AK
Alaska Senate Bill SB115

Alaska 2023-2024 Regular Session

Alaska Senate Bill SB115 Compare Versions

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1212 IN THE LEGISLATURE OF THE STATE OF ALASKA
1313
1414 THIRTY-THIRD LEGISLATURE - SECOND SESSION
1515
16-BY THE HOUSE LABOR AND COMMERCE COMMITTEE
16+BY THE SENATE HEALTH AND S OCIAL SERVICES COMMITTEE
1717
18-Offered: 5/10/24
19-Referred: Rules
18+Amended: 4/24/24
19+Offered: 2/19/24
2020
2121 Sponsor(s): SENATORS TOBIN BY REQUEST, Giessel, Gray-Jackson, Hughes, Dunbar
2222 A BILL
2323
2424 FOR AN ACT ENTITLED
2525
2626 "An Act relating to physician assistants; relating to physicians; and relating to health 1
2727 care insurance policies." 2
2828 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
2929 * Section 1. AS 08.64.107 is amended to read: 4
3030 Sec. 08.64.107. Licensure and scope of practice [REGULATION] of
3131 5
3232 physician assistants. The board shall adopt regulations regarding the licensure of 6
3333 physician assistants and the medical services that they may perform, including the 7
3434 (1) educational and other qualifications, including education in pain 8
3535 management and opioid use and addiction; 9
3636 (2) application and licensing procedures; 10
3737 (3) scope of activities authorized in this section; [AND] 11
3838 (4) responsibilities of a [THE] supervising or training physician; and 12
3939 (5) hours of practice experience, if any, that a physician assistant 13
40-must complete under a collaborative agreement to practice in a practice area that 14 33-LS0542\R
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4444 is substantively different than the physician assistant's previous practice areas; 1
4545 the board may not require that a physician assistant complete more than 4,000 2
46-hours under this paragraph, in addition to the hours required under (c) and (f) of 3
47-this section, to practice in a new practice area without a collaborative agreement. 4
46+hours under this paragraph, in addition to the hours required under (c) of this 3
47+section, to practice in a new practice area without a collaborative agreement. 4
4848 * Sec. 2. AS 08.64.107 is amended by adding new subsections to read: 5
4949 (b) A physician assistant may 6
5050 (1) perform a comprehensive health history and physical examination 7
5151 of a patient; 8
5252 (2) evaluate, diagnose, manage, and treat disease and injury; 9
5353 (3) order, perform, and interpret diagnostic studies and therapeutic 10
54-procedures in compliance with regulations adopted under AS 08.64.106; 11
54+procedures; 11
5555 (4) educate patients on health promotion and disease prevention; 12
5656 (5) provide consultation upon request; 13
5757 (6) write medical orders; 14
5858 (7) supervise and delegate therapeutic and diagnostic measures to 15
5959 licensed or unlicensed personnel, in compliance with regulations adopted under 16
6060 AS 08.64.106; 17
6161 (8) request, receive, and sign for professional samples and distribute 18
6262 professional samples to patients; 19
6363 (9) authenticate by signature, certification, stamp, verification, 20
6464 affidavit, or endorsement a document that a physician would be authorized to 21
6565 authenticate by signature, certification, stamp, verification, affidavit, or endorsement; 22
6666 (10) prescribe, dispense, order, administer, and procure drugs and 23
6767 medical devices; 24
6868 (11) prescribe, dispense, order, and administer a schedule II, III, IV, or 25
6969 V controlled substance under federal law if the physician assistant has a valid federal 26
70-Drug Enforcement Administration registration number; and 27
70+Drug Enforcement Administration registration number; 27
7171 (12) plan and initiate a therapeutic regimen that includes ordering and 28
7272 prescribing non-pharmacological interventions, including durable medical equipment, 29
7373 nutrition, blood, blood products, home health care, hospice, physical or occupational 30
74-therapy, and other diagnostic support services. 31 33-LS0542\R
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74+therapy, and other diagnostic support services; and 31 33-LS0542\U.A
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78-(c) Unless additional hours are required under (a)(5) or (f) of this section, a 1
79-physician assistant with less than 6,000 hours of practice experience may practice only 2
80-under a collaborative agreement in a hospital, clinic, or other clinical setting in which 3
81-the physician assistant works with a collaborating physician to provide patient care. 4
82-The collaborating physician shall oversee the performance, practice, and activities of 5
83-the physician assistant, and the physician assistant must be able to communicate 6
84-during work hours, in person or by telephone or another telecommunications device, 7
85-with the collaborating physician. The collaborative agreement must 8
86-(1) be in writing; 9
87-(2) be between a physician assistant and a collaborating physician who 10
88-practices in each of the practice areas of the physician assistant; 11
89-(3) describe the practice areas of the physician assistant and the 12
90-collaborating physician; 13
91-(4) describe how collaboration will occur in accordance with this 14
78+(13) perform any other medical service that the physician assistant is 1
79+competent to perform based on education, training, and experience. 2
80+(c) Unless additional hours are required by the board to practice in a new 3
81+practice area under (a)(5) of this section, a physician assistant with less than 4,000 4
82+hours of practice experience may practice only under a collaborative agreement in a 5
83+hospital, clinic, or other clinical setting in which the physician assistant works with 6
84+one or more collaborating physicians to provide patient care. A collaborating 7
85+physician or physicians shall oversee the performance, practice, and activities of the 8
86+physician assistant, and the physician assistant must be able to communicate during 9
87+work hours, in person or by telephone or another telecommunications device, with one 10
88+or more collaborating physicians who, collectively, practice in each of the physician 11
89+assistant's practice areas. The collaborative agreement must 12
90+(1) be in writing; 13
91+(2) describe how collaboration will occur in accordance with this 14
9292 chapter; 15
93-(5) describe the methods to be used for evaluating the physician 16
93+(3) describe the methods to be used for evaluating the physician 16
9494 assistant's competency, knowledge, and skills; 17
95-(6) establish that the physician assistant and collaborating physician 18
95+(4) establish that the physician assistant and collaborating physician 18
9696 have knowledge of the physician assistant's qualifications and limitations in caring for 19
9797 patients; 20
98-(7) require the physician assistant to consult with the collaborating 21
98+(5) require the physician assistant to consult with the collaborating 21
9999 physician while remaining responsible for care provided by the physician assistant; 22
100-and 23
101-(8) require the collaborating physician to give direction and guidance 24
102-to the physician assistant. 25
103-(d) The physician assistant or collaborating physician shall provide a copy of 26
104-the collaborative agreement, along with documentation of compliance, to the board 27
105-upon request of the board. 28
106-(e) A physician assistant and collaborating physician shall maintain a record 29
107-on a form provided by the department of the number of hours of practice experience 30
108-obtained by the physician assistant. The form must include the 31 33-LS0542\R
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100+ (6) require the collaborating physician to give direction and guidance 23
101+ to the physician assistant; and 24
102+(7) describe the physician assistant's practice areas and the 25
103+collaborating physicians who practice in those areas. 26
104+(d) The physician assistant or collaborating physician shall provide a copy of 27
105+the collaborative agreement, along with documentation of compliance, to the board 28
106+upon request of the board. 29
107+(e) In this section, "collaborative agreement" means a plan that is mutually 30
108+agreed on by a physician assistant and a collaborating physician that designates the 31 33-LS0542\U.A
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112-(1) area of practice specialty of the collaborating physician; and 1
113-(2) hours completed by practice type. 2
114-(f) Upon the physician assistant's completion of 4,000 hours of practice 3
115-experience, additional hours required under (a)(5) of this section, or additional hours 4
116-required under this subsection, the collaborating physician shall attest on a form 5
117-provided by the department that the physician assistant is competent to practice 6
118-without supervision. If the collaborating physician determines that the physician 7
119-assistant is not competent to practice without supervision, the board shall require that 8
120-the physician assistant practice under a collaborative agreement for additional hours, 9
121-as determined by the board. 10
122-(g) A physician assistant is entitled to a hearing conducted by the board to 11
123-appeal a determination by a collaborating physician that the physician assistant is not 12
124-competent to practice without supervision. The physician assistant may appeal an 13
125-adverse decision of the board to a court of competent jurisdiction. The board or court 14
126-may reverse the collaborating physician's determination that the physician assistant is 15
127-not competent to practice without supervision if the board or court finds that the 16
128-collaborating physician's determination was arbitrary and capricious or without just 17
129-cause. 18
130-(h) The board shall randomly audit three percent of the physician assistants 19
131-licensed under this section to assess each physician assistant's compliance with the 20
132-requirements of this chapter. 21
133-(i) Before a physician assistant may provide services under this section, the 22
134-physician assistant must inform the patient that the services will be performed by a 23
135-physician assistant. 24
136-(j) In this section, "collaborative agreement" means a plan that is mutually 25
137-agreed on by a physician assistant and a collaborating physician that designates the 26
138-scope of services the physician assistant may provide to patients. 27
139- * Sec. 3. AS 08.64.170(a) is amended to read: 28
140-(a) A person may not practice medicine, podiatry, or osteopathy in the state 29
141-unless the person is licensed under this chapter, except that 30
142-(1) a physician assistant may examine, diagnose, or treat persons as 31 33-LS0542\R
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112+scope of services the physician assistant may provide to patients. 1
113+ * Sec. 3. AS 08.64.170(a) is amended to read: 2
114+(a) A person may not practice medicine, podiatry, or osteopathy in the state 3
115+unless the person is licensed under this chapter, except that 4
116+(1) a physician assistant may examine, diagnose, or treat persons as 5
117+authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 6
118+RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 7
119+CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 8
120+AS 08.64.370]; 9
121+(2) a person who is licensed or authorized under another law of the 10
122+state may engage in a practice that is authorized under that law; and 11
123+(3) a person may perform routine medical duties delegated under 12
124+AS 08.64.106. 13
125+ * Sec. 4. AS 11.71.900(20) is amended to read: 14
126+(20) "practitioner" means 15
127+(A) a physician, physician assistant, dentist, advanced practice 16
128+registered nurse, optometrist, veterinarian, scientific investigator, or other 17
129+person licensed, registered, or otherwise permitted to distribute, dispense, 18
130+conduct research with respect to, or to administer or use in teaching or 19
131+chemical analysis a controlled substance in the course of professional practice 20
132+or research in the state; 21
133+(B) a pharmacy, hospital, or other institution licensed, 22
134+registered, or otherwise permitted to distribute, dispense, conduct research with 23
135+respect to, or to administer a controlled substance in the course of professional 24
136+practice or research in the state; 25
137+ * Sec. 5. AS 21.07.010(b) is amended to read: 26
138+(b) A contract between a participating health care provider and a health care 27
139+insurer that offers a health care insurance policy may not contain a provision that 28
140+(1) has as its predominant purpose the creation of direct financial 29
141+incentives to the health care provider for withholding covered medical care services 30
142+that are medically necessary; nothing in this paragraph shall be construed to prohibit a 31 33-LS0542\U.A
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146-authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 1
147-RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 2
148-CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 3
149-AS 08.64.370]; 4
150-(2) a person who is licensed or authorized under another law of the 5
151-state may engage in a practice that is authorized under that law; and 6
152-(3) a person may perform routine medical duties delegated under 7
153-AS 08.64.106. 8
154- * Sec. 4. AS 11.71.900(20) is amended to read: 9
155-(20) "practitioner" means 10
156-(A) a physician, physician assistant, dentist, advanced practice 11
157-registered nurse, optometrist, veterinarian, scientific investigator, or other 12
158-person licensed, registered, or otherwise permitted to distribute, dispense, 13
159-conduct research with respect to, or to administer or use in teaching or 14
160-chemical analysis a controlled substance in the course of professional practice 15
161-or research in the state; 16
162-(B) a pharmacy, hospital, or other institution licensed, 17
163-registered, or otherwise permitted to distribute, dispense, conduct research with 18
164-respect to, or to administer a controlled substance in the course of professional 19
165-practice or research in the state; 20
166- * Sec. 5. AS 21.07.010(b) is amended to read: 21
167-(b) A contract between a participating health care provider and a health care 22
168-insurer that offers a health care insurance policy may not contain a provision that 23
169-(1) has as its predominant purpose the creation of direct financial 24
170-incentives to the health care provider for withholding covered medical care services 25
171-that are medically necessary; nothing in this paragraph shall be construed to prohibit a 26
172-contract between a participating health care provider and a health care insurer from 27
173-containing incentives for efficient management of the utilization and cost of covered 28
174-medical care services; 29
175-(2) requires the provider to contract for all products that are currently 30
176-offered or that may be offered in the future by the health care insurer; [OR] 31 33-LS0542\R
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180-(3) requires the health care provider to be compensated for medical 1
181-care services performed at the same rate as the health care provider has contracted 2
182-with another health care insurer; or 3
183-(4) imposes a practice, education, or collaboration requirement on 4
184-physician assistants that is inconsistent with or more restrictive than the 5
185-requirements imposed under AS 08.64.107 or a regulation adopted by the State 6
186-Medical Board. 7
187- * Sec. 6. AS 23.30.395(3) is amended to read: 8
188-(3) "attending physician" means one of the following designated by the 9
189-employee under AS 23.30.095(a) or (b): 10
190-(A) a licensed medical doctor; 11
191-(B) a licensed doctor of osteopathy; 12
192-(C) a licensed dentist or dental surgeon; 13
193-(D) a licensed physician assistant [ACTING UNDER 14
194-SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 15
195-OSTEOPATHY]; 16
196-(E) a licensed advanced practice registered nurse; or 17
197-(F) a licensed chiropractor; 18
198- * Sec. 7. AS 33.30.901(10) is amended to read: 19
199-(10) "health care provider" means 20
200-(A) a physician assistant licensed to practice in the state [AND 21
201-WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 22
202-PHYSICIAN OR PSYCHIATRIST]; 23
203-(B) a mental health professional as defined in AS 47.30.915; or 24
204-(C) an advanced practice registered nurse as defined in 25
205-AS 08.68.850; 26
146+contract between a participating health care provider and a health care insurer from 1
147+containing incentives for efficient management of the utilization and cost of covered 2
148+medical care services; 3
149+(2) requires the provider to contract for all products that are currently 4
150+offered or that may be offered in the future by the health care insurer; [OR] 5
151+(3) requires the health care provider to be compensated for medical 6
152+care services performed at the same rate as the health care provider has contracted 7
153+with another health care insurer; or 8
154+(4) imposes a practice, education, or collaboration requirement on 9
155+physician assistants that is inconsistent with or more restrictive than the 10
156+requirements imposed under AS 08.64.107 or a regulation adopted by the State 11
157+Medical Board. 12
158+ * Sec. 6. AS 23.30.395(3) is amended to read: 13
159+(3) "attending physician" means one of the following designated by the 14
160+employee under AS 23.30.095(a) or (b): 15
161+(A) a licensed medical doctor; 16
162+(B) a licensed doctor of osteopathy; 17
163+(C) a licensed dentist or dental surgeon; 18
164+(D) a licensed physician assistant [ACTING UNDER 19
165+SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 20
166+OSTEOPATHY]; 21
167+(E) a licensed advanced practice registered nurse; or 22
168+(F) a licensed chiropractor; 23
169+ * Sec. 7. AS 33.30.901(10) is amended to read: 24
170+(10) "health care provider" means 25
171+(A) a physician assistant licensed to practice in the state [AND 26
172+WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 27
173+PHYSICIAN OR PSYCHIATRIST]; 28
174+(B) a mental health professional as defined in AS 47.30.915; or 29
175+(C) an advanced practice registered nurse as defined in 30
176+AS 08.68.850; 31