CSSB 115(HSS) am: "An Act relating to physician assistants; relating to physicians; and relating to health care insurance policies."
00 CS FOR SENATE BILL NO. 115(HSS) am 01 "An Act relating to physician assistants; relating to physicians; and relating to health 02 care insurance policies." 03 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA: 04 * Section 1. AS 08.64.107 is amended to read: 05 Sec. 08.64.107. Licensure and scope of practice [REGULATION] of 06 physician assistants. The board shall adopt regulations regarding the licensure of 07 physician assistants and the medical services that they may perform, including the 08 (1) educational and other qualifications, including education in pain 09 management and opioid use and addiction; 10 (2) application and licensing procedures; 11 (3) scope of activities authorized in this section; [AND] 12 (4) responsibilities of a [THE] supervising or training physician; and 13 (5) hours of practice experience, if any, that a physician assistant 14 must complete under a collaborative agreement to practice in a practice area that
01 is substantively different than the physician assistant's previous practice areas; 02 the board may not require that a physician assistant complete more than 4,000 03 hours under this paragraph, in addition to the hours required under (c) of this 04 section, to practice in a new practice area without a collaborative agreement. 05 * Sec. 2. AS 08.64.107 is amended by adding new subsections to read: 06 (b) A physician assistant may 07 (1) perform a comprehensive health history and physical examination 08 of a patient; 09 (2) evaluate, diagnose, manage, and treat disease and injury; 10 (3) order, perform, and interpret diagnostic studies and therapeutic 11 procedures; 12 (4) educate patients on health promotion and disease prevention; 13 (5) provide consultation upon request; 14 (6) write medical orders; 15 (7) supervise and delegate therapeutic and diagnostic measures to 16 licensed or unlicensed personnel, in compliance with regulations adopted under 17 AS 08.64.106; 18 (8) request, receive, and sign for professional samples and distribute 19 professional samples to patients; 20 (9) authenticate by signature, certification, stamp, verification, 21 affidavit, or endorsement a document that a physician would be authorized to 22 authenticate by signature, certification, stamp, verification, affidavit, or endorsement; 23 (10) prescribe, dispense, order, administer, and procure drugs and 24 medical devices; 25 (11) prescribe, dispense, order, and administer a schedule II, III, IV, or 26 V controlled substance under federal law if the physician assistant has a valid federal 27 Drug Enforcement Administration registration number; 28 (12) plan and initiate a therapeutic regimen that includes ordering and 29 prescribing non-pharmacological interventions, including durable medical equipment, 30 nutrition, blood, blood products, home health care, hospice, physical or occupational 31 therapy, and other diagnostic support services; and
01 (13) perform any other medical service that the physician assistant is 02 competent to perform based on education, training, and experience. 03 (c) Unless additional hours are required by the board to practice in a new 04 practice area under (a)(5) of this section, a physician assistant with less than 4,000 05 hours of practice experience may practice only under a collaborative agreement in a 06 hospital, clinic, or other clinical setting in which the physician assistant works with 07 one or more collaborating physicians to provide patient care. A collaborating 08 physician or physicians shall oversee the performance, practice, and activities of the 09 physician assistant, and the physician assistant must be able to communicate during 10 work hours, in person or by telephone or another telecommunications device, with one 11 or more collaborating physicians who, collectively, practice in each of the physician 12 assistant's practice areas. The collaborative agreement must 13 (1) be in writing; 14 (2) describe how collaboration will occur in accordance with this 15 chapter; 16 (3) describe the methods to be used for evaluating the physician 17 assistant's competency, knowledge, and skills; 18 (4) establish that the physician assistant and collaborating physician 19 have knowledge of the physician assistant's qualifications and limitations in caring for 20 patients; 21 (5) require the physician assistant to consult with the collaborating 22 physician while remaining responsible for care provided by the physician assistant; 23 (6) require the collaborating physician to give direction and guidance 24 to the physician assistant; and 25 (7) describe the physician assistant's practice areas and the 26 collaborating physicians who practice in those areas. 27 (d) The physician assistant or collaborating physician shall provide a copy of 28 the collaborative agreement, along with documentation of compliance, to the board 29 upon request of the board. 30 (e) In this section, "collaborative agreement" means a plan that is mutually 31 agreed on by a physician assistant and a collaborating physician that designates the
01 scope of services the physician assistant may provide to patients. 02 * Sec. 3. AS 08.64.170(a) is amended to read: 03 (a) A person may not practice medicine, podiatry, or osteopathy in the state 04 unless the person is licensed under this chapter, except that 05 (1) a physician assistant may examine, diagnose, or treat persons as 06 authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 07 RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 08 CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 09 AS 08.64.370]; 10 (2) a person who is licensed or authorized under another law of the 11 state may engage in a practice that is authorized under that law; and 12 (3) a person may perform routine medical duties delegated under 13 AS 08.64.106. 14 * Sec. 4. AS 11.71.900(20) is amended to read: 15 (20) "practitioner" means 16 (A) a physician, physician assistant, dentist, advanced practice 17 registered nurse, optometrist, veterinarian, scientific investigator, or other 18 person licensed, registered, or otherwise permitted to distribute, dispense, 19 conduct research with respect to, or to administer or use in teaching or 20 chemical analysis a controlled substance in the course of professional practice 21 or research in the state; 22 (B) a pharmacy, hospital, or other institution licensed, 23 registered, or otherwise permitted to distribute, dispense, conduct research with 24 respect to, or to administer a controlled substance in the course of professional 25 practice or research in the state; 26 * Sec. 5. AS 21.07.010(b) is amended to read: 27 (b) A contract between a participating health care provider and a health care 28 insurer that offers a health care insurance policy may not contain a provision that 29 (1) has as its predominant purpose the creation of direct financial 30 incentives to the health care provider for withholding covered medical care services 31 that are medically necessary; nothing in this paragraph shall be construed to prohibit a
01 contract between a participating health care provider and a health care insurer from 02 containing incentives for efficient management of the utilization and cost of covered 03 medical care services; 04 (2) requires the provider to contract for all products that are currently 05 offered or that may be offered in the future by the health care insurer; [OR] 06 (3) requires the health care provider to be compensated for medical 07 care services performed at the same rate as the health care provider has contracted 08 with another health care insurer; or 09 (4) imposes a practice, education, or collaboration requirement on 10 physician assistants that is inconsistent with or more restrictive than the 11 requirements imposed under AS 08.64.107 or a regulation adopted by the State 12 Medical Board. 13 * Sec. 6. AS 23.30.395(3) is amended to read: 14 (3) "attending physician" means one of the following designated by the 15 employee under AS 23.30.095(a) or (b): 16 (A) a licensed medical doctor; 17 (B) a licensed doctor of osteopathy; 18 (C) a licensed dentist or dental surgeon; 19 (D) a licensed physician assistant [ACTING UNDER 20 SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 21 OSTEOPATHY]; 22 (E) a licensed advanced practice registered nurse; or 23 (F) a licensed chiropractor; 24 * Sec. 7. AS 33.30.901(10) is amended to read: 25 (10) "health care provider" means 26 (A) a physician assistant licensed to practice in the state [AND 27 WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 28 PHYSICIAN OR PSYCHIATRIST]; 29 (B) a mental health professional as defined in AS 47.30.915; or 30 (C) an advanced practice registered nurse as defined in 31 AS 08.68.850;