SB 38 Summary

• Replaces references to "managed care entities" with "health care insurers" throughout Alaska's health insurance regulations and removes certain confidentiality provisions related to managed care.

• Authorizes pharmacy benefits managers to operate subject to division of insurance oversight and requires them to register as third-party administrators with detailed regulatory requirements for agreements, prohibited practices, and fiduciary duties.

• Establishes requirements for pharmacy benefits managers including: using nationally recognized benchmarks for drug reimbursement, processing claims within 7 days, prohibiting retroactive claim denials beyond 7 days, and disclosing all financial arrangements with drug manufacturers.

• Prohibits pharmacy benefits managers from intervening in prescriptions to influence therapy choices, switching drugs without prescriber authorization, unfairly discriminating against pharmacies, or penalizing pharmacists who file complaints or advocate for patients.

• Amends definitions of "managed care plan," "utilization review," and "health care insurer" to align with new regulatory framework; applies pharmacy benefits manager rules to state group insurance and certain bargaining units.