04/08/1994 05:30 PM House FIN

  HB 341    An  Act  relating  to  physician  assistants;  and                 
            providing for an effective date.                                   
                                                                               
            CS HB 341 (HES) was reported out of Committee with                 
            a "do  pass" recommendation  and with  zero fiscal                 
            notes by  the  Department  of  Health  and  Social                 
            Services, the Department  of Commerce and Economic                 
            Development and the Department of Labor.                           
  HOUSE BILL 341                                                               
                                                                               
       "An Act relating to physician assistants; and providing                 
       for an effective date."                                                 
                                                                               
  MICHAEL  JOHNSON, STAFF,  REPRESENTATIVE JOE  SITTON, stated                 
  that HB 341 would amend several current statutes relating to                 
  health  care providers  giving  Alaskans  greater access  to                 
  quality  health care  and  placing physician  assistants  on                 
  equal  footing  to those  providers  with similar  levels of                 
  training.                                                                    
                                                                               
  He  added  that HB  341 would  amend the  statutes governing                 
  workers'  compensation and  private  insurance companies  to                 
  account  for physicians  assistants'  (P.A.'s) emergence  as                 
  health care providers and insure  that those companies would                 
  not have trouble receiving payment from those entities.  The                 
  legislation also  would  add  physician  assistants  to  the                 
  statute  that  prohibits  private  insurance companies  from                 
  refusing  to  pay  one  health   care  provider  if  another                 
  qualified practitioner  could  offer the  same procedure  or                 
  level of care.                                                               
                                                                               
                                3                                              
                                                                               
                                                                               
  Mr. Johnson pointed out that  Representative Sitton does not                 
  support  the fiscal note  as provided  by the  Department of                 
  Health and Social Services and  consequently has provided an                 
  alternative note.                                                            
                                                                               
  DAVE WILLIAMS, DIVISION OF MEDICAL ASSISTANCE, DEPARTMENT OF                 
  HEALTH  AND  SOCIAL  SERVICES,  explained  that  in  Alaska,                 
  physicians  assistants  have  not  been  paid  directly  for                 
  services rendered.  He  pointed out that there are  a number                 
  of reasons  why the legislation  will cost the  Department a                 
  large amount  of money,  adding that  the legislation  would                 
  provide seventeen new access points  for services in Alaska.                 
  Thus far this  year, $1.8 million  dollars has been paid  by                 
  the  Department  for rural  health  clinics enrolled  as IHS                 
  providers.                                                                   
                                                                               
  Mr. Johnson  explained that  the Department  assumes that  a                 
  certain number of physician assistants  will enroll and that                 
  there will be a  number of new patients contributing  to the                 
  cost of the program.  He indicated that the assumption would                 
  not  include  any  cost  shifting  or  accounting  for  cost                 
  shifting  and  felt  the  fiscal  note should  reflect  that                 
  information.                                                                 
                                                                               
  BARRY  CAMPBELL,  PRESIDENT,  ALASKA  ACADEMY  OF  PHYSICIAN                 
  ASSISTANTS, ANCHORAGE,  remarked that a  physician assistant                 
  (P.A.'s) requires two to four years training.  Some programs                 
  require  prior  medical  background.    Mr.  Campbell  noted                 
  support of Representative Sitton's fiscal note.                              
                                                                               
  Mr. Williams advised that the  legislation would provide for                 
  P.A.'s in  both rural  and urban  areas and  added that  the                 
  Department had provided  their fiscal  note based upon  that                 
  information and the Governor's proposed budget.                              
                                                                               
  Discussion followed  among Committee  members regarding  the                 
  fiscal note and the  impact to the Department of  Health and                 
  Social Services.                                                             
                                                                               
  Representative  Hanley  MOVED to  adopt  Amendment #1  which                 
  would rearrange services payable by the Department of Health                 
  and  Social  Services  and would  place  physician assistant                 
  services  in  the  first  category.    Representative  Brown                 
  OBJECTED.                                                                    
                                                                               
  A roll call vote was taken on the MOTION.                                    
                                                                               
       IN FAVOR:      Hanley.                                                  
       OPPOSED:       Hoffman,    Martin,   Parnell,    Brown,                 
                      Grussendorf, MacLean, Larson.                            
                                                                               
                                                                               
                                4                                              
                                                                               
                                                                               
  Representatives Navarre and Foster were  not present for the                 
  vote.                                                                        
                                                                               
  The MOTION FAILED (1-7).                                                     
                                                                               
  Representative Hanley MOVED to report CS HB 341 (HES) out of                 
  Committee with individual  recommendations and  with a  zero                 
  fiscal note by the Department of Health and Social Services.                 
  There being NO OBJECTION, it was so ordered.                                 
                                                                               
  CS HB  341 (HES) was  reported out  of Committee with  a "do                 
  pass"  recommendation  and  with zero  fiscal  notes  by the                 
  Department of Health and Social  Services, the Department of                 
  Commerce  and  Economic Development  and  the  Department of                 
  Labor.