04/15/2024 06:00 PM House WAYS & MEANS

               HB 277-LICENSING RECIPROCITY; FEES                                                                           
                                                                                                                                
6:22:55 PM                                                                                                                    
                                                                                                                                
CHAIR CARPENTER announced that the  final order of business would                                                               
be  HOUSE  BILL  NO.  277,   "An  Act  relating  to  occupational                                                               
licensing; and  providing for  an effective  date."   [Before the                                                               
committee,  adopted as  a  working document  on  4/3/24, was  the                                                               
proposed  committee  substitute  (CS)  for HB  277,  Version  33-                                                               
LS0905\B, Gunther, 3/7/24 ("Version B").]                                                                                       
                                                                                                                                
6:23:16 PM                                                                                                                    
                                                                                                                                
CHAIR CARPENTER  opened public  testimony on  HB 277,  Version B.                                                               
After ascertaining  there was  no one who  wished to  testify, he                                                               
closed public testimony.                                                                                                        
                                                                                                                                
6:23:50 PM                                                                                                                    
                                                                                                                                
CHAIR   CARPENTER  announced   the   committee  would   entertain                                                               
amendments.                                                                                                                     
                                                                                                                                
6:23:57 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  GRAY  moved  to  adopt Amendment  1  to  HB  277,                                                               
Version B, labeled 33-LS0905\B.2,  Gunther, 4/6/24, which read as                                                               
follows:                                                                                                                        
                                                                                                                                
     Page 1, lines 3 - 4:                                                                                                       
          Delete "relating to collection agencies;"                                                                           
                                                                                                                                
     Page 9, line 30, through page 14, line 10:                                                                                 
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 25, line 24, through page 26, line 1:                                                                                 
          Delete all material.                                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 27, lines 13 - 15:                                                                                                    
          Delete       "AS 08.24.045,       08.24.090(b)(7),                                                                    
     08.24.090(c),    08.24.100,    08.24.110,    08.24.120,                                                                    
     08.24.130,    08.24.135,    08.24.140(a),    08.24.150,                                                                    
     08.24.160, 08.24.170,  08.24.190, 08.24.200, 08.24.230,                                                                    
     08.24.240, 08.24.290, 08.24.310, 08.24.370;"                                                                               
                                                                                                                                
     Page 27, line 24:                                                                                                          
     Delete "AS 12.62.400(a)(4);"                                                                                               
                                                                                                                                
CHAIR CARPENTER objected for the purpose of discussion.                                                                         
                                                                                                                                
REPRESENTATIVE GRAY spoke  to Amendment 1.  He  explained that it                                                               
would delete  all language  related to  collection agencies.   He                                                               
noted that  the fee is "a  mild" $175 and the  "paperwork burden"                                                               
is not  too extensive.   Not having  a collection  agency license                                                               
can lead to  unwanted outcomes.  He explained that  for most debt                                                               
collectors, the  motivation to  follow the law  is the  threat of                                                               
losing their  license.   Without that  [threat], he  warned, they                                                               
could misrepresent the nature of  debt and/or falsely claim to be                                                               
an attorney,  among other  things.   He pointed  to New  York and                                                               
California,  both of  which he  said  learned the  hard way  that                                                               
requiring  the  license  of  debt   collectors  is  a  necessary.                                                               
Representative Gray  added that  the way  that the  Department of                                                               
Commerce,   Community  &   Economic  Development   (DCCED)  funds                                                               
investigations  of  violations is  through  the  license fees  it                                                               
collects.  Without those fees,  the department would not have the                                                               
budget to  be able to  "investigate the  bad actors."   He talked                                                               
about the  vulnerability of  some people to  fall for  phone call                                                               
[scams] perpetrated upon them and the concern of their being no                                                                 
recourse for those people when they are taken advantage of.                                                                     
                                                                                                                                
6:26:54 PM                                                                                                                    
                                                                                                                                
CHAIR CARPENTER removed his objection to Amendment 1.                                                                           
                                                                                                                                
6:26:56 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE MCCABE objected.                                                                                                 
                                                                                                                                
6:27:03 PM                                                                                                                    
                                                                                                                                
A roll call vote was taken.   Representatives Groh and Gray voted                                                               
in favor of Amendment 1.   Representatives Allard, McCabe, McKay,                                                               
Tilton, and Carpenter  voted against it.   Therefore, Amendment 1                                                               
failed to be adopted by a vote of 2-5.                                                                                          
                                                                                                                                
6:27:46 PM                                                                                                                    
                                                                                                                                
CHAIR CARPENTER moved to adopt Amendment 2 to HB 277, Version B,                                                                
labeled 33-LS0905\B.1, Gunther, 3/20/24, which read:                                                                            
                                                                                                                                
     Page 6, following line 7:                                                                                                  
          Insert new bill sections to read:                                                                                     
        "* Sec. 4. AS 08.02.130(a) is amended to read:                                                                      
          (a)  A health care provider [LICENSED] in this                                                                        
     state  may  provide  health care  services  within  the                                                                    
     health care provider's authorized  scope of practice to                                                                    
     a  patient in  this  state  through telehealth  without                                                                    
     first conducting an in-person visit.                                                                                       
        * Sec. 5. AS 08.02.130(c) is amended to read:                                                                         
          (c)  If a physician licensed in another state or                                                                  
     a health  care provider determines  in the course  of a                                                                
     telehealth encounter with a  patient under this section                                                                    
     that some  or all of  the encounter will  extend beyond                                                                    
     the  physician's or  health care  provider's authorized                                                                
     scope  of  practice,  the   physician  or  health  care                                                                
     provider shall  advise the  patient that  the physician                                                                
     or health  care provider  is not authorized  to provide                                                                
     some or all  of the services to  the patient, recommend                                                                    
     that the  patient contact  an appropriate  provider for                                                                    
     the services  the physician or health  care provider is                                                                
     not authorized  to provide, and limit  the encounter to                                                                    
     only  those  services  the  physician  or  health  care                                                                
     provider  is authorized  to provide.  The physician  or                                                                
     health care provider may not  charge for any portion of                                                                    
     an  encounter that  extends beyond  the physician's  or                                                                
     health care provider's authorized scope of practice.                                                                       
        * Sec. 6. AS 08.02.130(g) is amended to read:                                                                         
          (g)  Except as authorized under (e) and (f) of                                                                        
     this section,  a health  care provider  [LICENSED UNDER                                                                    
     THIS TITLE] may not  prescribe, dispense, or administer                                                                    
     through  telehealth  under  this section  a  controlled                                                                    
     substance listed in AS 11.71.140 - 11.71.190.                                                                              
        * Sec. 7. AS 08.02.130(h) is amended to read:                                                                         
          (h)  A physician licensed in another state or a                                                                   
     health care provider may not  be required to document a                                                                    
     barrier to  an in-person  visit to provide  health care                                                                    
     services through telehealth. The  department or a board                                                                    
     may  not  limit  the  physical  setting  from  which  a                                                                    
     physician licensed  in another  state or a  health care                                                                
     provider  may  provide  health  care  services  through                                                                    
     telehealth.                                                                                                                
        * Sec. 8. AS 08.02.130(i) is amended to read:                                                                         
          (i)  Nothing in this section requires the use of                                                                      
     telehealth when  a physician licensed in  another state                                                                
     or  a health  care provider  determines that  providing                                                                
     health   care  services   through  telehealth   is  not                                                                    
     appropriate or  when a patient  chooses not  to receive                                                                    
     health care services through telehealth."                                                                                  
                                                                                                                                
     Renumber the following bill sections accordingly.                                                                          
                                                                                                                                
     Page 6, line 10:                                                                                                           
          Delete "(A)"                                                                                                          
          Insert "[(A)]"                                                                                                        
                                                                                                                                
     Page 6, lines 18 - 19:                                                                                                     
          Delete "[A DISPENSING OPTICIAN LICENSED UNDER                                                                         
     AS 08.71;]"                                                                                                                
          Insert "a dispensing optician as defined in                                                                       
     AS 08.72.274(c) [LICENSED UNDER AS 08.71];"                                                                            
                                                                                                                                
     Page 6, lines 22 - 23:                                                                                                     
          Delete "or                                                                                                            
               (B)  a physician licensed in another state;"                                                                     
          Insert "[OR                                                                                                           
               (B)  A PHYSICIAN LICENSED IN ANOTHER                                                                             
     STATE;]"                                                                                                                   
                                                                                                                                
     Page 19, lines 29 - 30:                                                                                                    
          Delete "[A DISPENSING OPTICIAN LICENSED UNDER                                                                         
     AS 08.71;]"                                                                                                                
          Insert "a dispensing optician as defined in                                                                       
     AS 08.72.274(c) [LICENSED UNDER AS 08.71];"                                                                            
                                                                                                                                
     Page 22, lines 15 - 16:                                                                                                    
          Delete "[A DISPENSING OPTICIAN LICENSED UNDER                                                                         
     AS 08.71;]"                                                                                                                
    Insert   "a   dispensing   optician   as   defined   in                                                                 
     AS 08.72.274(c) [LICENSED UNDER AS 08.71];"                                                                            
                                                                                                                                
6:27:59 PM                                                                                                                    
                                                                                                                                
DONNA ARDUIN, Staff,  spoke to Amendment 2 to HB  277, Version B,                                                               
on behalf  of the  bill sponsor, the  House Special  Committee on                                                               
Ways and Means.  She noted  that the amendment was recommended by                                                               
Legislative Legal  Services.  She  further noted there  are three                                                               
places in statute  where "health care provider" is  defined.  She                                                               
spoke of  ensuring that physicians  licensed in other  states are                                                               
included  under the  requirements of  telehealth.   She indicated                                                               
that the  other part  of Amendment 2  includes the  definition of                                                               
health care  provider "for purposes  of medical  malpractice" and                                                               
health  care  provider  "for  the   purposes  of  medical  review                                                               
organizations dispensing optics."                                                                                               
                                                                                                                                
REPRESENTATIVE  MCCABE removed  his  objection.   There being  no                                                               
further objection, Amendment 2 was adopted.                                                                                     
                                                                                                                                
6:29:24 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  MCCABE  moved to  report  CSHB  277, Version  33-                                                               
LS0905\B,  Gunther, 3/7/24,  as  amended, out  of committee  with                                                               
individual  recommendations and  the  accompanying fiscal  notes.                                                               
There being no  objection, CSSB 277(W&M) was reported  out of the                                                               
House Special Committee on Ways and Means.