[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6287413,"mediaKeyId","2553186-d0d4c666e5fd228bfaed1f59d8ca3f98","parentId",2553186,"title","Senate panel hears bill to require Alaska-specific provider-network minimums","audioSeconds",1535,"startMs",4064470,"endMs",5599500,"viewUrl","/Search/View?dp=1&key=2553186-d0d4c666e5fd228bfaed1f59d8ca3f98&start=4064&end=5599","thumbnailUrl","https://assets.pipeline.soar.com/2553186-d0d4c666e5fd228bfaed1f59d8ca3f98/thumbnail_4064470.jpg","articleUrl","/articles/6287413/Alaska/Senate-panel-hears-bill-to-require-Alaska-specific-provider-network-minimums","mediaUrl","https://secure.pipeline.soar.com/6287413-ef1c354cb4d30e5c52770a02b0bccc9d/orig.mp4?Expires=1771167889&Signature=a~YnZRDKbWR5QwLy6WlWOIiFWpcSKCSGz-nUTRhMY971MS4Lxz0gHBpUQDP82Ofl53mPYocwjHxIOIhbU5TChQX0f2yzv3fdH4vGLH5dLxV1lqj89s2qd~l1ftFFTBvAfat4PpXikn9gkwKSCP8qu-iuNyBgNvVwfrHqe2UeFYbbj~-G33h8ZX0iLzuF9VfCSeEQaLkfuC2b1vXMO9z7-DR2s4ICv1Axu2sxqIEZALbytRzWSr5soS7TQ6dc-68lfqc7U4u6micsxF-6PIv7NVwwRIv-4loSrZCgFbtB~40n2XESlu9oU8HCQYB9jI~1FyfaxUtcd1zYSta9q3ve1w__&Key-Pair-Id=KUT5TJCACFTXG","author","Alaska Legislature","date","2025-03-11T00:00:00Z","article","Juneau — The Senate Health and Social Services Committee on March 11 considered Senate Bill 122, which would establish state-defined minimum standards for health insurer provider networks designed for Alaska\u0000s geography and workforce distribution.

Senator Kathy Giesel, vice chair of the committee and sponsor of SB 122, said the bill is intended to prevent narrow-network insurance products from limiting access to needed specialties in a state already designated a federal health care professional shortage area. \"Narrow networks would be detrimental to Alaskans' health and would hinder access to needed providers,\" Giesel said in her introductory remarks.

Under the draft language discussed in committee, the bill would divide Alaska into six contracting regions (Anchorage municipality; Matanuska-Susitna Borough; Fairbanks North Star Borough and Southeast Fairbanks Census Area; Kenai Peninsula Borough; a Southeast cluster including Juneau, Ketchikan and Sitka; and the remainder of the state). Each region would be required to include a minimum percentage of active physicians, physician assistants and advanced practice registered nurses (APRNs) by specialty and to include each hospital, skilled nursing facility and mental health/substance use facility in the insurer\u0000s network directories.

Percentages in the draft sectional presented to the committee vary by region: Anchorage would require coverage of 85% of active physicians, PAs and APRNs in each specialty and 85% of provider groups by specialty; Matanuska-Susitna and Fairbanks regions were described with a 90% standard (a typographical error in the sectional transcription was noted and will be corrected in drafting); Kenai Peninsula and the Southeast cluster were given 95% standards in the draft. The bill would allow insurers to request an exception from the director of the Division of Insurance for up to 36 months and requires a corrective-action plan and annual progress reports during any exception period.

Why it matters: Witnesses and the sponsor said minimum standards are a commonly used regulatory tool elsewhere and cited the National Association of Insurance Commissioners (NAIC) guidance noting provider-network standards as a primary state-level mechanism to ensure well-functioning markets. \"This will establish simple standards tailored to the geography and distribution of population and providers in Alaska,\" Giesel said.

Jeffrey Davis, the consultant who presented for the sponsor, told the committee that many lower-48 states use drive-time or provider-to-population ratios, but those approaches do not translate well to Alaska. He said Alaska-specific rules should focus on share-of-market and inclusion of facilities and tribal health organizations, and should be phased in to avoid market disruption.

Committee members raised concerns about trade-offs: several senators asked whether the standard effectively imposes state-managed network design and whether it will reduce insurers' product offerings. Senator Clayman asked whether the measure is effectively a form of price or market regulation; Davis and the sponsor said the bill addresses network adequacy and not price setting, although network rules influence negotiation leverage at the bargaining table.

The division director, Laurie Winghire, participated in questioning and said the department already evaluates whether charges are reasonable and that exemptions and regulation drafting would be done through the Division of Insurance. Several senators asked for data on current network participation and how many insurers would be able to comply; the record included staff notes that 38 states or territories have adopted provider-network minimums.

No vote was taken. Committee leadership said the bill would be set aside for further work and that public comment and letters received would be posted online. The sponsor and staff said they expected follow-up hearings and additional stakeholder input.","mediaType","Video","parentTitle","03/11/2025 03:30 PM Senate HEALTH & SOCIAL SERVICES","oneSentenceSummary","Juneau — The Senate Health and Social Services Committee on March 11 considered Senate Bill 122, a proposal to set Alaska-specific minimum standards for insurers' provider networks to protect access to specialties across the state's diverse regions.","taxTitle","2025 Legislature Alaska, Alaska","taxId",78559,"location","Alaska","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6287418,"Senate committee weighs bill to set minimum allowable charges for out-of-network care",3697,332640,4030260,"/Search/View?dp=1&key=2553186-d0d4c666e5fd228bfaed1f59d8ca3f98&start=332&end=4030","https://assets.pipeline.soar.com/2553186-d0d4c666e5fd228bfaed1f59d8ca3f98/thumbnail_332640.jpg","/articles/6287418/Alaska/Senate-committee-weighs-bill-to-set-minimum-allowable-charges-for-out-of-network-care","https://secure.pipeline.soar.com/6287418-d1ff81ef6584fd04a0c05c6adb318ad8/orig.mp4?Expires=1771167889&Signature=YgsFDpVMsVv1qHGJZNg-eRpn9eb-~52WO7quep94MaDN4qU44Hf95oHJAqmelYKQI9Dy4Xyn2jw1HxO9exbRpk0hc37mTp0XS51GxQnt36DTzVwNwtwxIfhiJjkLvIoaKCon0hq~J~5jh5G1dQ1eFjkjPWsnj0ERoN644rYE4sGNQCg0IaVjlaBXaZWuL22v1Ngz8~6rZrPMcA-ZFi-O7uJzbyc46Jel2Lxea-kWlIAvddc1WgwOL5tuWjImzCtCW9qD6XTrR4K1JuRI-NFXpWgT3GAGi0k8rGoRLh7rnCSWGxDeEao5qEju3GIOiUksyIYYwuX3fpNmgsVQbqlETA__&Key-Pair-Id=KUT5TJCACFTXG","Juneau — The Senate Health and Social Services Committee on Tuesday heard testimony on Senate Bill 121, which would require the Alaska Division of Insurance to adopt standards insurers must use to determine allowable charges for out-of-network health care services and set a state-defined minimum reimbursement floor for providers.

Senator Kathy Giesel, vice chair of the committee and sponsor of SB 121, told the committee the bill is meant to restore a minimum reimbursement after the state\u0000s previous regulation (the 80th-percentile standard) was repealed without a replacement. \"The insurance companies now have no minimum reimbursement that they have to meet when providers provide services,\" Giesel said, adding that some clinicians face contract renewals with declining or flat reimbursement and that some practices have closed.

The bill would direct the director of the Division of Insurance to require insurers to use \"statistically credible market-based methodology\" based on the most recent 12 months of Alaskan data to set allowable charges and to ensure reimbursements are \"not less than the 70 fifth percentile of charges statewide\" or a floor equal to 450% of the Medicare (CMS) fee schedule, whichever is higher, according to the bill text read into the record and a sectional analysis provided to the committee. The bill also would require periodic audits of insurer methodology and mandate insurers update charges every 3 to 5 years.

Why it matters: Proponents said the lack of a floor after repeal has given insurers leverage to push down contract offers, threatening access to care in a state already designated as a federal health professional shortage area. \"Without some minimum reimbursement requirement these health insurers are not reimbursing clinicians for the cost of the care,\" Giesel said.

Supporters and experts at the hearing argued the proposal is intended to create a balanced, Alaska-specific replacement that avoids the unintended consequences that critics say were produced by the former 80th-percentile rule. Jeffrey Davis, principal of Weston Group Consulting, told the committee the original rule (adopted in 2004) reduced patient balance billing but over time contributed to higher charges in parts of the market; he said a statewide, market-based floor would reduce the ability of a single provider group to distort statewide benchmarks.

Committee members pressed proponents on mechanics and trade-offs. Senator Hughes asked whether the proposal applies to all provider charges or only primary care; the sponsor and staff confirmed it would apply to all CPT-coded charges statewide, while primary care was highlighted as an especially fragile segment. Committee members also asked whether the 450% floor could make out-of-network rates higher than some in-network contracts and whether a percentile floor could simply move upward again if providers increased charges together in the future.

Division of Insurance Director Laurie Winghire told the committee the division already requires charges to be \"reasonable\" and that some insurers use a Fair Health-like database to set allowables. Winghire said the market segment directly affected by SB 121 is the fully insured market (about 118,000 Alaskans, as stated during the hearing) and that filings showed a 4% decrease in 2025 rate filings and about 2.5% in 2024 — figures the director said reflected multiple factors in addition to repeal.

Proponents asked for a mechanism that is both market-based and statewide to avoid the prior regulation\u0000s geographic fragmentation and to limit the possibility a single provider group could capture a region\u0000s benchmark. The bill includes a transition provision allowing insurers to use data beginning as early as February 2023 during an initial adjustment period and sets an effective date for Jan. 1, 2026 in the draft sectional.

No formal action was taken at this hearing. Committee leadership said they would take additional testimony and posted letters for and against the bill online; the committee set the matter aside after the hearing and invited further written submissions and public testimony.

Ending: Senators and witnesses signaled the issue will return for additional hearings. Several members said they want more data on contract negotiations, insurer filings and the status of a lawsuit tied to the prior repeal before moving to committee action.","Juneau — The Senate Health and Social Services Committee on Tuesday heard testimony on Senate Bill 121, which would require the Division of Insurance to adopt market-based standards for allowable charges and set a state-defined minimum reimbursement floor for out-of-network health care services.","actionData","errors"]

Article not found

Senate panel hears bill to require Alaska-specific provider-network minimums

Senate committee weighs bill to set minimum allowable charges for out-of-network care