Alaska Governor Approves PBM Regulation

After delaying a decision for several months, Alaska Gov. Mike Dunleavy (R) signed HB 226, an anti-PBM bill that passed by the legislature earlier this year. The bill contains problematic language that could ultimately raise costs and reduce choice for employers and consumers. Those provisions include restrictions on the use of white bagging and home delivery; any willing provider language; a prohibition against spread pricing contracts; as well as changes to drug pricing methodology, labeling, and Maximum Allowable Costs (MAC) lists. Lastly, the law requires PBMs to maintain a “duty of care” with health plans that they contract with for pharmacy services.

Fortunately, during the legislative process, the bill was significantly amended to remove some of the costliest provisions, including the elimination of National Average Drug Acquisition Cost (NADAC) pricing, dispensing fee mandates, and applicability to Employee Retirement Income Security Act of 1974 (ERISA) plans and public sector plans. As a result, only the fully insured market, estimated to be appropriately 14% of the commercial market, will be impacted by the new law. The legislation is effective on Jan. 1, 2025.