Broad support at hearing for SB133 prior-authorization reform aimed at faster approvals and automation

The Senate Labor and Commerce Committee heard invited and public testimony March 20 on Senate Bill 133, legislation crafted by providers, insurers and regulators to reform prior-authorization processes in Alaska. Supporters said the bill shortens approval timeframes, encourages electronic submission, increases transparency about reviewer qualifications, and adds protections for patients with chronic and serious conditions.

Conrad Jackson, staff to Senator Jesse Bjorkman, summarized SB133 as the product of many stakeholder meetings and described it as a compromise that establishes clearer timeframes and communication requirements between insurers and providers. He said the bill permits the Division of Insurance to monitor compliance.

Jared Kosin, president and CEO of the Alaska Hospital and Healthcare Association, testified in strong support. He said the bill speeds turnaround times (from a common five working days to a 72-hour standard), provides long-term approvals for chronic conditions, and creates an exception process for step-therapy protocols. "This bill is comprehensive and has the strong backing of Alaska's hospitals through the Alaska Hospital and Healthcare Association," Kosin said, adding that the measure prioritizes automation and transparency.

Gary Strandigan, testifying for Premera Blue Cross Blue Shield of Alaska, also supported SB133 and said his company's prior authorization rate is about 2 percent compared with as much as 20 percent reported for some carriers elsewhere. "Our vision is that most prior auths will be approved instantaneously, improving care for our members," Strandigan said, while noting that automation is impossible if providers continue to submit requests by fax.

Heather Carpenter, deputy director of the Division of Insurance, said regulators participated in the multi-stakeholder drafting and support the resulting compromise; she said one insurer suggested the language could serve as a model for other states.

In public testimony, Lucy Lobb (identified as representing "National Thrive Theft Foundation" in the record) urged protections against step therapy policies that require patients to try a payer-preferred drug before receiving the medication originally prescribed by their clinician; she cited studies showing delayed or denied care can worsen outcomes for patients with chronic conditions. Bruce Richards, government affairs director for Central Peninsula Hospital, said prior-authorization delays create real harm for local patients and praised the bill's timelines and transparency provisions. Katie Capozzi, president and CEO of the Alaska Chamber of Commerce, said the chamber supports the compromise language because it preserves necessary utilization-management tools while reducing administrative burden.

Committee members asked about whether 72 hours could be shortened; witnesses and insurers said automation and electronic portals are expected to make many determinations instantaneous when sufficient clinical data accompany a request. The committee kept public testimony open and set SB133 aside for further consideration; no formal votes were taken at this hearing.

Why it matters: Prior authorization affects timeliness of care for patients across Alaska; SB133 attempts to balance insurer utilization-management needs with faster, more transparent approvals for providers and patients.

Next steps: The committee will accept additional testimony through the next hearing on Insurance Day and will revisit the bill.