This bill establishes new standards for health insurance provider networks and the settlement of health insurance claims in Alaska. It mandates that health care insurers consider specific network requirements when calculating benefits for policies that require or incentivize the use of limited networks. Insurers must include a comprehensive range of licensed health care providers, including hospitals, skilled nursing facilities, and mental health organizations, in their networks. The bill also sets minimum provider network standards based on six contracting regions in the state, requiring insurers to include a specified percentage of actively practicing health care providers in each specialty. Additionally, insurers must attest annually to their compliance with these standards and submit corrective action plans if they fall short.

Furthermore, the bill introduces regulations for setting allowable charges for health care services in the absence of a contract between insurers and providers. The director of the relevant department will establish these standards, which must be based on current data reflecting charges by providers over a 12-month period and must be at least 345 percent of the federal Medicare physician fee schedule. The bill also includes provisions for periodic audits of the methodology used by insurers to ensure compliance. Notably, it repeals a previous section of law and outlines a transition period for calculating allowable charges for the year 2027, with the act set to take effect on January 1, 2027.

Statutes affected:
SB0121A, AM SB 121, introduced 03/05/2025: 21.54.500
SB0121B, AM CSSB 121(HSS), introduced 03/31/2025: 21.54.500
SB0121C, AM CSSB 121(L&C), introduced 04/15/2026: 21.54.500, 21.07.020