Legislature(2015 - 2016)CAPITOL 106
03/17/2016 03:00 PM House HEALTH & SOCIAL SERVICES
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| Audio | Topic |
|---|---|
| Start | |
| HB234 | |
| HB237 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| += | HB 234 | TELECONFERENCED | |
| += | HB 237 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| += | HB 344 | TELECONFERENCED | |
HB 237-INTERSTATE MEDICAL LICENSURE COMPACT
4:35:48 PM
CHAIR SEATON announced that the final order of business would be
HOUSE BILL NO. 237, "An Act relating to an interstate compact on
medical licensure; amending the duties of the State Medical
Board; and relating to the Department of Public Safety's
authority to conduct national criminal history record checks of
physicians."
4:36:19 PM
TANEEKA HANSEN, Staff, Representative Paul Seaton, Alaska State
Legislature, stated that this was model legislation, and that
there were currently 12 states in the Compact, with 14 other
states, including Alaska, considering this legislation. She
paraphrased from the FAQ [included in members' packets], which
read:
The Interstate Medical Licensure Compact would create
a new pathway to expedite the licensing of physicians
seeking to practice medicine in multiple states. The
proposal could increase access to health care for
individuals in underserved or rural areas and allow
patients to more easily consult medical experts
through the use of telemedicine technologies. The
Compact would make it easier for physicians to obtain
licenses to practice in multiple states and would
strengthen public protection because it would help
states share investigative and disciplinary
information that they cannot share now.
MS. HANSEN reviewed the proposed bill, and stated that the first
six Sections were conforming language and applied to existing
state statute of the medical board. These sections directed the
board to implement the Compact. She directed attention to
Section 2, which added to the board requirement that a physician
shall submit their fingerprints along with their application and
fees for an expedited license and a national criminal history
record check. She noted that the medical board did not
currently do background checks for applicants, and were not
currently authorized to do so. She pointed out that a
background check was required for this expedited license.
CHAIR SEATON clarified that an expedited license through the
Compact would have a more thorough background check than someone
solely applying for a license in Alaska.
MS. HANSEN expressed agreement, specifically for the criminal
background check connected with fingerprints. She surmised that
unless a background check was specifically noticed in statute,
it was not allowed.
4:39:49 PM
MS. HANSEN moved on to page 5 of the proposed bill, and
addressed the definition for an eligible physician to this
expedited license, which included graduation from an accredited
medical school, passing each component of a licensing
examination, successfully completing graduate medical education,
a specialty certification from the American Board of Medical
Specialists, and a full and unrestricted license to engage in
the practice of medicine. They would also never have been
convicted of an offense by a court of appropriate jurisdiction,
never held a license subject to discipline, and were not under
active investigation.
MS. HANSEN stated that there were similar licensing requirements
by the State of Alaska, which included graduation from a medical
school and no encumbrance on your license. She relayed that the
requirements under the Compact were more specific, noting that
Alaska did not require the specialty certification. She
reported that the idea behind the Compact was to allow any
physician who qualified to pay the necessary fees and have
license in another Compact state. They would be responsible for
all medical and malpractice laws in each state they were
licensed. She shared that there were concerns for the
relinquishing of state authority to the federation of state
medical boards; however, she pointed out that each of the voting
members of the Commission were members of the state medical
board from the member states.
4:44:19 PM
REPRESENTATIVE TARR referenced the aforementioned letter from
Ms. Maureen Powers, dated February 11, 2016, [included in
members' packets], which read: "There is no discretion to look
at moral character, malpractice history, training
irregularities, or other requirements." She asked what would
happen in a circumstance related to any of those issues if one
of the Compact states had a more restrictive statute than
another; which would take precedence, the more restrictive or
the least restrictive.
MS. HANSEN explained that the qualifications for the expedited
licenses were presented in the Compact. She stated that these
were stricter than the Alaska statutes, as the Compact was
drafted to be the strictest version of the licensure
requirements; hence the reason for inclusion of the specialty
certification. She relayed that an intention of the Compact was
to hold those physicians applying for the expedited licensure to
the highest level of requirements. She noted that a physician
could apply using a normal procedure through the individual
state medical boards if they did not qualify for the expedited
license.
REPRESENTATIVE TARR asked about the cost of the recertification
process mentioned in the aforementioned letter, and whether it
was possible to "sync up" during the next natural
recertification.
MS. HANSEN replied that the Compact had no effect on current
licensees unless they desired to get an expedited license for
automatic licensing in other Compact states.
REPRESENTATIVE TARR mused that the physician could then continue
their scope of practice and not engage in activities outside the
state.
4:47:40 PM
CHAIR SEATON reminded the committee that the proposed bill was
being considered because it took so long for many doctors to get
licensed in Alaska, and that this was an attempt to make the
system work better to more easily get physicians into the state.
He stated that, as the state did not want to lose doctors
because of delays in the state's system, a doctor already having
a license in a Compact state could more easily get the expedited
license. He emphasized that all the fees still had to be paid.
REPRESENTATIVE WOOL asked if this would affect a newly licensed
medical professional coming to Alaska to practice for the first
time.
MS. HANSEN replied that, as a requirement to receive the
expedited license was to already possess a license, they would
have to go through the examination process.
CHAIR SEATON pointed out that someone with a specialty license,
as well as licenses in other states, who was still waiting for
an Alaska license under the current system, could apply through
the Compact if they met all the other criteria. He clarified
that a specialty license included family practice and
preventative medicine, and was not limited to brain surgery.
MS. HANSEN explained that any disciplinary action or suspension
in one state would result in notification to the other Compact
states, each of which would then decide whether to maintain the
action or reinstate the license.
REPRESENTATIVE WOOL asked if a practitioner in another state
could come to Alaska and apply for a license through the current
system, opting to not apply through the Compact because of a
prior disciplinary action in a Compact state.
MS. HANSEN replied that the Alaska State Medical Board would
also review disciplinary actions, but allowed for the
possibility of more leniency should the board decide that action
was not a concern. She opined that for a physician applying
under the language of the Compact, the Alaska State Medical
Board would not have this discretion.
4:52:54 PM
CHAIR SEATON opened public testimony.
4:54:03 PM
JAY BUTLER, MD, Chief Medical Officer/ DPH Director, Central
Office, Division of Public Health, Department of Health and
Social Services, listed some of the advantages for participation
in the Compact which included increased ease in recruiting and
faster "on-boarding" of providers when they arrived in Alaska.
This allowed for providers and sub-specialty providers to begin
service more quickly in underserved areas and facilities. He
reported that this also streamlined the participation and
availability by out of state providers in limited emergency and
disaster responses, those events that were not big enough to
lead to a state disaster declaration and the use of federal
assets, such as a localized infectious disease outbreak.
REPRESENTATIVE WOOL asked if this would allow the inclusion of
providers from another Compact state through telemedicine. This
would allow medical personnel to have multiple licenses while
residing in only one state.
DR. BUTLER replied that it would be included if the requirement
for provision of telemedicine services included medical
licensing in Alaska.
CHAIR SEATON shared that these requirements included those in
the upper levels of the profession to receive the expedited
license.
4:57:33 PM
KEVIN LUPPEN, Alaska State Medical Board, stated the support of
the Alaska State Medical Board for the proposed bill, HB 237.
He offered a personal anecdote for the loss of practitioners
because of the current delays in licensing.
REPRESENTATIVE TARR asked if the Alaska State Medical Board were
related to the Federation of State Medical Boards.
MR. LUPPEN replied no.
REPRESENTATIVE TARR asked if there was any mistrust with this
national organization.
MR. LUPPEN replied that there had not been any concern from the
state board with the national organization, and that some trends
and expertise had been provided to the state board. He stated
that he had not seen any potential threats from the national
organization.
5:00:11 PM
CHAIR SEATON directed attention to page 7, line 8, of the
proposed bill which stated the requirement that a formal license
application had to be submitted, contrary to the claims of the
aforementioned letter to the committee.
5:01:32 PM
CHAIR SEATON closed public testimony after ascertaining no one
further wished to testify.
5:01:43 PM
REPRESENTATIVE VAZQUEZ directed attention to page 4, line 2, of
the proposed bill, and she highlighted that the Compact did not
change the existing medical practice act of the state. She read
from page 4, line 7, of the proposed bill:
State medical boards that participate in the Compact
retain the jurisdiction to impose an adverse action
against a license to practice medicine in that state
issued to a physician through the procedures in the
Compact.
REPRESENTATIVE VAZQUEZ pointed to page 6, lines 22-25, of the
proposed bill, which clarified that the proposed bill did not
usurp the current Alaska law.
5:03:31 PM
REPRESENTATIVE VAZQUEZ moved to report HB 237, labeled 29-
LS1100\A, out of committee with individual recommendations and
the accompanying indeterminate fiscal notes. There being no
objection, HB 237 was moved from the House Health and Social
Services Standing Committee.