03/28/2019 03:00 PM House HEALTH & SOCIAL SERVICES

         HB 97-TELEHEALTH: PHYSICIAN ASSISTANTS; DRUGS                                                                      
                                                                                                                                
4:03:52 PM                                                                                                                    
                                                                                                                                
CO-CHAIR  SPOHNHOLZ announced  that  the next  order of  business                                                               
would be HOUSE BILL NO. 97,  "An Act relating to the prescription                                                               
of drugs by a physician assistant without physical examination."                                                                
                                                                                                                                
4:04:02 PM                                                                                                                    
                                                                                                                                
REID  HARRIS,  Staff,   Representative  Jonathan  Kreiss-Tomkins,                                                               
Alaska State Legislature, paraphrased  from the Sponsor Statement                                                               
[Included in members' packets], which read:                                                                                     
                                                                                                                                
     The 2016 Medicaid Reform Bill  (SB 74) provided for the                                                                    
     use of telehealth, revising  Alaska statutes to require                                                                    
     the  Alaska State  Medical Board  to adopt  regulations                                                                    
     and  guidelines for  physicians rendering  a diagnosis;                                                                    
     providing  treatment;  or prescribing,  dispensing,  or                                                                    
     administering a  prescription drug to a  person without                                                                    
     first  conducting  a   physical  examination  under  AS                                                                    
     08.64.364.                                                                                                                 
                                                                                                                                
     However,  SB  74  only  addressed  physicians  and  the                                                                    
     Board's interpretation  was that the  bill's provisions                                                                    
     should not  apply to physician assistants  (PA's). This                                                                    
     effectively barred  PA's from  practicing telemedicine,                                                                    
     requiring    them    to   first    conduct    in-person                                                                    
     examinations.                                                                                                              
                                                                                                                                
     House Bill  97 aligns  statute with  the intent  of the                                                                    
     Medicaid Reform Bill, clarifying  that PA's can provide                                                                    
     telemedicine  in  collaboration   with  and  under  the                                                                    
     oversight of  physicians. Under HB97, PA's  are subject                                                                    
     to   the  same   statutory   oversight  as   physicians                                                                    
     regarding the practice of telemedicine,  as well as the                                                                    
     same disciplinary sanctions when appropriate.                                                                              
                                                                                                                                
     Alaska,  with  its  vast  geographical  challenges  and                                                                    
     limited access  to vital healthcare, stands  to benefit                                                                    
     from  this legislation.  HB  97  will increase  patient                                                                    
     access  to care,  extending the  reach  of medicine  to                                                                    
     medically underserved areas.                                                                                               
                                                                                                                                
4:05:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRUITT asked for  clarification that this bill was                                                               
necessary because the State Medical  Board had interpreted Senate                                                               
Bill 74 as to not include  physician assistants.  He asked if Ms.                                                               
Stovern  believed  that the  intent  of  Senate  Bill 74  was  to                                                               
include physician assistants.                                                                                                   
                                                                                                                                
4:06:51 PM                                                                                                                    
                                                                                                                                
DEBORAH  STOVERN, Executive  Administrator, State  Medical Board,                                                               
Division of  Corporations, Business, and  Professional Licensing,                                                               
Department  of   Commerce,  Community  &   Economic  Development,                                                               
offered  her  belief  that  the State  Medical  Board  could  not                                                               
determine the  legislative intent regarding  physician assistants                                                               
so other stakeholders  asked that the proposed  bill clarify that                                                               
physician assistants would be covered under the statute.                                                                        
                                                                                                                                
4:07:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE PRUITT  asked if  the State Medical  Board covered                                                               
physicians assistants as well as physicians.                                                                                    
                                                                                                                                
MS. STOVERN replied "yes, they do."                                                                                             
                                                                                                                                
REPRESENTATIVE  PRUITT shared  his concern  that, as  more people                                                               
were  allowed the  opportunity  to prescribe  up  to Schedule  II                                                               
drugs, there  may be a  challenge as physicians  assistants would                                                               
no longer  have to interact  with a patient for  these controlled                                                               
substances.                                                                                                                     
                                                                                                                                
MS.  STOVERN,  in  response,  stated that  part  of  the  statute                                                               
required  the board  to adopt  the nationally  published American                                                               
Medical  Association  guidelines  for  practicing  telehealth  by                                                               
physician  assistants.   She added  that  the collaborative  plan                                                               
with the  supervising physician determined the  scope of practice                                                               
by the physician assistant and  included the type of prescriptive                                                               
authority.                                                                                                                      
                                                                                                                                
4:11:49 PM                                                                                                                    
                                                                                                                                
CO-CHAIR   SPOHNHOLZ  asked   for  confirmation   that  physician                                                               
assistants  had  to  utilize  the  Prescription  Drug  Monitoring                                                               
Database (PDMP).                                                                                                                
                                                                                                                                
MS. STOVERN  said that  anyone prescribing  controlled substances                                                               
was required  to use  the PDMP and  this would  include physician                                                               
assistants engaging in prescriptions through telehealth.                                                                        
                                                                                                                                
4:12:45 PM                                                                                                                    
                                                                                                                                
CO-CHAIR SPOHNHOLZ closed public testimony.                                                                                     
                                                                                                                                
4:12:58 PM                                                                                                                    
                                                                                                                                
REPRESENTATIVE  DRUMMOND moved  to  report CSHB  97, Version  31-                                                               
LS0695\M,   Marx,  3/21/19,   from   committee  with   individual                                                               
recommendations and  the accompanying fiscal notes.   There being                                                               
no objection,  CSHB97(HSS) was  moved from  the House  Health and                                                               
Social Services Standing Committee.