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CS FOR SENATE BILL NO. 115(HSS)
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-THIRD LEGISLATURE - SECOND SESSION
BY THE SENATE HEALTH AND S OCIAL SERVICES COMMITTEE
Offered: 2/19/24
Referred: Labor & Commerce
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. 12
* Sec. 2. AS 08.64.107 is amended by adding new subsections to read: 13
(b) A physician assistant may 14 33-LS0542\U
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(1) perform a comprehensive health history and physical examination 1
of a patient; 2
(2) evaluate, diagnose, manage, and treat disease and injury; 3
(3) order, perform, and interpret diagnostic studies and therapeutic 4
procedures; 5
(4) educate patients on health promotion and disease prevention; 6
(5) provide consultation upon request; 7
(6) write medical orders; 8
(7) supervise and delegate therapeutic and diagnostic measures to 9
licensed or unlicensed personnel, in compliance with regulations adopted under 10
AS 08.64.106; 11
(8) request, receive, and sign for professional samples and distribute 12
professional samples to patients; 13
(9) authenticate by signature, certification, stamp, verification, 14
affidavit, or endorsement a document that a physician would be authorized to 15
authenticate by signature, certification, stamp, verification, affidavit, or endorsement; 16
(10) prescribe, dispense, order, administer, and procure drugs and 17
medical devices; 18
(11) prescribe, dispense, order, and administer a schedule II, III, IV, or 19
V controlled substance under federal law if the physician assistant has a valid federal 20
Drug Enforcement Administration registration number; 21
(12) plan and initiate a therapeutic regimen that includes ordering and 22
prescribing non-pharmacological interventions, including durable medical equipment, 23
nutrition, blood, blood products, home health care, hospice, physical or occupational 24
therapy, and other diagnostic support services; and 25
(13) perform any other medical service that the physician assistant is 26
competent to perform based on education, training, and experience. 27
(c) A physician assistant with less than 4,000 hours of practice experience 28
may practice only under a collaborative agreement in a hospital, clinic, or other 29
clinical setting in which the physician assistant works with one or more collaborating 30
physicians to provide patient care. A collaborating physician or physicians shall 31 33-LS0542\U
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oversee the performance, practice, and activities of the physician assistant, and the 1
physician assistant must be able to communicate with at least one collaborating 2
physician during work hours in person or by telephone or another telecommunications 3
device. The collaborative agreement must 4
(1) be in writing; 5
(2) describe how collaboration will occur in accordance with this 6
chapter; 7
(3) describe the methods to be used for evaluating the physician 8
assistant's competency, knowledge, and skills; 9
(4) establish that the physician assistant and collaborating physician 10
have knowledge of the physician assistant's qualifications and limitations in caring for 11
patients; 12
(5) require the physician assistant to consult with the collaborating 13
physician while remaining responsible for care provided by the physician assistant; 14
and 15
(6) require the collaborating physician to give direction and guidance 16
to the physician assistant. 17
(d) The physician assistant or collaborating physician shall provide a copy of 18
the collaborative agreement, along with documentation of compliance, to the board 19
upon request of the board. 20
(e) In this section, "collaborative agreement" means a plan that is mutually 21
agreed on by a physician assistant and a collaborating physician that designates the 22
scope of services the physician assistant may provide to patients. 23
* Sec. 3. AS 08.64.170(a) is amended to read: 24
(a) A person may not practice medicine, podiatry, or osteopathy in the state 25
unless the person is licensed under this chapter, except that 26
(1) a physician assistant may examine, diagnose, or treat persons as 27
authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 28
RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 29
CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 30
AS 08.64.370]; 31 33-LS0542\U
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(2) a person who is licensed or authorized under another law of the 1
state may engage in a practice that is authorized under that law; and 2
(3) a person may perform routine medical duties delegated under 3
AS 08.64.106. 4
* Sec. 4. AS 11.71.900(20) is amended to read: 5
(20) "practitioner" means 6
(A) a physician, physician assistant, dentist, advanced practice 7
registered nurse, optometrist, veterinarian, scientific investigator, or other 8
person licensed, registered, or otherwise permitted to distribute, dispense, 9
conduct research with respect to, or to administer or use in teaching or 10
chemical analysis a controlled substance in the course of professional practice 11
or research in the state; 12
(B) a pharmacy, hospital, or other institution licensed, 13
registered, or otherwise permitted to distribute, dispense, conduct research with 14
respect to, or to administer a controlled substance in the course of professional 15
practice or research in the state; 16
* Sec. 5. AS 21.07.010(b) is amended to read: 17
(b) A contract between a participating health care provider and a health care 18
insurer that offers a health care insurance policy may not contain a provision that 19
(1) has as its predominant purpose the creation of direct financial 20
incentives to the health care provider for withholding covered medical care services 21
that are medically necessary; nothing in this paragraph shall be construed to prohibit a 22
contract between a participating health care provider and a health care insurer from 23
containing incentives for efficient management of the utilization and cost of covered 24
medical care services; 25
(2) requires the provider to contract for all products that are currently 26
offered or that may be offered in the future by the health care insurer; [OR] 27
(3) requires the health care provider to be compensated for medical 28
care services performed at the same rate as the health care provider has contracted 29
with another health care insurer; or 30
(4) imposes a practice, education, or collaboration requirement on 31 33-LS0542\U
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physician assistants that is inconsistent with or more restrictive than the 1
requirements imposed under AS 08.64.107 or a regulation adopted by the State 2
Medical Board. 3
* Sec. 6. AS 23.30.395(3) is amended to read: 4
(3) "attending physician" means one of the following designated by the 5
employee under AS 23.30.095(a) or (b): 6
(A) a licensed medical doctor; 7
(B) a licensed doctor of osteopathy; 8
(C) a licensed dentist or dental surgeon; 9
(D) a licensed physician assistant [ACTING UNDER 10
SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 11
OSTEOPATHY]; 12
(E) a licensed advanced practice registered nurse; or 13
(F) a licensed chiropractor; 14
* Sec. 7. AS 33.30.901(10) is amended to read: 15
(10) "health care provider" means 16
(A) a physician assistant licensed to practice in the state [AND 17
WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 18
PHYSICIAN OR PSYCHIATRIST]; 19
(B) a mental health professional as defined in AS 47.30.915; or 20
(C) an advanced practice registered nurse as defined in 21
AS 08.68.850; 22