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CS FOR SENATE BILL NO. 91(HSS)
IN THE LEGISLATURE OF THE STATE OF ALASKA
THIRTY-THIRD LEGISLATURE - FIRST SESSION
BY THE SENATE HEALTH AND S OCIAL SERVICES COMMITTEE
Offered: 4/14/23
Referred: Finance
Sponsor(s): SENATOR CLAMAN
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
member of a physician's multidisciplinary care team may provide a health care 9
service through telehealth to a patient located in this state only if the health care 10
service is not reasonably available in the state. A physician shall be [, AND] 11
subject to disciplinary action by the State Medical Board under AS 08.64.333, and a 12
member of the physician's multidisciplinary care team shall be subject to 13
disciplinary action by the department under AS 08.02.140. The privilege to 14 33-LS0193\B
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practice under this subsection extends only to 1
(1) ongoing treatment or follow-up care provided by a physician 2
licensed in another state, or a member of the physician's multidisciplinary care 3
team, that is related to health care services previously provided by the physician to 4
the patient and applies only if 5
(A) the physician and the patient have an established physician-6
patient relationship; and 7
(B) the physician has previously conducted an in-person visit 8
with the patient; or 9
(2) a visit with a physician licensed in another state, or a member 10
of the physician's multidisciplinary care team, regarding a suspected or diagnosed 11
life-threatening condition for which 12
(A) the patient has been referred to the physician licensed in 13
another state, or a member of the physician's multidisciplinary care team, 14
by a physician licensed in this state or by a physician licensed in another 15
state who meets the requirements of (1) of this subsection and that referral 16
has been documented by the referring physician; and 17
(B) the visit involves communication with the patient regarding 18
diagnostic or treatment plan options or analysis of test results for the life-19
threatening condition. 20
* Sec. 2. AS 08.02.130(j)(1) is amended to read: 21
(1) "health care provider" means 22
(A) an audiologist or speech-language pathologist licensed 23
under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 24
licensed under AS 08.20; a professional counselor licensed under AS 08.29; a 25
dental hygienist licensed under AS 08.32; a dentist licensed under AS 08.36; a 26
dietitian or nutritionist licensed under AS 08.38; a naturopath licensed under 27
AS 08.45; a marital and family therapist licensed under AS 08.63; a physician 28
licensed under AS 08.64; a podiatrist, osteopath, or physician assistant licensed 29
under AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse 30
licensed under AS 08.68; a dispensing optician licensed under AS 08.71; an 31 33-LS0193\B
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optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 1
physical therapist or occupational therapist licensed under AS 08.84; a 2
psychologist or psychological associate licensed under AS 08.86; or a social 3
worker licensed under AS 08.95; [OR] 4
(B) a physician licensed in another state; or 5
(C) a member of a multidisciplinary care team; 6
* Sec. 3. AS 08.02.130(j) is amended by adding a new paragraph to read: 7
(5) "member of a multidisciplinary care team" means an audiologist, 8
speech-language pathologist, behavior analyst, professional counselor, dietitian, 9
nutritionist, naturopath, marital and family therapist, podiatrist, osteopath, physician 10
assistant, nurse, pharmacist, physical therapist, occupational therapist, psychologist or 11
psychological associate, or a social worker who is a member of a team that includes a 12
physician licensed in another state who meets the requirements of (b)(1) of this 13
section. 14
* Sec. 4. AS 08.02.130 is amended by adding a new subsection to read: 15
(k) A member of a multidisciplinary care team shall register with the 16
department before providing telehealth services to a patient located in the state. To 17
register with the department, a member of a multidisciplinary care team shall submit 18
(1) the name of the physician leading the multidisciplinary care team; 19
(2) the area of health care in which the member of the 20
multidisciplinary care team will be practicing and proof of licensure in a state or 21
territory of the United States in that area; 22
(3) any applicable fees, as determined by the department. 23
* Sec. 5. AS 08.02 is amended by adding new sections to read: 24
Sec. 08.02.135. Grounds for imposition of disciplinary sanctions of out-of-25
state multidisciplinary care team members. The department may sanction a member 26
of an out-of-state physician's multidisciplinary care team who provides health care 27
services through telehealth under AS 08.02.130 if the department finds after a hearing 28
that the member 29
(1) secured a license through deceit, fraud, or intentional 30
misrepresentation; 31 33-LS0193\B
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(2) engaged in deceit, fraud, or intentional misrepresentation while 1
providing professional services or engaging in professional activities; 2
(3) advertised professional services in a false or misleading manner; 3
(4) has been convicted, including conviction based on a guilty plea or 4
plea of nolo contendere, of 5
(A) a class A or unclassified felony or a crime in another 6
jurisdiction with elements similar to a class A or unclassified felony in this 7
jurisdiction; 8
(B) a class B or class C felony or a crime in another jurisdiction 9
with elements similar to a class B or class C felony in this jurisdiction if the 10
felony or other crime is substantially related to the qualifications, functions, or 11
duties of the member; or 12
(C) a crime involving the unlawful procurement, sale, 13
prescription, or dispensing of drugs; 14
(5) has procured, sold, prescribed, or dispensed drugs in violation of a 15
law regardless of whether there has been a criminal action or harm to the patient; 16
(6) intentionally or negligently permitted the performance of patient 17
care by persons under the member's supervision that does not conform to minimum 18
professional standards even if the patient was not injured; 19
(7) failed to comply with AS 08.02.130 - 08.02.140, a regulation 20
adopted under AS 08.02.130 - 08.02.140, or an order of the department; 21
(8) has demonstrated 22
(A) professional incompetence, gross negligence, or repeated 23
negligent conduct; the department may not base a finding of professional 24
incompetence solely on the basis that a member's practice is unconventional or 25
experimental in the absence of demonstrable physical harm to a patient; 26
(B) addiction to, severe dependency on, or habitual overuse of 27
alcohol or other drugs that impairs the member's ability to practice safely; 28
(C) unfitness because of physical or mental disability; 29
(9) engaged in unprofessional conduct, in sexual misconduct, or in 30
lewd or immoral conduct in connection with the delivery of professional services to 31 33-LS0193\B
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patients; in this paragraph, "sexual misconduct" includes sexual contact, or attempted 1
sexual contact with a patient outside the scope of generally accepted methods of 2
examination or treatment of the patient, regardless of the patient's consent or lack of 3
consent, during the term of the health care provider-patient relationship, unless the 4
patient was the member's spouse at the time of the contact or, immediately preceding 5
the health care provider-patient relationship, was in a dating, courtship, or engagement 6
relationship with the member; 7
(10) has violated any code of ethics adopted imposed by the 8
department; 9
(11) has denied care or treatment to a patient or person seeking 10
assistance from the member if the only reason for the denial is the failure or refusal of 11
the patient to agree to arbitrate as provided in AS 09.55.535(a); 12
(12) has had a license or certificate to practice health care in another 13
state or territory of the United States, or a province or territory of Canada, denied, 14
suspended, revoked, surrendered while under investigation for an alleged violation, 15
restricted, limited, conditioned, or placed on probation unless the denial, suspension, 16
revocation, or other action was caused by the failure of the member to pay fees to that 17
state, territory, or province; 18
(13) exceeded the scope of the member's privilege to practice in this 19
state under AS 08.02.130; or 20
(14) prescribed, dispensed, or administered through telehealth to a 21
patient located in the state a controlled substance listed in AS 11.71.140 - 11.71.190. 22
Sec. 08.02.140. Disciplinary sanctions for an out-of-state multidisciplinary 23
care team member. (a) If the department finds grounds to sanction a member of an 24
out-of-state physician's multidisciplinary care team under AS 08.02.135, the 25
department may 26
(1) permanently prohibit the member from practicing in the state; 27
(2) prohibit the member from practicing in the state for a determinate 28
period; 29
(3) censure the member; 30
(4) issue a letter of reprimand to the member; 31 33-LS0193\B
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(5) place the member on probationary status under (c) of this section; 1
(6) limit or impose conditions on the member's privilege to practice in 2
the state; 3
(7) impose a civil penalty of not more than $25,000; 4
(8) issue a cease and desist order prohibiting the member from 5
providing health care services through telehealth under AS 08.02.130; an order issued 6
under this paragraph remains in effect until the member submits evidence acceptable 7
to the department showing that the violation has been corrected; 8
(9) promptly notify the licensing authority in each state in which the 9
member is licensed of a sanction imposed under this subsection. 10
(b) In a case finding grounds for sanction under AS 08.02.135(12), the final 11
findings of fact, conclusions of law, and order of the authority that suspended or 12
revoked a license or certificate constitute a prima facie case that the license or 13
certificate was suspended or revoked and the grounds under which the suspension or 14
revocation was granted. 15
(c) The department may place a member on probation under this section until 16
the department finds that the deficiencies that required the imposition of a sanction 17
have been remedied. The department may require a member on probation to 18
(1) report regularly to the department on matters involving the reason 19
for which the member was placed on probation; 20
(2) limit the member's practice in the state to those areas prescribed by 21
the department; 22
(3) participate in professional education until the department 23
determines that a satisfactory degree of skill has been attained in areas identified by 24
the department as needing improvement. 25
(d) The department may summarily prohibit a member from practicing in the 26
state under AS 08.02.130 if the department finds that the member, by continuing to 27
practice, poses a clear and immediate danger to public health and safety. A member 28
prohibited from practicing under this subsection is entitled to a hearing conducted by 29
the office of administrative hearings (AS 44.64.010) not later than seven days after the 30
effective date of the order prohibiting the member from practicing. The department 31 33-LS0193\B
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may lift an order prohibiting a member from practicing if the department finds after a 1
hearing that the member is able to practice with reasonable skill and safety. The 2
member may appeal a decision of the department under this subsection to the superior 3
court. 4
(e) The department shall take measures to recover from a member the cost of 5
proceedings resulting in a sanction under (a) of this section, including the costs of 6
investigation by the department, and hearing costs. 7
(f) The department may prohibit a member from practicing in the state upon 8
receiving a certified copy of evidence that a license or certificate to practice within the 9
member's scope of practice in another state or territory of the United States or 10
province or territory of Canada has been suspended or revoked. The prohibition 11
remains in effect until a hearing can be held by the department. 12
(g) The department shall be consistent in the application of disciplinary 13
sanctions. A significant departure from earlier decisions of the department involving 14
similar situations must be explained in findings of fact or orders made by the 15
department. 16
* Sec. 6. AS 44.33.381(b) is amended to read: 17
(b) The department shall maintain the registry of businesses performing 18
telemedicine services in the state. The registry must include the name, address, and 19
contact information of businesses performing telemedicine services in the state. The 20
department may renew every two years the registration of a business that meets 21
all renewal requirements established by regulation and pays a renewal fee every 22
two years. 23
* Sec. 7. AS 44.33.381 is amended by adding a new subsection to read: 24
(d) The department shall charge the following fees for businesses performing 25
telemedicine services in the state: 26
(1) initial registration fee, $100, adjusted for inflation in a manner 27
determined by the department; 28
(2) renewal fee, $100, adjusted for inflation in a manner determined by 29
the department; 30
(3) fee to report changes in the business's registration information, $50. 31