In Review: HB 226 (omnibus) has undergone significant amendments that have substantially narrowed its scope, affecting only about 15% of the fully insured market, specifically targeting AK Title 21 plans. Organized labor, led by the Pacific Health Coalition, utilized PCMA resources to successfully exclude ERISA plans and those under state and municipal government coverage. Additionally, the bill has removed provisions concerning reimbursement language and dispensing fees, which effectively eliminates fiscal note impacts, and has dropped the patient choice of pharmacy section and anti-steering language. However, it still introduces a contradictory measure that allows the use of claims data to direct patients to lower-cost options. The adopted bill language has set prohibitions against practices such as white bagging and spread pricing, and on the transparency front, the bill is attempting to adopt Washington, D.C. Fiduciary language.

Up Next: HB 226 has been removed from the Finance Committee and is now in House Rules awaiting floor action, with a Senate Labor & Commerce Committee hearing currently scheduled for Wednesday, May 1.

If you have any questions, please contact Bill Head at tsorrell-neal@pcmanet.org.