SB0115d -1- HCS CSSB 115(L&C)
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HOUSE CS FOR CS FOR SENATE BILL NO. 115(L&C)
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-THIRD LEGISLATURE - SECOND SESSION
BY THE HOUSE LABOR AND COMMERCE COMMITTEE
Offered: 5/10/24
Referred: Rules
Sponsor(s): SENATORS TOBIN BY REQUEST, Giessel, Gray-Jackson, Hughes, Dunbar
A BILL
FOR AN ACT ENTITLED
"An Act relating to physician assistants; relating to physicians; and relating to health 1
care insurance policies." 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
* Section 1. AS 08.64.107 is amended to read: 4
Sec. 08.64.107. Licensure and scope of practice [REGULATION] of
5
physician assistants. The board shall adopt regulations regarding the licensure of 6
physician assistants and the medical services that they may perform, including the 7
(1) educational and other qualifications, including education in pain 8
management and opioid use and addiction; 9
(2) application and licensing procedures; 10
(3) scope of activities authorized in this section; [AND] 11
(4) responsibilities of a [THE] supervising or training physician; and 12
(5) hours of practice experience, if any, that a physician assistant 13
must complete under a collaborative agreement to practice in a practice area that 14 33-LS0542\R
HCS CSSB 115(L&C) -2- SB0115d
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is substantively different than the physician assistant's previous practice areas; 1
the board may not require that a physician assistant complete more than 4,000 2
hours under this paragraph, in addition to the hours required under (c) and (f) of 3
this section, to practice in a new practice area without a collaborative agreement. 4
* Sec. 2. AS 08.64.107 is amended by adding new subsections to read: 5
(b) A physician assistant may 6
(1) perform a comprehensive health history and physical examination 7
of a patient; 8
(2) evaluate, diagnose, manage, and treat disease and injury; 9
(3) order, perform, and interpret diagnostic studies and therapeutic 10
procedures in compliance with regulations adopted under AS 08.64.106; 11
(4) educate patients on health promotion and disease prevention; 12
(5) provide consultation upon request; 13
(6) write medical orders; 14
(7) supervise and delegate therapeutic and diagnostic measures to 15
licensed or unlicensed personnel, in compliance with regulations adopted under 16
AS 08.64.106; 17
(8) request, receive, and sign for professional samples and distribute 18
professional samples to patients; 19
(9) authenticate by signature, certification, stamp, verification, 20
affidavit, or endorsement a document that a physician would be authorized to 21
authenticate by signature, certification, stamp, verification, affidavit, or endorsement; 22
(10) prescribe, dispense, order, administer, and procure drugs and 23
medical devices; 24
(11) prescribe, dispense, order, and administer a schedule II, III, IV, or 25
V controlled substance under federal law if the physician assistant has a valid federal 26
Drug Enforcement Administration registration number; and 27
(12) plan and initiate a therapeutic regimen that includes ordering and 28
prescribing non-pharmacological interventions, including durable medical equipment, 29
nutrition, blood, blood products, home health care, hospice, physical or occupational 30
therapy, and other diagnostic support services. 31 33-LS0542\R
SB0115d -3- HCS CSSB 115(L&C)
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(c) Unless additional hours are required under (a)(5) or (f) of this section, a 1
physician assistant with less than 6,000 hours of practice experience may practice only 2
under a collaborative agreement in a hospital, clinic, or other clinical setting in which 3
the physician assistant works with a collaborating physician to provide patient care. 4
The collaborating physician shall oversee the performance, practice, and activities of 5
the physician assistant, and the physician assistant must be able to communicate 6
during work hours, in person or by telephone or another telecommunications device, 7
with the collaborating physician. The collaborative agreement must 8
(1) be in writing; 9
(2) be between a physician assistant and a collaborating physician who 10
practices in each of the practice areas of the physician assistant; 11
(3) describe the practice areas of the physician assistant and the 12
collaborating physician; 13
(4) describe how collaboration will occur in accordance with this 14
chapter; 15
(5) describe the methods to be used for evaluating the physician 16
assistant's competency, knowledge, and skills; 17
(6) establish that the physician assistant and collaborating physician 18
have knowledge of the physician assistant's qualifications and limitations in caring for 19
patients; 20
(7) require the physician assistant to consult with the collaborating 21
physician while remaining responsible for care provided by the physician assistant; 22
and 23
(8) require the collaborating physician to give direction and guidance 24
to the physician assistant. 25
(d) The physician assistant or collaborating physician shall provide a copy of 26
the collaborative agreement, along with documentation of compliance, to the board 27
upon request of the board. 28
(e) A physician assistant and collaborating physician shall maintain a record 29
on a form provided by the department of the number of hours of practice experience 30
obtained by the physician assistant. The form must include the 31 33-LS0542\R
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(1) area of practice specialty of the collaborating physician; and 1
(2) hours completed by practice type. 2
(f) Upon the physician assistant's completion of 4,000 hours of practice 3
experience, additional hours required under (a)(5) of this section, or additional hours 4
required under this subsection, the collaborating physician shall attest on a form 5
provided by the department that the physician assistant is competent to practice 6
without supervision. If the collaborating physician determines that the physician 7
assistant is not competent to practice without supervision, the board shall require that 8
the physician assistant practice under a collaborative agreement for additional hours, 9
as determined by the board. 10
(g) A physician assistant is entitled to a hearing conducted by the board to 11
appeal a determination by a collaborating physician that the physician assistant is not 12
competent to practice without supervision. The physician assistant may appeal an 13
adverse decision of the board to a court of competent jurisdiction. The board or court 14
may reverse the collaborating physician's determination that the physician assistant is 15
not competent to practice without supervision if the board or court finds that the 16
collaborating physician's determination was arbitrary and capricious or without just 17
cause. 18
(h) The board shall randomly audit three percent of the physician assistants 19
licensed under this section to assess each physician assistant's compliance with the 20
requirements of this chapter. 21
(i) Before a physician assistant may provide services under this section, the 22
physician assistant must inform the patient that the services will be performed by a 23
physician assistant. 24
(j) In this section, "collaborative agreement" means a plan that is mutually 25
agreed on by a physician assistant and a collaborating physician that designates the 26
scope of services the physician assistant may provide to patients. 27
* Sec. 3. AS 08.64.170(a) is amended to read: 28
(a) A person may not practice medicine, podiatry, or osteopathy in the state 29
unless the person is licensed under this chapter, except that 30
(1) a physician assistant may examine, diagnose, or treat persons as 31 33-LS0542\R
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authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 1
RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 2
CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 3
AS 08.64.370]; 4
(2) a person who is licensed or authorized under another law of the 5
state may engage in a practice that is authorized under that law; and 6
(3) a person may perform routine medical duties delegated under 7
AS 08.64.106. 8
* Sec. 4. AS 11.71.900(20) is amended to read: 9
(20) "practitioner" means 10
(A) a physician, physician assistant, dentist, advanced practice 11
registered nurse, optometrist, veterinarian, scientific investigator, or other 12
person licensed, registered, or otherwise permitted to distribute, dispense, 13
conduct research with respect to, or to administer or use in teaching or 14
chemical analysis a controlled substance in the course of professional practice 15
or research in the state; 16
(B) a pharmacy, hospital, or other institution licensed, 17
registered, or otherwise permitted to distribute, dispense, conduct research with 18
respect to, or to administer a controlled substance in the course of professional 19
practice or research in the state; 20
* Sec. 5. AS 21.07.010(b) is amended to read: 21
(b) A contract between a participating health care provider and a health care 22
insurer that offers a health care insurance policy may not contain a provision that 23
(1) has as its predominant purpose the creation of direct financial 24
incentives to the health care provider for withholding covered medical care services 25
that are medically necessary; nothing in this paragraph shall be construed to prohibit a 26
contract between a participating health care provider and a health care insurer from 27
containing incentives for efficient management of the utilization and cost of covered 28
medical care services; 29
(2) requires the provider to contract for all products that are currently 30
offered or that may be offered in the future by the health care insurer; [OR] 31 33-LS0542\R
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(3) requires the health care provider to be compensated for medical 1
care services performed at the same rate as the health care provider has contracted 2
with another health care insurer; or 3
(4) imposes a practice, education, or collaboration requirement on 4
physician assistants that is inconsistent with or more restrictive than the 5
requirements imposed under AS 08.64.107 or a regulation adopted by the State 6
Medical Board. 7
* Sec. 6. AS 23.30.395(3) is amended to read: 8
(3) "attending physician" means one of the following designated by the 9
employee under AS 23.30.095(a) or (b): 10
(A) a licensed medical doctor; 11
(B) a licensed doctor of osteopathy; 12
(C) a licensed dentist or dental surgeon; 13
(D) a licensed physician assistant [ACTING UNDER 14
SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 15
OSTEOPATHY]; 16
(E) a licensed advanced practice registered nurse; or 17
(F) a licensed chiropractor; 18
* Sec. 7. AS 33.30.901(10) is amended to read: 19
(10) "health care provider" means 20
(A) a physician assistant licensed to practice in the state [AND 21
WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 22
PHYSICIAN OR PSYCHIATRIST]; 23
(B) a mental health professional as defined in AS 47.30.915; or 24
(C) an advanced practice registered nurse as defined in 25
AS 08.68.850; 26