SB 265-PHYSICIAN ASSISTANTS/NURSE PRACTITIONERS  CHAIRMAN STEVENS announced SB 265 to be up for consideration. SENATOR DONALD OLSON, sponsor of SB 265, said it names physicians' assistants as bonafide health care providers. He said: As a physician, I have used physician assistants many times, especially those that are experienced - are very good resources to be depending on especially out in rural Alaska where many of them are by themselves. The reason I presented this is because I feel in order for them to be recognized by the health insurance industry, the health maintenance organizations and other health care delivery entities out there - that they need to be equivalent to other providers there so they can be paid and continue on unencumbered by other aspects of the health care delivery system. That is why I have submitted this bill. Section 1 amends AS 09.55.560(1) to add "physician assistant" to the definitional clause for medical liability statutes. Section 2 similarly amends AS 21.36.090(d) to include "physician assistant" as a provider that may not be unfairly discriminated against by a health insurance company, health maintenance organization or other health delivery organization. Section 3 responds to a third request of the academy. It is to allow physician assistants to provide proof of eligibility for a special, disabled veterans license plate and for issuance of a parking permit for a handicapped or disabled person. Eligibility is currently provided by only physicians and advanced nurse practitioners. MR. ED HALL, Physician Assistant representing the Alaska Academy of Physician Assistants, supported Senator Olson's comments on the resolution. He said the question was raised whether this was an attempt by physician assistants to become independent from physicians and said: I wanted to assure the committee that that's absolutely and in no way accurate. All this is is a request for recognition as a licensed provider in the state to be included in the statute…. We don't feel as if we've been excluded for anything vindictive or anything, but I think these statutes were actually written years ago before physician assistants were a recognizable treating provider within the state. So I think this is more of a housecleaning type of thing and bringing the current statutes up to date… MS. SUSAN MASON-BONTUSE, Executive Director, Sunshine Community Health Center, supported SB 265. They are a mid-level clinic with four physician assistants providing primary care in a rural setting. They are working under a collaborative agreement with a doctor in Wasilla. These providers are critical to the on-going health care of residents in the communities that we serve as well as to the on-going functioning of our health center. Because our current statutes do not include physician assistants in the listing of health care providers, we periodically have our billing for medical services by these medical providers denied by third party payers…This can represent a significant barrier to health care. This can represent a barrier for individuals with health insurance as well as to clinics in terms of being able to maximize our potential remedies - particularly for small rural health clinics… MR. JOHN RILEY, Chairman, Alaska Primary Care Association, supported SB 265. They exist to provide support to clinicians who serve patients regardless of their ability to pay. P.A.s provide a significant share of health care services in small communities in rural Alaska and there are several rural clinics that are staffed exclusively by P.A.s. There are many examples of insurance companies who are refusing to reimburse services provided by the P.A.s because of not being on this list. This may require insured patients to travel outside their communities to obtain needed health care. So ironically this creates a barrier to access for insured patients. We urge the committee to approve this legislation and remedy this oversight… MS. ELIZABETH RIPLEY, Director, Community Health Planning, Valley Hospital, fully supported SB 265 and explained that P.A.s staff local physician offices in Wasilla and Palmer. They also staff rural clinics such as Sunshine Community Health Center in the Upper Susitna Valley. Especially in our rural areas, these P.A.s work out of sense of mission and they provide services where most doctors would not choose to set up a practice due to [indisc] and volume of patients. So, the mid-levels in terms of the P.A.s are a critical piece of our mid- level providers. This is especially important in light of the health care workforce shortage. SENATOR LEMAN moved to pass CSSB 265(TRA) from committee with individual recommendations. There were no objections and it was so ordered.