HB 266-PRACTICE OF NATUROPATHY  3:28:18 PM CHAIR OLSON announced that the first order of business would be HOUSE BILL NO. 266, "An Act relating to the practice of naturopathy; and providing for an effective date." 3:29:14 PM REPRESENTATIVE JOHNSON moved to adopt the proposed committee substitute (CS) for HB 266, labeled 27-LS1110\Y, Martin, 4/12/12 as the working document. 3:29:28 PM CHAIR OLSON objected for purpose of discussion. 3:31:15 PM The committee took an at-ease from 3:31 p.m. to 3:34 p.m. due to technical difficulties. 3:34:21 PM KONRAD JACKSON, Staff, Representative Kurt Olson, Alaska State Legislature, introduced himself and explained the changes in the proposed committee substitute (CS) of HB 266, Version Y, from the original bill. He explained that at the initial hearing for HB 266 the bill sponsor, Representative Cathy Munoz, and a representative of the naturopaths, Dr. Jasper, expressed concern about erosion of the scope of practice for the naturopaths. The naturopaths indicated they were not interested in an expansion of their practices, but would like to protect their current scope of practice. 3:35:26 PM CHAIR OLSON noted that Representative Gara has joined the meeting. MR. JACKSON explained that efforts were initiated by the Department of Commerce, Community & Economic Development (DCCED) to make changes to current regulations for naturopaths. The naturopaths wanted to move regulatory language to statute. He related his understanding that the bill went through a number of iterations due to discussions between staff, the bill sponsor, the medical doctors, pharmacist, and naturopaths. 3:36:22 PM MR. JACKSON related that HB 266, Version Y, is an attempt to be clear that the naturopaths' scope of practice is not expanded or erode the scope of practice, but to statutorily lock in the scope of practice for naturopaths in Alaska. He reviewed the changes beginning with Section 1 (A), page 1, lines 7-10, which reads, "...except as in subsection (b) of this section;.... Thus naturopaths would not be able to give, prescribe, or recommend in their practice a prescription drug except as provided in (b) of this section. He then referred to proposed Section 2 (b), which read, "Notwithstanding (a)(1)(A) of this section, a person who practices naturopathy may give, prescribe, or recommend in the practice a device or a homeopathic remedy." This proposed section goes on to discuss the status of a drug a naturopath may give or prescribe with respect to compounding, and in proposed subsection (d) on page 2, lines 5-6, with respect to Medicaid reimbursement. He referred to proposed Section 3, on page 2, lines 28-29, that adds a new paragraph (8), which reads, "has procured, sold, prescribed, or dispensed drugs in violation of a law regardless of whether there has been a criminal action." He clarified that this section relates to grounds for suspension, revocation, or refusal to issue a license for a naturopath. He indicated proposed Section 4, would amend the definition of naturopathy in AS 08.45.200(3), by adding the following language, "a dietetic remedy, an herbal remedy, a homeopathic remedy ...." 3:38:48 PM MR. JACKSON related that proposed Section 5 would add definitions for dietetic remedy, herbal remedy, homeopathic remedy, and hydrotherapy to AS 08.45.200. Proposed Section 6 relates to Medicaid reimbursement and proposed Section 7 adds an immediate effective date. He reiterated that Version Y attempts to define the scope of practice for naturopaths, also give the department clear guidelines for regulations, and give pharmacists a clear definition of what they may or may not fill for naturopathic patients. 3:39:54 PM REPRESENTATIVE SADDLER referred to page 3, line 18. He asked for clarification on the language "... the department may not offer services for prescribed drugs given or prescribed by a naturopath." MR. JACKSON answered this language to ensure naturopaths are not eligible for Medicaid reimbursement which may not be necessary since the bill does not expand the prescriptive scope of practice. He pointed out a minor expansion of practice is allowed since the bill allows naturopaths to write prescriptions for homeopathic remedies, such as capsicum. He referred members to language on page 2 lines 5-7. CHAIR OLSON removed his objection. There being no further objections, Version Y was before the committee. 3:41:31 PM CHRISTOPHER CLARK, Staff, Representative Cathy Munoz, Alaska State Legislature, explained that there has not been support for Version Y. He disagreed that naturopaths who are writing prescriptions for homeopathic remedies creates an expansion of the practice of naturopathy. He agreed to disagree with that remark. Furthermore, the language in Version Y would not allow for the sterile versions of B-12, vitamin C and B-complex vitamins that naturopaths would provide in an injectible form to be dispensed so the argument could be made that Version Y represents a diminishment or reduction of the scope of practice for naturopaths. He asked to make sure the record was clear with respect to the practice of naturopathy. 3:42:26 PM CHAIR OLSON pointed out some things had been discovered during the work on this bill, including that some action was taken against some naturopaths whose practice was not supported by regulation. He highlighted that even though some naturopaths (NDs) had been practicing out of the scope of their practice for years that they have not been entitled to do so. He said that Version Y brings the regulations in alignment with existing statutes. He agreed it removes some types of things the naturopaths have been doing, but not necessarily doing so under the statutory authorization. He related several active investigations have transpired that found NDs working well outside the scope of practice, including prescribing injectible drugs - schedule 1 and schedule 2 drugs - and using out of state prescription pads. He clarified that the purpose of Version Y is to align the regulatory language with the current statutes and not necessarily to endorse what NDs have been doing in their practice. He appreciated the work that the sponsor's staff, Christopher Clark put into the bill. 3:44:16 PM REPRESENTATIVE THOMPSON moved to report the proposed committee substitute (CS) for HB 266, labeled 27-LS110\Y, Martin, 4/12/12 out of committee with individual recommendations and the accompanying fiscal notes. 3:45:04 PM The committee took an at-ease from 3:45 p.m. to 3:46 p.m. 3:46:27 PM REPRESENTATIVE THOMPSON [withdrew] his motion to report the proposed committee substitute (CS) for HB 266, labeled 27- LS110\Y, Martin, 4/12/12 out of committee. 3:46:45 PM DON HABEGER, Director, Division of Business and Professional Licensing, introduced himself. 3:46:52 PM CHAIR OLSON asked whether Version Y meets the intention to bring the regulations into conformance with statutes and not yet expand the scope of practice for naturopaths. MR. HABEGER answered that the statute clearly does not allow prescriptive authority for naturopaths. Some time ago regulations were written that have been interpreted by the department over time to mean no prescription authority. He said he referred early on to the original letter that was used as the foundation for today's interpretation. He offered his belief that Version Y is compliant with the division's interpretation of current statutes and regulations. 3:47:57 PM CHAIR OLSON stated that he would set aside HB 266. [HB 266 was held over.] The committee took an at-ease from 3:47 p.m. to 3:49 p.m.