Alaska 2023-2024 Regular Session

Alaska Senate Bill SB91 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	Enrolled SB 91
2		-	LAWS OF ALASKA
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4		-	2024
	2	+	SB0091d -1- CSSB 91(FIN) am H
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6		-
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8		-	Source Chapter No.
9		-	CSSB 91(FIN) am H _______
	5	+	33-LS0193\S.A
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14		-	~~AN ACT~~
	10	+	CS FOR SENATE BILL NO. 91(FIN) am H
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16		-	Relating to telehealth; relating to multidisciplinary care teams; and relating to the practice of
17		-	medicine.
	12	+	IN THE LEGISLATURE OF THE STATE OF ALASKA
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	14	+	THIRTY-THIRD LEGISLATURE - SECOND SESSION
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20		-	~~_______________~~
	16	+	BY THE SENATE FINANCE COMMITTEE
21	17
	18	+	Amended: 5/13/24
	19	+	Offered: 3/1/24
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23		-	~~BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA~~:
	21	+	Sponsor(s): SENATOR CLAMAN
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	23	+	REPRESENTATIVES Mina , Josephson, Schrage
	24	+	A BILL
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	26	+	FOR AN ACT ENTITLED
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27		-	THE ACT FOLLOWS ON PAGE 1
28		-	-1- Enrolled SB 91
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50		-	AN ACT
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53		-	Relating to telehealth; relating to multidisciplinary care teams; and relating to the practice of 1
54		-	medicine. 2
55		-	_______________ 3
	28	+	"An Act relating to telehealth; relating to multidisciplinary care teams; and relating to 1
	29	+	the practice of medicine." 2
	30	+	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 3
56	31		* Section 1. AS 08.02.130(b) is amended to read: 4
57	32		(b) A physician licensed in another state or an out-of-state member of the
58	33		5
59	34		physician's multidisciplinary care team may provide health care services through 6
60	35		telehealth to a patient located in the state as provided in this subsection, subject to the 7
61	36		investigative and enforcement powers of the department under AS 08.01.087. A 8
62	37		member of a physician's multidisciplinary care team may provide a health care 9
63	38		service through telehealth to a patient located in this state if the health care 10
64	39		service, as provided by the multidisciplinary care team, is not reasonably 11
65	40		available in the state. A physician shall be [, AND] subject to disciplinary action by 12
66	41		the State Medical Board under AS 08.64.333, and a member of the physician's 13
67		-	multidisciplinary care team shall be subject to disciplinary action by the 14
68		-	Enrolled SB 91 -2-
	42	+	multidisciplinary care team shall be subject to disciplinary action by the 14 33-LS0193\S.A
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69	46		department under AS 08.02.140. The privilege to practice under this subsection 1
70	47		extends only to 2
71	48		(1) ongoing treatment or follow-up care related to health care services 3
72	49		previously provided by the physician to the patient and applies only if 4
73	50		(A) the physician and the patient have an established physician-5
74	51		patient relationship; and 6
75	52		(B) the physician has previously conducted an in-person visit 7
76	53		with the patient; [OR] 8
77	54		(2) a visit regarding a suspected or diagnosed life-threatening 9
78	55		condition for which 10
79	56		(A) the patient has been referred to the physician licensed in 11
80	57		another state by a physician licensed in this state and that referral has been 12
81	58		documented by the referring physician; and 13
82	59		(B) the visit involves communication with the patient regarding 14
83	60		diagnostic or treatment plan options or analysis of test results for the life-15
84	61		threatening condition; or 16
85	62		(3) ongoing treatment or follow-up care provided by a physician 17
86	63		licensed in another state or a member of the physician's multidisciplinary care 18
87	64		team regarding a suspected or diagnosed life-threatening condition. 19
88	65		* Sec. 2. AS 08.02.130(j)(1) is amended to read: 20
89	66		(1) "health care provider" means 21
90	67		(A) an audiologist or speech-language pathologist licensed 22
91	68		under AS 08.11; a behavior analyst licensed under AS 08.15; a chiropractor 23
92	69		licensed under AS 08.20; a professional counselor licensed under AS 08.29; a 24
93	70		dental hygienist licensed under AS 08.32; a dentist licensed under AS 08.36; a 25
94	71		dietitian or nutritionist licensed under AS 08.38; a naturopath licensed under 26
95	72		AS 08.45; a marital and family therapist licensed under AS 08.63; a physician 27
96	73		licensed under AS 08.64; a podiatrist, osteopath, or physician assistant licensed 28
97	74		under AS 08.64; a direct-entry midwife certified under AS 08.65; a nurse 29
98	75		licensed under AS 08.68; a dispensing optician licensed under AS 08.71; an 30
99		-	optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 31
100		-	-3- Enrolled SB 91
	76	+	optometrist licensed under AS 08.72; a pharmacist licensed under AS 08.80; a 31 33-LS0193\S.A
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101	80		physical therapist or occupational therapist licensed under AS 08.84; a 1
102	81		psychologist or psychological associate licensed under AS 08.86; or a social 2
103	82		worker licensed under AS 08.95; [OR] 3
104	83		(B) a physician licensed in another state; or 4
105	84		(C) a member of a multidisciplinary care team who is 5
106	85		licensed in another state; 6
107	86		* Sec. 3. AS 08.02.130(j) is amended by adding a new paragraph to read: 7
108	87		(5) "member of a multidisciplinary care team" means an audiologist, 8
109	88		speech-language pathologist, behavior analyst, professional counselor, dietitian, 9
110	89		nutritionist, naturopath, marital and family therapist, podiatrist, osteopath, physician 10
111	90		assistant, nurse, pharmacist, physical therapist, occupational therapist, psychologist or 11
112		-	psychological associate, advanced nurse practitioner, or social worker who is a 12
	91	+	psychological associate, advanced nurse practitioner, or a social worker who is a 12
113	92		member of a team coordinated by a physician licensed in another state who meets the 13
114	93		requirements of (b)(3) of this section. 14
115		-	* Sec. 4. AS 08.02 is amended by adding new sections to ~~article 3 to~~ read: 15
	94	+	* Sec. 4. AS 08.02 is amended by adding new sections to read: 15
116	95		Sec. 08.02.135. Grounds for imposition of disciplinary sanctions of out-of-16
117	96		state multidisciplinary care team members. The department may sanction a member 17
118	97		of an out-of-state physician's multidisciplinary care team who provides health care 18
119	98		services through telehealth under AS 08.02.130 if the department finds after a hearing 19
120	99		that the member 20
121	100		(1) secured a license through deceit, fraud, or intentional 21
122	101		misrepresentation; 22
123	102		(2) engaged in deceit, fraud, or intentional misrepresentation while 23
124	103		providing professional services or engaging in professional activities; 24
125	104		(3) advertised professional services in a false or misleading manner; 25
126	105		(4) has been convicted, including conviction based on a guilty plea or 26
127	106		plea of nolo contendere, of 27
128	107		(A) a class A or unclassified felony or a crime in another 28
129	108		jurisdiction with elements similar to a class A or unclassified felony in this 29
130	109		jurisdiction; 30
131		-	(B) a class B or class C felony or a crime in another jurisdiction 31
132		-	Enrolled SB 91 -4-
	110	+	(B) a class B or class C felony or a crime in another jurisdiction 31 33-LS0193\S.A
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133	114		with elements similar to a class B or class C felony in this jurisdiction if the 1
134	115		felony or other crime is substantially related to the qualifications, functions, or 2
135	116		duties of the member; or 3
136	117		(C) a crime involving the unlawful procurement, sale, 4
137	118		prescription, or dispensing of drugs; 5
138	119		(5) has procured, sold, prescribed, or dispensed drugs in violation of a 6
139	120		law regardless of whether there has been a criminal action or harm to the patient; 7
140	121		(6) intentionally or negligently permitted the performance of patient 8
141	122		care by persons under the member's supervision that does not conform to minimum 9
142	123		professional standards even if the patient was not injured; 10
143	124		(7) failed to comply with AS 08.02.130 - 08.02.140, a regulation 11
144	125		adopted under AS 08.02.130 - 08.02.140, or an order of the department; 12
145	126		(8) has demonstrated 13
146	127		(A) professional incompetence, gross negligence, or repeated 14
147	128		negligent conduct; the department may not base a finding of professional 15
148	129		incompetence solely on the basis that a member's practice is unconventional or 16
149	130		experimental in the absence of demonstrable physical harm to a patient; 17
150	131		(B) addiction to, severe dependency on, or habitual overuse of 18
151	132		alcohol or other drugs that impairs the member's ability to practice safely; 19
152	133		(C) unfitness because of physical or mental disability; 20
153	134		(9) engaged in unprofessional conduct, in sexual misconduct, or in 21
154	135		lewd or immoral conduct in connection with the delivery of professional services to 22
155	136		patients; in this paragraph, "sexual misconduct" includes sexual contact, or attempted 23
156		-	sexual contact, with a patient outside the scope of generally accepted methods of 24
	137	+	sexual contact with a patient outside the scope of generally accepted methods of 24
157	138		examination or treatment of the patient, regardless of the patient's consent or lack of 25
158	139		consent, during the term of the health care provider-patient relationship, unless the 26
159	140		patient was the member's spouse at the time of the contact or, immediately preceding 27
160	141		the health care provider-patient relationship, was in a dating, courtship, or engagement 28
161	142		relationship with the member; 29
162	143		(10) has violated any code of ethics adopted by the department; 30
163		-	(11) has denied care or treatment to a patient or person seeki
164		-	ng 31
165		-	-5- Enrolled SB 91
	144	+	(11) has denied care or treatment to a patient or person seeking
	145	+	31 33-LS0193\S.A
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166	149		assistance from the member if the only reason for the denial is the failure or refusal of 1
167	150		the patient to agree to arbitrate as provided in AS 09.55.535(a); 2
168	151		(12) has had a license or certificate to practice health care in another 3
169	152		state or territory of the United States, or a province or territory of Canada, denied, 4
170	153		suspended, revoked, surrendered while under investigation for an alleged violation, 5
171	154		restricted, limited, conditioned, or placed on probation unless the denial, suspension, 6
172	155		revocation, or other action was caused by the failure of the member to pay fees to that 7
173	156		state, territory, or province; 8
174	157		(13) exceeded the scope of the member's privilege to practice in this 9
175	158		state under AS 08.02.130; or 10
176	159		(14) prescribed, dispensed, or administered through telehealth to a 11
177	160		patient located in the state a controlled substance listed in AS 11.71.140 - 11.71.190. 12
178	161		Sec. 08.02.140. Disciplinary sanctions for an out-of-state multidisciplinary 13
179	162		care team member. (a) If the department finds grounds to sanction a member of an 14
180	163		out-of-state physician's multidisciplinary care team under AS 08.02.135, the 15
181	164		department may 16
182	165		(1) permanently prohibit the member from practicing in the state; 17
183	166		(2) prohibit the member from practicing in the state for a determinate 18
184	167		period; 19
185	168		(3) censure the member; 20
186	169		(4) issue a letter of reprimand to the member; 21
187	170		(5) place the member on probationary status under (c) of this section; 22
188	171		(6) limit or impose conditions on the member's privilege to practice in 23
189	172		the state; 24
190	173		(7) impose a civil penalty of not more than $25,000; 25
191	174		(8) issue a cease and desist order prohibiting the member from 26
192	175		providing health care services through telehealth under AS 08.02.130; an order issued 27
193	176		under this paragraph remains in effect until the member submits evidence acceptable 28
194	177		to the department showing that the violation has been corrected; 29
195	178		(9) promptly notify the licensing authority in each state in which the 30
196		-	member is licensed of a sanction imposed under this subsection. 31
197		-	Enrolled SB 91 -6-
	179	+	member is licensed of a sanction imposed under this subsection. 31 33-LS0193\S.A
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198	183		(b) In a case finding grounds for sanction under AS 08.02.135(12), the final 1
199	184		findings of fact, conclusions of law, and order of the authority that suspended or 2
200	185		revoked a license or certificate constitute a prima facie case that the license or 3
201	186		certificate was suspended or revoked and the grounds under which the suspension or 4
202	187		revocation was granted. 5
203	188		(c) The department may place a member on probation under this section until 6
204	189		the department finds that the deficiencies that required the imposition of a sanction 7
205	190		have been remedied. The department may require a member on probation to 8
206	191		(1) report regularly to the department on matters involving the reason 9
207	192		for which the member was placed on probation; 10
208	193		(2) limit the member's practice in the state to those areas prescribed by 11
209	194		the department; 12
210	195		(3) participate in professional education until the department 13
211	196		determines that a satisfactory degree of skill has been attained in areas identified by 14
212	197		the department as needing improvement. 15
213	198		(d) The department may summarily prohibit a member from practicing in the 16
214	199		state under AS 08.02.130 if the department finds that the member, by continuing to 17
215	200		practice, poses a clear and immediate danger to public health and safety. A member 18
216	201		prohibited from practicing under this subsection is entitled to a hearing conducted by 19
217	202		the office of administrative hearings (AS 44.64.010) not later than seven days after the 20
218	203		effective date of the order prohibiting the member from practicing. The department 21
219	204		may lift an order prohibiting a member from practicing if the department finds after a 22
220	205		hearing that the member is able to practice with reasonable skill and safety. The 23
221	206		member may appeal a decision of the department under this subsection to the superior 24
222	207		court. 25
223	208		(e) The department shall take measures to recover from a member the cost of 26
224	209		proceedings resulting in a sanction under (a) of this section, including the costs of 27
225		-	investigation by the department and hearing costs. 28
	210	+	investigation by the department, and hearing costs. 28
226	211		(f) The department may prohibit a member from practicing in the state upon 29
227	212		receiving a certified copy of evidence that a license or certificate to practice within the 30
228		-	member's scope of practice in another state or territory of the United States, or a 31
229		-	-7- Enrolled SB 91
230		-	province or territory of Canada, has been suspended or revoked. The prohibition 1
	213	+	member's scope of practice in another state or territory of the United States or 31 33-LS0193\S.A
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	217	+	province or territory of Canada has been suspended or revoked. The prohibition 1
231	218		remains in effect until a hearing can be held by the department. 2
232	219		(g) The department shall be consistent in the application of disciplinary 3
233	220		sanctions. A significant departure from earlier decisions of the department involving 4
234	221		similar situations must be explained in findings of fact or orders made by the 5
235	222		department. 6
236	223		* Sec. 5. AS 44.33.381(b) is amended to read: 7
237	224		(b) The department shall maintain the registry of businesses performing 8
238	225		telemedicine services in the state. The registry must include the name, address, and 9
239	226		contact information of businesses performing telemedicine services in the state. The 10
240	227		department may renew every two years the registration of a business that meets 11
241	228		all renewal requirements established by regulation and pays a renewal fee every 12
242	229		two years. 13
243	230		* Sec. 6. AS 44.33.381 is amended by adding a new subsection to read: 14
244	231		(d) The department shall charge the following fees for businesses performing 15
245	232		telemedicine services in the state: 16
246	233		(1) initial registration fee, $100, adjusted for inflation in a manner 17
247	234		determined by the department; 18
248	235		(2) renewal fee, $100, adjusted for inflation in a manner determined by 19
249	236		the department; 20
250	237		(3) fee to report changes in the business's registration information, $50. 21