRESENTATIVE GRAY moved to report SB 134, as amended, out of committee with individual recommendations and the accompanying fiscal notes. There being no objection, HCSSB 134(HSS) was reported out of the House Health and Social Services Standing Committee.