00 SENATE BILL NO. 115 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. 13  * Sec. 2. AS 08.64.107 is amended by adding new subsections to read: 14 (b) A physician assistant may 01 (1) perform a comprehensive health history and physical examination 02 of a patient; 03 (2) evaluate, diagnose, manage, and treat disease and injury; 04 (3) order, perform, and interpret diagnostic studies and therapeutic 05 procedures; 06 (4) educate patients on health promotion and disease prevention; 07 (5) provide consultation upon request; 08 (6) write medical orders; 09 (7) supervise and delegate therapeutic and diagnostic measures to 10 licensed or unlicensed personnel, in compliance with regulations adopted under 11 AS 08.64.106; 12 (8) request, receive, and sign for professional samples and distribute 13 professional samples to patients; 14 (9) authenticate by signature, certification, stamp, verification, 15 affidavit, or endorsement a document that a physician would be authorized to 16 authenticate by signature, certification, stamp, verification, affidavit, or endorsement; 17 (10) prescribe, dispense, order, administer, and procure drugs and 18 medical devices; 19 (11) prescribe, dispense, order, and administer a schedule II, III, IV, or 20 V controlled substance under federal law if the physician assistant has a valid federal 21 Drug Enforcement Administration registration number; 22 (12) plan and initiate a therapeutic regimen that includes ordering and 23 prescribing non-pharmacological interventions, including durable medical equipment, 24 nutrition, blood, blood products, home health care, hospice, physical or occupational 25 therapy, and other diagnostic support services; and 26 (13) perform any other medical service that the physician assistant is 27 competent to perform based on education, training, and experience. 28 (c) A physician assistant with less than 2,000 hours of practice experience 29 may practice only under a collaborative agreement in a hospital, clinic, or other 30 clinical setting in which the physician assistant works with one or more collaborating 31 physicians to provide patient care. A collaborating physician or physicians shall 01 oversee the performance, practice, and activities of the physician assistant, and the 02 physician assistant must be able to communicate with at least one collaborating 03 physician during work hours in person or by telephone or another telecommunications 04 device. The collaborative agreement must 05 (1) be in writing; 06 (2) describe how collaboration will occur in accordance with this 07 chapter; 08 (3) describe the methods to be used for evaluating the physician 09 assistant's competency, knowledge, and skills; 10 (4) establish that the physician assistant and collaborating physician 11 have knowledge of the physician assistant's qualifications and limitations in caring for 12 patients; 13 (5) require the physician assistant to consult with the collaborating 14 physician while remaining responsible for care provided by the physician assistant; 15 and 16 (6) require the collaborating physician to give direction and guidance 17 to the physician assistant. 18 (d) The physician assistant or collaborating physician shall provide a copy of 19 the collaborative agreement, along with documentation of compliance, to the board 20 upon request of the board. 21 (e) In this section, "collaborative agreement" means a plan that is mutually 22 agreed on by a physician assistant and a collaborating physician that designates the 23 scope of services the physician assistant may provide to patients. 24  * Sec. 3. AS 08.64.170(a) is amended to read: 25 (a) A person may not practice medicine, podiatry, or osteopathy in the state 26 unless the person is licensed under this chapter, except that 27 (1) a physician assistant may examine, diagnose, or treat persons as  28 authorized in AS 08.64.107 [UNDER THE SUPERVISION, CONTROL, AND 29 RESPONSIBILITY OF EITHER A PHYSICIAN LICENSED UNDER THIS 30 CHAPTER OR A PHYSICIAN EXEMPTED FROM LICENSING UNDER 31 AS 08.64.370]; 01 (2) a person who is licensed or authorized under another law of the 02 state may engage in a practice that is authorized under that law; and 03 (3) a person may perform routine medical duties delegated under 04 AS 08.64.106. 05  * Sec. 4. AS 11.71.900(20) is amended to read: 06 (20) "practitioner" means 07 (A) a physician, physician assistant, dentist, advanced practice 08 registered nurse, optometrist, veterinarian, scientific investigator, or other 09 person licensed, registered, or otherwise permitted to distribute, dispense, 10 conduct research with respect to, or to administer or use in teaching or 11 chemical analysis a controlled substance in the course of professional practice 12 or research in the state; 13 (B) a pharmacy, hospital, or other institution licensed, 14 registered, or otherwise permitted to distribute, dispense, conduct research with 15 respect to, or to administer a controlled substance in the course of professional 16 practice or research in the state; 17  * Sec. 5. AS 21.07.010(b) is amended to read: 18 (b) A contract between a participating health care provider and a health care 19 insurer that offers a health care insurance policy may not contain a provision that 20 (1) has as its predominant purpose the creation of direct financial 21 incentives to the health care provider for withholding covered medical care services 22 that are medically necessary; nothing in this paragraph shall be construed to prohibit a 23 contract between a participating health care provider and a health care insurer from 24 containing incentives for efficient management of the utilization and cost of covered 25 medical care services; 26 (2) requires the provider to contract for all products that are currently 27 offered or that may be offered in the future by the health care insurer; [OR] 28 (3) requires the health care provider to be compensated for medical 29 care services performed at the same rate as the health care provider has contracted 30 with another health care insurer; or  31 (4) imposes a practice, education, or collaboration requirement on  01 physician assistants that is inconsistent with or more restrictive than the  02 requirements imposed under AS 08.64.107 or a regulation adopted by the State  03 Medical Board. 04  * Sec. 6. AS 23.30.395(3) is amended to read: 05 (3) "attending physician" means one of the following designated by the 06 employee under AS 23.30.095(a) or (b): 07 (A) a licensed medical doctor; 08 (B) a licensed doctor of osteopathy; 09 (C) a licensed dentist or dental surgeon; 10 (D) a licensed physician assistant [ACTING UNDER 11 SUPERVISION OF A LICENSED MEDICAL DOCTOR OR DOCTOR OF 12 OSTEOPATHY]; 13 (E) a licensed advanced practice registered nurse; or 14 (F) a licensed chiropractor; 15  * Sec. 7. AS 33.30.901(10) is amended to read: 16 (10) "health care provider" means 17 (A) a physician assistant licensed to practice in the state [AND 18 WORKING UNDER THE DIRECT SUPERVISION OF A LICENSED 19 PHYSICIAN OR PSYCHIATRIST]; 20 (B) a mental health professional as defined in AS 47.30.915; or 21 (C) an advanced practice registered nurse as defined in 22 AS 08.68.850;