AK SB134

Requires pharmacy benefits managers (PBMs) and third-party administrators to obtain state licenses rather than simply registering, subjecting them to enhanced regulatory oversight and examination authority by the Division of Insurance

Prohibits PBMs from engaging in spread pricing, charging pharmacies various fees (claim processing, network participation, accreditation fees), or reversing and resubmitting pharmacy claims more than 90 days after initial adjudication

Mandates that PBMs reimburse non-affiliated pharmacies at rates equal to or greater than what they pay their own affiliated pharmacies for the same services

Establishes detailed licensing requirements for PBMs including disclosure of ownership, certified financial statements, designation of a compliance officer, and notification requirements for changes in business information or criminal convictions

Takes effect January 1, 2026