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SENATE BILL NO. 91
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-THIRD LEGISLATURE - FIRST SESSION
BY SENATOR CLAMAN
Introduced: 3/6/23
Referred: Health & Social Services, Finance
A BILL
FOR AN ACT ENTITLED
"An Act relating to telehealth; relating to multidisciplinary care teams; and relating to 1
the practice of medicine." 2
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
* Section 1. AS 08.02.130(b) is amended to read: 4
(b) A physician licensed in another state or an out-of-state member of the
5
physician's multidisciplinary care team may provide health care services through 6
telehealth to a patient located in the state as provided in this subsection, subject to the 7
investigative and enforcement powers of the department under AS 08.01.087. A 8
physician shall be [, AND] subject to disciplinary action by the State Medical Board 9
under AS 08.64.333, and a member of the physician's multidisciplinary care team 10
shall be subject to disciplinary action by the department under AS 08.02.140. The 11
privilege to practice under this subsection extends only to 12
(1) ongoing treatment or follow-up care provided by a physician 13
licensed in another state, or a member of the physician's multidisciplinary care 14 33-LS0193\A
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team, that is related to health care services previously provided by the physician to 1
the patient and applies only if 2
(A) the physician and the patient have an established physician-3
patient relationship; and 4
(B) the physician has previously conducted an in-person visit 5
with the patient; or 6
(2) a visit with a physician licensed in another state, or a member 7
of the physician's multidisciplinary care team, regarding a suspected or diagnosed 8
life-threatening condition for which 9
(A) the patient has been referred to the physician licensed in 10
another state, or a member of the physician's multidisciplinary care team, 11
by a physician licensed in this state or by a physician licensed in another 12
state who meets the requirements of (1) of this subsection and that referral 13
has been documented by the referring physician; and 14
(B) the visit involves communication with the patient regarding 15
diagnostic or treatment plan options or analysis of test results for the life-16
threatening condition. 17
* Sec. 2. AS 08.02.130(j)(1) is amended to read: 18
(1) "health care provider" means 19
(A) an audiologist or speech-language pathologist licensed 20
under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 21
licensed under AS 08.20; a professional counselor licensed under AS 08.29; a 22
dental hygienist licensed under AS 08.32; a dentist licensed under AS 08.36; a 23
dietitian or nutritionist licensed under AS 08.38; a naturopath licensed under 24
AS 08.45; a marital and family therapist licensed under AS 08.63; a physician 25
licensed under AS 08.64; a podiatrist, osteopath, or physician assistant licensed 26
under AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse 27
licensed under AS 08.68; a dispensing optician licensed under AS 08.71; an 28
optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 29
physical therapist or occupational therapist licensed under AS 08.84; a 30
psychologist or psychological associate licensed under AS 08.86; or a social 31 33-LS0193\A
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worker licensed under AS 08.95; [OR] 1
(B) a physician licensed in another state; or 2
(C) a member of a multidisciplinary care team that includes 3
a physician licensed in another state who meets the requirements of (b)(1) 4
of this section; 5
* Sec. 3. AS 08.02 is amended by adding new sections to read: 6
Sec. 08.02.135. Grounds for imposition of disciplinary sanctions of out-of-7
state multidisciplinary care team members. The department may sanction a member 8
of an out-of-state physician's multidisciplinary care team who provides health care 9
services through telehealth under AS 08.02.130 if the department finds after a hearing 10
that the member 11
(1) secured a license through deceit, fraud, or intentional 12
misrepresentation; 13
(2) engaged in deceit, fraud, or intentional misrepresentation while 14
providing professional services or engaging in professional activities; 15
(3) advertised professional services in a false or misleading manner; 16
(4) has been convicted, including conviction based on a guilty plea or 17
plea of nolo contendere, of 18
(A) a class A or unclassified felony or a crime in another 19
jurisdiction with elements similar to a class A or unclassified felony in this 20
jurisdiction; 21
(B) a class B or class C felony or a crime in another jurisdiction 22
with elements similar to a class B or class C felony in this jurisdiction if the 23
felony or other crime is substantially related to the qualifications, functions, or 24
duties of the member; or 25
(C) a crime involving the unlawful procurement, sale, 26
prescription, or dispensing of drugs; 27
(5) has procured, sold, prescribed, or dispensed drugs in violation of a 28
law regardless of whether there has been a criminal action or harm to the patient; 29
(6) intentionally or negligently permitted the performance of patient 30
care by persons under the member's supervision that does not conform to minimum 31 33-LS0193\A
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professional standards even if the patient was not injured; 1
(7) failed to comply with AS 08.02.130 - 08.02.140, a regulation 2
adopted under AS 08.02.130 - 08.02.140, or an order of the department; 3
(8) has demonstrated 4
(A) professional incompetence, gross negligence, or repeated 5
negligent conduct; the department may not base a finding of professional 6
incompetence solely on the basis that a member's practice is unconventional or 7
experimental in the absence of demonstrable physical harm to a patient; 8
(B) addiction to, severe dependency on, or habitual overuse of 9
alcohol or other drugs that impairs the member's ability to practice safely; 10
(C) unfitness because of physical or mental disability; 11
(9) engaged in unprofessional conduct, in sexual misconduct, or in 12
lewd or immoral conduct in connection with the delivery of professional services to 13
patients; in this paragraph, "sexual misconduct" includes sexual contact, or attempted 14
sexual contact with a patient outside the scope of generally accepted methods of 15
examination or treatment of the patient, regardless of the patient's consent or lack of 16
consent, during the term of the health care provider-patient relationship, unless the 17
patient was the member's spouse at the time of the contact or, immediately preceding 18
the health care provider-patient relationship, was in a dating, courtship, or engagement 19
relationship with the member; 20
(10) has violated any code of ethics adopted imposed by the 21
department; 22
(11) has denied care or treatment to a patient or person seeking 23
assistance from the member if the only reason for the denial is the failure or refusal of 24
the patient to agree to arbitrate as provided in AS 09.55.535(a); 25
(12) has had a license or certificate to practice health care in another 26
state or territory of the United States, or a province or territory of Canada, denied, 27
suspended, revoked, surrendered while under investigation for an alleged violation, 28
restricted, limited, conditioned, or placed on probation unless the denial, suspension, 29
revocation, or other action was caused by the failure of the member to pay fees to that 30
state, territory, or province; 31 33-LS0193\A
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(13) exceeded the scope of the member's privilege to practice in this 1
state under AS 08.02.130; or 2
(14) prescribed, dispensed, or administered through telehealth to a 3
patient located in the state a controlled substance listed in AS 11.71.140 - 11.71.190. 4
Sec. 08.02.140. Disciplinary sanctions for an out-of-state multidisciplinary 5
care team member. (a) If the department finds grounds to sanction a member of an 6
out-of-state physician's multidisciplinary care team under AS 08.02.135, the 7
department may 8
(1) permanently prohibit the member from practicing in the state; 9
(2) prohibit the member from practicing in the state for a determinate 10
period; 11
(3) censure the member; 12
(4) issue a letter of reprimand to the member; 13
(5) place the member on probationary status under (c) of this section; 14
(6) limit or impose conditions on the member's privilege to practice in 15
the state; 16
(7) impose a civil penalty of not more than $25,000; 17
(8) issue a cease and desist order prohibiting the member from 18
providing health care services through telehealth under AS 08.02.130; an order issued 19
under this paragraph remains in effect until the member submits evidence acceptable 20
to the department showing that the violation has been corrected; 21
(9) promptly notify the licensing authority in each state in which the 22
member is licensed of a sanction imposed under this subsection. 23
(b) In a case finding grounds for sanction under AS 08.02.135(12), the final 24
findings of fact, conclusions of law, and order of the authority that suspended or 25
revoked a license or certificate constitute a prima facie case that the license or 26
certificate was suspended or revoked and the grounds under which the suspension or 27
revocation was granted. 28
(c) The department may place a member on probation under this section until 29
the department finds that the deficiencies that required the imposition of a sanction 30
have been remedied. The department may require a member on probation to 31 33-LS0193\A
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(1) report regularly to the department on matters involving the reason 1
for which the member was placed on probation; 2
(2) limit the member's practice in the state to those areas prescribed by 3
the department; 4
(3) participate in professional education until the department 5
determines that a satisfactory degree of skill has been attained in areas identified by 6
the department as needing improvement. 7
(d) The department may summarily prohibit a member from practicing in the 8
state under AS 08.02.130 if the department finds that the member, by continuing to 9
practice, poses a clear and immediate danger to public health and safety. A member 10
prohibited from practicing under this subsection is entitled to a hearing conducted by 11
the office of administrative hearings (AS 44.64.010) not later than seven days after the 12
effective date of the order prohibiting the member from practicing. The department 13
may lift an order prohibiting a member from practicing if the department finds after a 14
hearing that the member is able to practice with reasonable skill and safety. The 15
member may appeal a decision of the department under this subsection to the superior 16
court. 17
(e) The department shall take measures to recover from a member the cost of 18
proceedings resulting in a sanction under (a) of this section, including the costs of 19
investigation by the department, and hearing costs. 20
(f) The department may prohibit a member from practicing in the state upon 21
receiving a certified copy of evidence that a license or certificate to practice within the 22
member's scope of practice in another state or territory of the United States or 23
province or territory of Canada has been suspended or revoked. The prohibition 24
remains in effect until a hearing can be held by the department. 25
(g) The department shall be consistent in the application of disciplinary 26
sanctions. A significant departure from earlier decisions of the department involving 27
similar situations must be explained in findings of fact or orders made by the 28
department. 29