Legislature(2001 - 2002)
02/19/2002 02:03 PM Senate TRA
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* first hearing in first committee of referral
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+ teleconferenced
= bill was previously heard/scheduled
SB 265-PHYSICIAN ASSISTANTS/NURSE PRACTITIONERS
SENATOR OLSON, sponsor of SB 265, introduced the bill on the
advice and request of the Alaska Academy of Physician Assistants.
He said he could answer questions on Section 1 and Section 2 but
the section that was of most interest was Section 3 under the
Committee Substitute (CS). This would allow physician assistants
to provide proof of eligibility for a disabled veteran license
plate and for issuance of a parking permit for a handicapped or
disabled person. Currently physicians, other mid-level
practitioners and specifically advanced nurse practitioners
provide eligibility.
ED HALL, Physician Assistant, Alaska Academy of Physician
Assistants, said all three of the issues in Sections 1, 2 and 3
were very important to physician assistants. He said they
probably had been excluded because the statutes were written
before physician assistants were a recognized presents in Alaska.
SUSAN MASON BOUTERSE, Executive Director of Sunshine Community
Health Center, expressed her support of SB 265. She addressed
the first two statutes being amended to add physician assistants
as being critical to health care in Alaska. Sunshine Community
Health Center is a mid-level clinic with four physician
assistants providing primary health care. They work under a
collaborative agreement with a physician in Wasilla. They are
critical to health care of residents in the community and the
ongoing functioning of the health center.
Because the current state statute denies inclusion of physician
assistants to the listing of health care providers they
periodically have their billing for medical services by those
providers denied by third party payers. This represents a
significant barrier to health care for individuals that have
health insurance as well as for clinics to be able to maximize
potential revenue. For all rural health clinics every potential
revenue source is critical to ongoing support.
CHAIRMAN COWDERY asked Senator Olson to elaborate on duties taken
care of by physician assistants.
SENATOR OLSON explained physician assistants work with a
collaborative physician and do many things a physician would do.
Because they do not have the training of a medical doctor they
are at times not accorded some of the privileges allowed
physicians and in this case advanced nurse practitioners. For
example they are not included in some of the medical liability
statutes as well as recognition by some third party payment
recipients. He said that was the reason the bill was being
presented and specifically the CS that has the provision that
allows physician assistants to give specially disabled veterans
license plates and parking permits for those people that are
handicapped.
SENATOR TAYLOR said the concern he had was the impact this would
have on the ability of physician assistants to get reimbursement.
He asked if that was part of the purpose of the bill because the
insurance company would recognize them as a full service provider
and they can bill directly.
SENATOR OLSON said that was exactly what they were specifically
trying to do in Section 2. That was the intent of the bill.
SENATOR TAYLOR said the bill mentioned medical malpractice. He
asked if adding them to the list would require them to provide
medical malpractice insurance or did it give them the opportunity
to come under the medical malpractice insurance of the hospital
or the physician they work with.
SENATOR OLSON said that question was part of the whole issue of
trying to recognize physician assistants as professionals and
with that came responsibility. If they make a mistake they need
to be named as a defendant in a malpractice case. That does not
mean they are guilty it just means they need to be able to be
named by the plaintiff's attorney. He said with this also comes
the ability for them to bill. He said being required to have
malpractice insurance was not addressed in the bill and not the
intent of the sponsor.
MR. HALL said the other aspect of Section 2, brought to their
attention by an attorney, was when dealing with malpractice
claims sometimes there is an arbitration board put together. The
definition of who can participate on that arbitration board
placed a limitation on physician assistants because they were not
listed as a health care provider within that statute. Another
reason they were asking to have their name recognized within that
statute was so they could avail themselves to be on the
arbitration board if called upon.
MARY MARSHBURN, Director, Division of Motor Vehicles (DMV), said
she had not seen the CS. She had called Senator Olson's office
and suggested the CS. She asked Senator Olson if the CS
addressed AS 28.10.181 rather than Section 3 from the original
bill.
SENATOR OLSON said yes, section 3 relating to AS 28.10.181(d) was
amended and they did have her concern addressed.
MS. MARSHBURN said with that knowledge DMV had no opposition to
the bill. They think including physician assistants is a
reasonable and good thing. The CS would allow them to have the
same authority as physicians, nurse practitioners, and
chiropractors in terms of signing the permit for disability
placards or plates. If the CS is not substituted the bill in its
current form only allowed the physician assistants to sign the
evidence for permits and not for plates. DMV felt they should be
able to sign for both.
SENATOR WILKEN moved to amend the Committee Substitute for SB
265. Hearing no objection, CSSB 265 (TRA) was moved from
committee.
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