Committee advances bill to license pharmacy benefit managers, adds protection for pharmacies charging uncovered fees

The House Health and Social Services Committee advanced Senate Bill 134 on May 15, 2025, adding an amendment that would bar pharmacy benefit managers and third-party administrators from contract terms that prohibit pharmacies from collecting fees from patients for services not covered by their health plans. The committee moved the bill from committee with individual recommendations and an attached fiscal note.

Senate Bill 134 would require licensing and oversight of pharmacy benefit managers (PBMs) and third-party administrators by the state Division of Insurance, a change supporters said would increase transparency and accountability for entities that negotiate drug prices and process pharmacy claims. "Senate Bill 134 relates to third party administrators and pharmacy benefit managers. These entities do business as intermediaries between insurance companies and pharmacies or consumers," said Jane Rohrer, staff to Senator Giesel.

The committee adopted Amendment 1, offered by Representative Ruffridge, to add an unfair trade practice prohibition that would prevent PBMs from forbidding a pharmacy from charging a covered person for a service or product that the person's insurance does not cover. "This would add that into that unfair trade practice language," Ruffridge said while describing the change. Committee members discussed examples that the amendment is intended to address, including delivery charges and adherence packaging that a plan may not cover.

Representative Gray asked for clarification on who would pay such a fee. "Who would be paying the fee? Would it be the individual at the pharmacy picking up their prescription or would it be the PBM?" Gray asked. Rohrer replied that the fee would be charged to the patient when the service is not covered by their plan and described situations the amendment targets, including mail-order fills and pharmacies delivering medication to remote residents.

Committee members noted the amendment is especially relevant for Alaskans off the road system or in rural communities, where pharmacies sometimes mail medications from the Lower 48 or provide local delivery or specialized compounded medications that are not covered by plans. The bill sponsor and the amendment proponents said the change aims to ensure pharmacies can lawfully collect a nominal fee for uncovered services without risking termination of their contracts with PBMs.

After committee discussion, Rep. Ruffridge removed an objection and Amendment 1 was adopted by the committee. Representative Gray then moved the bill out of committee "as amended ... with individual recommendations and attached fiscal note." "Is there any objection? Seeing none, Senate Bill 134 passes from committee," Chair Rep. Mina said.

The bill will next follow the legislative process with the committee report sent to the House for further consideration.