Alaska 32nd Legislature (2021-2022) Status: Enacted Bipartisan · 5 D · 3 R · 1 I cosponsors

HB 265 — An Act relating to telehealth; relating to the practice of medicine and the practice of nursing; relating to medical assistance coverage for services provided by telehealth; and providing for an effective date.

Last action — (H) FN9: (CED)

  1. ✓
    Introduced
  2. ✓
    In Committee
  3. ✓
    Passed House
  4. ✓
    Passed Senate
  5. ✓
    To Executive
  6. 6
    Enacted

This bill has been enacted into law. Introduced January 18, 2022. Enacted.

Odds of enactment

High chance

Based on the sponsor, cosponsors, and committee posture, this bill has a high chance of becoming law.

Upgrade to see the exact probability and what's driving it.

A statistical estimate from our own model of past outcomes — an insight, not a guarantee. Policymaking is volatile.

Prognosis

Likely to advance 82% · high confidence

  • Enacted

    Current position in the legislative process.

  • 18 sponsors

    1 primary, 17 co-sponsors signed on.

  • Bipartisan support

    Sponsored across 3 parties (5 D · 3 R · 1 I) — cross-party backing.

  • Mixed recorded votes

    4 passed, 2 failed in recorded votes so far.

Based on stage, sponsorship breadth, committee status, recorded votes, and cross-state momentum — a description of the observable signals, not a prediction.

Bill Text

What changed in the latest version

499 added · 197 removed

Plain-language change summary

The amendment to Bill HB 265 allows healthcare providers in Alaska to deliver telehealth services to patients without requiring an in-person visit beforehand. It also now permits physicians licensed in other states to provide telehealth services to Alaskan patients, which was previously restricted. These changes are significant because they aim to improve access to healthcare, especially for people in remote areas, by enabling more flexible and timely healthcare services.

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32-LS0754\W HOUSE BILL NO.
LAWS OF ALASKA Source Chapter No.
265 IN THE LEGISLATURE OF THE STATE OF ALASKA THIRTY-SECOND LEGISLATURE - SECOND SESSION BY REPRESENTATIVES SPOHNHOLZ, Gillham, McCarty, Rasmussen, Schrage, Ortiz, Tarr, Merrick, Fields, Story, Hannan, Drummond, Josephson, Patkotak, Nelson, LeBon, McCabe, Foster Introduced:
SCS CSHB 265(FIN) _______ AN ACT Relating to telehealth;
1/18/22 Referred:
relating to the practice of medicine and the practice of nursing;
Health and Social Services, Finance A BILL FOR AN ACT ENTITLED "An Act relating to telehealth;
relating to the practice of medicine;
and providing for an effective date." BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
and providing for an effective date.
* Section 1.
_______________ BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ALASKA:
THE ACT FOLLOWS ON PAGE 1 Enrolled HB 265 AN ACT Relating to telehealth;
relating to the practice of medicine and the practice of nursing;
relating to medical assistance coverage for services provided by telehealth;
and providing for an effective date.
_______________ * Section 1.
(a) A health care provider 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 examination if the health care provider holds a license in good standing.
(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.
If a health care provider is licensed in another state, the health care provider may provide services under this section only to a patient who is referred by a health care provider licensed under this title or a federal or tribal health care program.
(b) A physician licensed in another state may provide health care services through telehealth to a patient located in the state as provided in this subsection, subject to the investigative and enforcement powers of the department under AS 08.01.087, and subject to disciplinary action by the State Medical Board under AS 08.64.333.
(b) If 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 HB0265a -1- HB 265 New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W the health care provider's authorized scope of practice, the health care provider shall advise the patient that the 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 health care provider is not authorized to provide, and limit the encounter to only those services the health care provider is authorized to provide.
The privilege to practice under this subsection extends only to -1- Enrolled HB 265 (1) ongoing treatment or follow-up care related to health careservices previously provided by the physician to the patient and applies only if (A) the physician and the patient have an established physician- patient relationship;
and (B) the physician has previously conducted an in-person visit with the patient;
or (2) a visit regarding a suspected or diagnosed life-threatening condition for which (A) the patient has been referred to the physician licensed in another state by a physician licensed in this state and that referral has been documented by the referring physician;
and (B) the visit involves communication with the patient regarding diagnostic or treatment plan options or analysis of test results for the life- threatening condition.
(c) If 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 health care provider's authorized scope of practice, the health care provider shall advise the patient that the 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 health care provider is not authorized to provide, and limit the encounter to only those services the health care provider is authorized to provide.
(c) A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.
(d) A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.
(d) A physician, osteopath, physician assistant, or advanced practice registered nurse may examine, diagnose, and provide treatment through telehealth under this section for opioid use disorder.
(e) A physician, podiatrist, osteopath, or physician assistant licensed under AS 08.64 may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 - 11.71.190 if the physician, podiatrist, osteopath, or physician assistant complies with state and federal law governing the prescription, dispensing, or administering of a controlled substance.
No other person licensed under this title or licensed in another state may examine, diagnose, or provide treatment through telehealth under this section for opioid use disorder.
Enrolled HB 265 -2- (f) An advanced practice registered nurse licensed under AS 08.68 may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 - 11.71.190 if the advanced practice registered nurse complies with state and federal law governing the prescription, dispensing, or administering of a controlled substance.
(e) A physician, podiatrist, osteopath, or physician assistant may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 - 11.71.190 or a botulinum toxin if the physician, podiatrist, osteopath, or physician assistant complies with AS 08.64.364.
(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.
An advanced practice registered nurse may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 - 11.71.190 other than buprenorphine to a patient if the advanced practice registered nurse first conducts an in-person examination of the patient.
(h) A health care provider may not be required to document a barrier to an in- person visit to provide health care services through telehealth.
No other person licensed under this title or in another state may prescribe, dispense, or administer through telehealth under this section a prescription for a controlled substance listed in AS 11.71.140 - 11.71.190 or a botulinum toxin.
The department or a board may not limit the physical setting from which a health care provider may provide health care services through telehealth.
(f) Nothing in this section requires the use of telehealth when a health care provider determines that providing health care services through telehealth is not appropriate or when a patient chooses not to receive health cae services through telehealth.
(i) Nothing in this section requires the use of telehealth when 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.
(g) In this section, HB 265 -2- HB0265a New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W (1) "health care provider" means an audiologist or speech-language pathologist licensed under AS 08.11 or in another state;
(j) In this section, (1) "health care provider" means (A) an audiologist or speech-language pathologist licensed under AS 08.11;
a behavior analyst licensed under AS 08.15 or in another state;
a behavior analyst licensed under AS 08.15;
a chiropractor licensed under AS 08.20 or in another state;
a chiropractor licensed under AS 08.20;
a professional counselor licensed under AS 08.29 or in another state;
a professional counselor licensed under AS 08.29;
a dental hygienist licensed under AS 08.32 or in another state;
a dental hygienist licensed under AS 08.32;
a dentist licensed under AS 08.36 or in another state;
a dentist licensed under AS 08.36;
a dietitian or nutritionist licensed under AS 08.38 or in another state;
a dietitian or nutritionist licensed under AS 08.38;
a naturopath licensed under AS 08.45 or in another state;
a naturopath licensed under AS 08.45;
a marital and family therapist licensed under AS 08.63 or in another state;
a marital and family therapist licensed under AS 08.63;
a physician, podiatrist, osteopath, or physician assistant licensed under AS 08.64 or in another state;
a physician licensed under AS 08.64;
a direct- entry midwife certified under AS 08.65 or in another state;
a podiatrist, osteopath, or physician assistant licensed under AS 08.64;
a nurse licensed under AS 08.68 or in another state;
a direct-entry midwife certified under AS 08.65;
a dispensing optician licensed under AS 08.71 or in another state;
a nurse licensed under AS 08.68;
an optometrist licensed under AS 08.72 or in another state;
a dispensing optician licensed under AS 08.71;
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a pharmacist licensed under AS 08.80 or in another state;
an optometrist licensed under AS 08.72;
a physical therapist or occupational therapist licensed under AS 08.84 or in another state;
a pharmacist licensed under AS 08.80;
a psychologist or psychological associate licensed under AS 08.86 or in another state;
a physical therapist or occupational therapist licensed under AS 08.84;
or a social worker licensed under AS 08.95 or in another state;
a psychologist or psychological associate licensed under AS 08.86;
(2) "telehealth" has the meaning given in AS 47.05.270(e).
or a social worker licensed under AS 08.95;
or -3- Enrolled HB 265 (B) a physician licensed in another state;
(2) "licensed" means holding a current license in good standing;
(3) "life-threatening condition" means any disease or condition from which the likelihood of death is probable unless the course of the disease or condition is interrupted;
(4) "telehealth" has the meaning given in AS 47.05.270(e).
AS 08.64.364(b) is amended to read:
AS 08.64 is amended by adding a new section to read:
(b) The board may not impose disciplinary sanctions on a physician or physician assistant for prescribing, dispensing, or administering a prescription drug that is a controlled substance or botulinum toxin if the requirements under (a) of this section and AS 08.64.363 are met [AND THE PHYSICIAN OR PHYSICIAN ASSISTANT PRESCRIBES, DISPENSES, OR ADMINISTERS THE CONTROLLED SUBSTANCE OR BOTULINUM TOXIN WHEN AN APPROPRIATE LICENSED HEALTH CARE PROVIDER IS PRESENT WITH THE PATIENT TO ASSIST THE PHYSICIAN OR PHYSICIAN ASSISTANT WITH EXAMINATION, DIAGNOSIS, AND TREATMENT].
Sec.
08.64.333.
Disciplinary sanctions:
physician licensed in another state.
(a) The board may sanction a physician licensed in another state who provides health care services through telehealth under AS 08.01.085(b) if the board finds after a hearing that (1) one or more of the grounds listed in AS 08.64.326(a)(1) - (13) exist with respect to that physician;
(2) the physician exceeded the scope of the physician's privilege to practice in this state under AS 08.01.085;
or (3) the physician prescribed, dispensed, or administered through telehealth to a patient located in the state a controlled substance listed in AS 11.71.140 - 11.71.190.
(b) If the board finds grounds to sanction a physician under (a) of this section, the board may (1) permanently prohibit the physician from practicing in the state;
(2) prohibit the physician from practicing in the state for a determinate period;
(3) censure the physician;
(4) issue a letter of reprimand to the physician;
(5) place the physician on probationary status under (d) of this section;
(6) limit or impose conditions on the physician's privilege to practice in the state;
(7) impose a civil fine of not more than $25,000;
(8) issue a cease and desist order prohibiting the physician from providing health care services through telehealth under AS 08.01.085(b);
an order Enrolled HB 265 -4- issued under this paragraph remains in effect until the physician submits evidence acceptable to the board showing that the violation has been corrected;
(9) promptly notify the licensing authority in each state in which the physician is licensed of a sanction imposed under this subsection.
(c) In a case finding grounds for sanction under AS 08.64.326(a)(13), the final findings of fact, conclusions of law, and order of the authority that suspended or revoked a license or certificate constitute a prima facie case that the license or certificate was suspended or revoked and the grounds under which the suspension or revocation was granted.
(d) The board may place a physician on probation under this section until the board finds that the deficiencies that required the imposition of a sanction have been remedied.
The board may require a physician on probation to (1) report regularly to the board on matters involving the reason for which the physician was placed on probation;
(2) limit the physician's practice in the state to those areas prescribed by the board;
(3) participate in professional education until the board determines that a satisfactory degree of skill has been attained in areas identified by the board as needing improvement.
(e) The board may summarily prohibit a physician from practicing in the state under AS 08.01.085(b) if the board finds that the physician, by continuing to practice, poses a clear and immediate danger to public health and safety.
A physician prohibited from practicing under this subsection is entitled to a hearing conducted by the office of administrative hearings (AS 44.64.010) not later than seven days after the effective date of the order prohibiting the physician from practicing.
The board may lift an order prohibiting a physician from practicing if the board finds after a hearing that the physician is able to practice with reasonable skill and safety.
The physician may appeal a decision of the board under this subsection to the superior court.
(f) The board shall take measures to recover from a physicianthe cost of proceedings resulting in a sanction under (b) of this section, including the costs of investigation by the board and department, and hearing costs.
-5- Enrolled HB 265 (g) The board may prohibit a physician from practicing in the state upon receipt of a certified copy of evidence that a license to practice medicine in another state or territory of the United States or province or territory of Canada has been suspended or revoked.
The prohibition remains in effect until a hearing can be held by the board.
(h) The board shall be consistent in the application of disciplinary sanctions.
A significant departure from earlier decisions of the board involving similar situations must be explained in findings of fact or orders made by the board.
AS 08.64.364(b) is amended to read:
(b) The board may not impose disciplinary sanctions on a physician or physician assistant for prescribing, dispensing, or administering a prescription drug that is a controlled substance [OR BOTULINUM TOXIN] if the requirements under (a) of this section and AS 08.64.363 are met [AND THE PHYSICIAN OR PHYSICIAN ASSISTANT PRESCRIBES, DISPENSES, OR ADMINISTERS THE CONTROLLED SUBSTANCE OR BOTULINUM TOXIN WHEN AN APPROPRIATE LICENSED HEALTH CARE PROVIDER IS PRESENT WITH THE PATIENT TO ASSIST THE PHYSICIAN OR PHYSICIAN ASSISTANT WITH EXAMINATION, DIAGNOSIS, AND TREATMENT].
* Sec.
4.
AS 08.64.370 is amended to read:
Sec.
08.64.370.
Exceptions to application of chapter.
This chapter does not apply to (1) officers in the regular medical service of the armed services of the United States or the United States Public Health Service while in the discharge of their official duties;
(2) a physician or osteopath licensed in another state [, WHO IS NOT A RESIDENT OF THIS STATE,] who is asked by a physician orsto eopath licensed in this state to help in the diagnosis or treatment of a case, unless the physician is practicing under AS 08.01.085(b);
(3) the practice of the religious tenets of a church;
(4) a physician in the regular medical service of the United States Public Health Service or the armed services of the United States volunteering services Enrolled HB 265 -6- without pay or other remuneration to a hospital, clinic, medical office, or other medical facility in the state;
(5) a person who is certified as a direct-entry midwife by the department under AS 08.65 while engaged in the practice of midwifery whether or not the person accepts compensation for those services;
(6) a physician licensed in another state who, under a written agreement with an athletic team located in the state in which the physician is licensed, provides medical services to members of the athletic team while the athletic team is traveling to or from or participating in a sporting event in this state.
* Sec.
5.
AS 08.68.100(a) is amended to read:
(a) The board shall (1) adopt regulations necessary to implement this chapter, including regulations (A) pertaining to practice as an advanced practice registered nurse, including requirements for an advanced practice registered nurse to practice as a certified registered nurse anesthetist, certified clinical nurse specialist, certified nurse practitioner, or certified nurse midwife;
regulations for an advanced practice registered nurse who holds a valid feedral Drug Enforcement Administration registration number must address training in pain management and opioid use and addiction;
(B) necessary to implement AS 08.68.331 - 08.68.336 relating to certified nurse aides in order to protect the health, , and welfare of clients served by nurse aides;
(C) pertaining to retired nurse status;
[AND] (D) establishing criteria for approval of practical nurse education programs that are not accredited by a national nursing accrediting body;
and (E) establishing guidelines for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug to a person without conducting a physical examination under AS 08.68.710;
the guidelines must include a nationally recognized -7- Enrolled HB 265 model policy for standards of care of a patient who is at afe drfnt location than the advanced practice registered nurse;
(2) approve curricula and adopt standards for basic education programs that prepare persons for licensing under AS 08.68.190;
(3) provide for surveys of the basic nursing education programs in the state at the times it considers necessary;
(4) approve education programs that meet the requirements of this chapter and of the board, and deny, revoke, or suspend approval of education programs for failure to meet the requirements;
(5) examine, license, and renew the licenses of qualified applicants;
(6) prescribe requirements for competence before a former registered, advanced practice registered, or licensed practical nurse may resume the practice of nursing under this chapter;
(7) define by regulation the qualifications and duties of the executive administrator and delegate authority to the executive administrator that is necessary to conduct board business;
(8) develop reasonable and uniform standards for nursing practice;
(9) publish advisory opinions regarding whether nursing practice procedures or policies comply with acceptable standards of nursing practice as defined under this chapter;
(10) require applicants under this chapter to submit fingerprints and the fees required by the Department of Public Safety under AS 12.62.160 for criminal justice information and a national criminal history record check;
the department shall submit the fingerprints and fees to the Department of Public Safety for a report of criminal justice information under AS 12.62 and a national criminal history record check under AS 12.62.400;
(11) require that a licensed advanced practice registered nurse who has a federal Drug Enforcement Administration registration number register with the controlled substance prescription database under AS 17.30.200(n).
* Sec.
6.
AS 08.68 is amended by adding a new section to article 6 to read:
Sec.
08.68.710.
Prescription of drugs without physical examination.
(a) The Enrolled HB 265 -8- board may not impose disciplinary sanctions on an advanced practice registered nurse for rendering a diagnosis, providing treatment, or prescribing, dispensing, or administering a prescription drug that is not a controlled substance to a person without conducting a physical examination if (1) the advanced practice registered nurse or another licensed health care provider in the medical practice is available to provide follow-up care;
and (2) the advanced practice registered nurse requests that the person consent to sending a copy of all records of the encounter to the person's primary care provider if the prescribing advanced practice registered nurse is not the person's primary care provider and, if the person consents, the advanced practice registered nurse sends the records to the person's primary care provider.
(b) The board may not impose disciplinary sanctions on an advanced practice registered nurse for prescribing, dispensing, or administering a prescription drug that is a controlled substance if the requirements under (a) of this section and AS 08.68.705 are met and the advanced practice registered nurse prescribes, dispenses, or administers the controlled substance.
(c) Notwithstanding (a) and (b) of this section, an advanced practice registered nurse may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the advanced practice registered nurse does not have a prior provider-patient relationship.
(d) In this section, (1) "controlled substance" has the meaning given in AS 11.71.900;
(2) "prescription drug" has the meaning given in AS 08.80.480;
(3) "primary care provider" has the meaning given in AS 21.07.250.
* Sec.
7.
(a) An individual certified or licensed under this chapter may practice within the individual's authorized scope of practice under this chapter through telehealth with a patient in this state if the individual's certification or HB0265a -3- HB 265 New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W license is in good standing.
(a) An individual certified or licensed under this chapter may practice within the individual's authorized scope of practice under this chapter through telehealth with a patient in this state if the individual's certification or license is in good standing.
(b) If an individual certified or licensed under this chapter determines in the course of a telehealth encounter with a patient that some or all of the encounter will extend beyond the individual's authorized scope of practice, the individual shall advise the patient that the individual 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 individual is not authorized to provide, and limit the encounter to only those services the individual is authorized to provide.
(b) If an individual certified or licensed under this chapter determines in the course of a telehealth encounter with a patient that some or all of the encounter will -9- Enrolled HB 265 extend beyond the individual's authorized scope of practice, the individual shall advise the patient that the individual 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 individual is not authorized to provide, and limit the encounter to only those services the individual is authorized to provide.
(d) Nothing in this section requires the use of telehealth when an individual certified or licensed under this chapter determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.
(d) An individual certified or licensed under this chapter may not be required to document a barrier to an in-person visit to provide health care services through telehealth.
(e) In this section, "telehealth" has the meaning given in AS 47.05.270(e).
The department or the council may not limit the physical setting from which an individual certified or licensed under this chapter may provide health care services through telehealth.
(e) Nothing in this section requires the use of telehealth when an individual certified or licensed under this chapter determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.
(f) In this section, "telehealth" has the meaning given in AS 47.05.270(e).
4.
8.
(a) The department shall pay for services provided through telehealth in the same manner as if the services had been provided in person.
(a) The department shall pay for all services covered by the medical assistance program provided through telehealth in the same manner as if the services had been provided in person, including (1) behavioral health services;
Except as provided in (b) of this section, the department shall pay for all services covered by the medical assistance program, including (1) behavioral health services;
(2) services covered under home and community-based waivers;
(2) services covered under federal waivers or demonstrations;
(3) services covered under state plan options under 42 U.S.C.
(3) services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Board;
1396 - 1396p (Title XIX, Social Security Act);
(4) services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;
(4) services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Board;
(5) services provided by a dental health aide therapist certified by the HB 265 -4- HB0265a New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W Community Health Aide Program Certification Board;
Enrolled HB 265 -10- (5) services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;
(6) services provided by a chemical dependency counselor certified by the Alaska Commission for Behavioral Health Certification;
(6) services provided by a dental health aide therapist certified by the Community Health Aide Program Certification Board;
(7) services provided by a rural health clinic or a federallyqualified health center;
(7) services provided by a chemical dependency counselor certified by a certifying entity for behavioral health professionals in the state specified by the department in regulation;
(8) services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;
(8) services provided by a rural health clinic or a federallyqualified health center;
(9) services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by facsimile, telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio;
(9) services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;
and (10) assessment, evaluation, consultation, planning, diagnosis, treatment, case management, and the prescription, dispensing, and administration of medications, including controlled substances.
(10) services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio;
(11) assessment, evaluation, consultation, planning, diagnosis, treatment, case management, and the prescription, dispensing, and administration of medications, including controlled substances;
and (12) services covered under federal waivers or demonstrations other than home and community-based waivers.
Regulations calculating the rate of payment for a rural health clinic or federally qualified health center must treat services provided through telehealth in the same manner as if the services had been provided in person, including calculations based on the rural health clinic or federally qualified health center's reasonable costs or on the number of visits for recipients provided services.
Regulations calculating the rate of payment for a rural health clinic or federally qualified health center must treat services provided through telehealth in the same manner as if the services had been provided in person, including calculations based on the rural health clinic's or federally qualified health center's reasonable costs or on the number of visits for recipients provided services, and must define "visit" to include a visit provided by telehealth.
The department may not decrease the rate of payment for a telehealth service based on the location of the person providing the service, the location of the eligible recipient of the service, the communication method used, or whether the service was provided asynchronously or synchronously.
The department may not decrease the rate of payment for a telehealth service based on the location of the person providing the service, the location of the eligible recipient of the service, the communication method used, or whether the service was provided asynchronously or -11- Enrolled HB 265 synchronously.
(2) determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the sped mode;
(2) determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the specified mode;
or HB0265a -5- HB 265 New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W (3) determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.
or (3) determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.
(c) In this section, (1) "federally qualified health center" has the meaning given in 42 U.S.C.
(c) All services delivered through telehealth under this section must comply with the Health Insurance Portability and Accountability Act of 1996 (P.L.
104-191).
(d) In this section, (1) "federally qualified health center" has the meaning given in 42 U.S.C.
(3) "telehealth" has the meaning given AS 47.05.270(e).
(3) "state plan" means the state plan for medical assistance coverage developed under AS 47.07.040;
(4) "telehealth" has the meaning given AS 47.05.270(e).
5.
9.
The uncodified law of the State of Alaska is amended by adding a new section to read:
AS 47.07.069(a), enacted by sec.
MEDICAID STATE PLAN FEDERAL APPROVAL.
8 of this Act, is amended to read:
To the extent necessary o t implement this Act, the Department of Health and Social Services shall amend and submit for federal approval the state plan for medical assistance coverage consistent with AS 47.07.069, enacted by sec.
(a) The department shall pay for services covered by the medical assistance program provided through telehealth if the department pays for those services when [IN THE SAME MANNER AS IF THE SERVICES HAD BEEN] provided in person, including (1) behavioral health services;
4 of this Act.
(2) services covered under home and community-based waivers;
(3) services covered under state plan options under 42 U.S.C.
1396 - 1396p (Title XIX, Social Security Act);
(4) services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Enrolled HB 265 -12- Board;
(5) services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;
(6) services provided by a dental health aide therapist certified by the Community Health Aide Program Certification Board;
(7) services provided by a chemical dependency counselor certified by a certifying entity for behavioral health professionals in the state specified by the department in regulation;
(8) services provided by a rural health clinic or a federallyqualified health center;
(9) services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;
(10) services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio;
(11) assessment, evaluation, consultation, planning, diagnosis, treatment, case management, and the prescription, dispensing, and administration of medications, including controlled substances;
and (12) services covered under federal waivers or demonstrations other than home and community-based waivers.
6.
10.
AS 47.07.069(b), enacted by sec.
8 of this Act, is amended to read:
(b) The department shall adopt regulations for services provided by telehealth, including setting rates of payment.
The department may set a rate of payment for a service provided through telehealth that is different from the rate of payment for the same service provided in person [REGULATIONS CALCULATING THE RATE OF PAYMENT FOR A RURAL HEALTH CLINIC OR FEDERALLY QUALIFIED HEALTH CENTER MUST TREAT SERVICES PROVIDED THROUGH TELEHEALTH IN THE SAME MANNER AS IF THE SERVICES HAD BEEN PROVIDED IN PERSON, INCLUDING CALCULATIONS BASED -13- Enrolled HB 265 ON THE RURAL HEALTH CLINIC OR FEDERALLY QUALIFIED HEALTH CENTER'S REASONABLE COSTS OR ON THE NUMBER OF VISITS FOR RECIPIENTS PROVIDED SERVICES, AND MUST DEFINE "VISIT" TO INCLUDE A VISIT PROVIDED BY TELEHEALTH.
THE DEPARTMENT MAY NOT DECREASE THE RATE OF PAYMENT FOR A TELEHEALTH SERVICE BASED ON THE LOCATION OF THE PERSON PROVIDING THE SERVICE, THE LOCATION OF THE ELIGIBLE RECIPIENT OF THE SERVICE, THE COMMUNICATION METHOD USED, OR WHETHER THE SERVICE WAS PROVIDED ASYNCHRONOUSLY OR SYNCHRONOUSLY].
The department may exclude or limit coverage or reimbursement for a service provided by telehealth, or limit the telehealth modes that may be used for a particular service, only if the department (1) specifically excludes or limits the service from telehealth coverage or reimbursement by regulations adopted under this subsection;
(2) determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the specified mode;
or (3) determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.
* Sec.
11.
AS 47.30 is amended by adding a new section to read:
Sec.
47.30.585.
Telehealth.
(a) An entity designated by the department under AS 47.30.520 - 47.30.620 may provide community mental health services authorized under AS 47.30.520 - 47.30.620 through telehealth to a patient in this state.
(b) If an individual employed by an entity designated by the department under AS 47.30.520 - 47.30.620, in the course of a telehealth encounter with a patient, determines that some or all of the encounter will extend beyond the community mental health services authorized under AS 47.30.520 - 47.30.620, the individual shall advise the patient that the entity 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 entity is not authorized to provide, and limit the encounter to only those services the entity is authorized to provide.
The entity may not charge a patient for any portion of Enrolled HB 265 -14- an encounter that extends beyond the community mental health services authorized under AS 47.30.520 - 47.30.620.
(c) A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.
(d) An entity permitted to provide telehealth under this section may not be required to document a barrier to an in-person visit to provide health care services through telehealth.
The department may not limit the physical setting from which an entity may provide health care services through telehealth.
(e) Nothing in this section requires the use of telehealth when an individual employed by an entity designated by the department under AS 47.30.520 - 47.30.620 determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.
(f) In this section, "telehealth" has the meaning given in AS 47.05.270(e).
* Sec.
12.
AS 47.37 is amended by adding a new section to read:
Sec.
47.37.145.
Telehealth.
(a) A public or private treatment facility approved under AS 47.37.140 may provide health care services authorized under AS 47.37.030 - 47.37.270 through telehealth to a patient in this state.
(b) If an individual employed by a public or private treatment facility approved under AS 47.37.140, in the course of a telehealth encounter with a patient, determines that some or all of the encounter will extend beyond the health care services authorized under AS 47.37.030 - 47.37.270, the individual shall advise the patient that the facility 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 facility is not authorized to provide, and limit the encounter to only those services the facility is authorized to provide.
The facility may not charge a patient for any portion of an encounter that extends beyond the health care services authorized under AS 47.37.030 - 47.37.270.
(c) A fee for a service provided through telehealth under this section must be reasonable and consistent with the ordinary fee typically charged for that service and may not exceed the fee typically charged for that service.
-15- Enrolled HB 265 (d) A facility permitted to practice telehealth under this section may not be required to document a barrier to an in-person visit to provide health care services through telehealth.
The department may not limit the physical setting from which a facility may provide health care services through telehealth.
(e) Nothing in this section requires the use of telehealth when an individual employed by a facility approved under AS 47.37.140 determines that providing services through telehealth is not appropriate or when a patient chooses not to receive services through telehealth.
(f) In this section, "telehealth" has the meaning given in AS 47.05.270(e).
* Sec.
13.
(a) Section 4 of this Act takes effect only if, on or before January 1, 2023, the United States Department of Health and Human Services (1) approves amendments to the state plan for medical assistance coverage under AS 47.07.069, enacted by sec.
(a) Sections 9 and 10 of this Act take effect only if, on or before June 30, 2030, the United States Department of Health and Human Services (1) approves amendments to the state plan for medical assistance coverage under AS 47.07.069(a), as amended by sec.
4 of this Act;
9 of this Act, and AS 47.07.069(b), as amended by sec.
or (2) determines that its approval of the amendments to the state plan for medical assistance coverage under AS 47.07.069, enacted by sec.
10 of this Act;
4 of this Act, is not necessary.
or (2) determines that its approval of the amendments to the state plan for medical assistance coverage under AS 47.07.069(a), as amended by sec.
(b) The commissioner of health and social services shall notify the revisor of statutes in writing within 30 days after the United States Department of Health and Human Services approves amendments to the state plan or determines that approval is not necessary under (a)(1) or (2) of this section.
9 of this Act, and AS 47.07.069(b), as amended by sec.
10 of this Act, is not necessary.
(b) The commissioner of health shall notify the revisor of statutes in writing within 30 days after the United States Department of Health and Human Services approves amendments to the state plan or determines that approval is not necessary under (a)(1) or (2) of this section.
7.
14.
If sec.
If secs.
4 of this Act takes effect, it takes effect on the day after the date the revisor of statutes receives notice from the commissioner of health and social services under sec.
9 and 10 of this Act take effect under sec.
6(b) HB 265 -6- HB0265a New Text Underlined [DELETED TEXT BRACKETED] 32-LS0754\W of this Act.
13 of this Act, they take effect June 30, 2030.
8.
15.
7 of this Act, this Act takes effect immediately under AS 01.10.070(c).
14 of this Act, this Act takes effect immediately under AS 01.10.070(c).
HB0265a -7- HB 265 New Text Underlined [DELETED TEXT BRACKETED]
Enrolled HB 265 -16-
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Action History

  1. (H) FN9: (CED)

  2. (H) FN8: (DHS/DOH)

  3. (H) FN7: (DHS/DOH)

  4. (H) FN(S) ATTACHED TO APPROP. BILL HB 281

  5. (H) LEG FINANCE APPROPRIATION MESSAGE 8/10/22

  6. (H) EFFECTIVE DATE(S) OF LAW SEE CHAPTER

  7. (H) Signed into law 7/13 CHAPTER 38 SLA 22

  8. (H) MANIFEST ERROR(S)

  9. (H) 11:10 A.M. 6/27/22 Transmitted to Governor

  10. (H) COSPONSOR(S): FOSTER

  11. (H) EFFECTIVE DATE(S) SAME AS PASSAGE

  12. (H) CONCUR AM OF (S) Y37 N1 A2

  13. (H) CONCUR TAKEN UP UC

  14. (H) LIMIT ALL INTROS TO 3 MIN, DEBATE TO 2 MIN EACH Y36 N4

  15. (H) CONCUR READ AND HELD

  16. (S) VERSION: SCS CSHB 265(FIN)

  17. (S) TRANSMITTED TO (H) AS AMENDED

  18. (S) EFFECTIVE DATE(S) SAME AS PASSAGE

  19. (S) PASSED Y17 N- E1 A2

  20. (S) READ THE THIRD TIME SCS CSHB 265(FIN)

  21. (S) ADVANCED TO THIRD READING UC

  22. (S) FIN SCS ADOPTED UC

  23. (S) READ THE SECOND TIME

  24. (S) RULES TO CALENDAR 5/17/2022

  25. (S) Minutes (SFIN)

  26. (S) Moved SCS CSHB 265(FIN) Out of Committee -- Delayed to 1:00 p.m. --

  27. (S) FINANCE at 11:00 AM SENATE FINANCE 532

  28. (S) CROSS SPONSOR(S): WILSON, KIEHL

  29. (S) FN9: (CED)

  30. (S) FN8: (DHS/DOH)

  31. (S) FN7: (DHS/DOH)

  32. (S) FN5: ZERO(DHS/DOH)

  33. (S) NR: WIELECHOWSKI

  34. (S) DP: BISHOP, WILSON, VON IMHOF

  35. (S) FIN RPT SCS(FIN) 3DP 1NR SAME TITLE

  36. (S) Minutes (SFIN)

  37. (S) Scheduled but Not Heard

  38. (S) FINANCE at 10:00 AM SENATE FINANCE 532

  39. (S) Minutes (SFIN)

  40. (S) Heard & Held

  41. (S) FINANCE at 01:00 PM SENATE FINANCE 532

  42. (S) -- Invited Testimony -- -- MEETING CANCELED --

  43. (S) FINANCE at 09:00 AM SENATE FINANCE 532

  44. (S) -- MEETING CANCELED --

  45. (S) FINANCE at 09:00 AM SENATE FINANCE 532

  46. (S) FN8: (DHS/DOH)

  47. (S) FN7: (DHS/DOH)

  48. (S) FN6: (CED)

  49. (S) FN5: ZERO(DHS/DOH)

  50. (S) DP: COSTELLO, GRAY-JACKSON, STEVENS, MICCICHE

  51. (S) L&C RPT 4DP

  52. (S) Minutes (SL&C)

  53. (S) Moved CSHB 265(FIN) Out of Committee

  54. (S) LABOR & COMMERCE at 01:30 PM BELTZ 105 (TSBldg)

  55. (S) L&C, FIN

  56. (S) READ THE FIRST TIME - REFERRALS

  57. (H) VERSION: CSHB 265(FIN)

  58. (H) TRANSMITTED TO (S)

  59. (H) COSPONSOR(S): PATKOTAK, NELSON, LEBON, MCCABE

  60. (H) EFFECTIVE DATE(S) SAME AS PASSAGE

  61. (H) PASSED Y38 N1 E1

  62. (H) READ THE THIRD TIME CSHB 265(FIN)

  63. (H) COSPONSOR(S): FIELDS, STORY, HANNAN, DRUMMOND, JOSEPHSON

  64. (H) ADVANCED TO THIRD READING 4/27 CALENDAR

  65. (H) AM NO 3 FAILED Y5 N32 E2 A1

  66. (H) CALL FOR THE QUESTION ON AM NO 3 UC

  67. (H) AM NO 2 FAILED Y4 N33 E2 A1

  68. (H) AM NO 1 NOT OFFERED

  69. (H) FIN CS ADOPTED UC

  70. (H) BEFORE HOUSE IN SECOND READING

  71. (H) MOVED TO BOTTOM OF CALENDAR

  72. (H) READ THE SECOND TIME

  73. (H) RULES TO CALENDAR 4/26/2022

  74. (H) FN8: (DHS/DOH)

  75. (H) FN7: (DHS/DOH)

  76. (H) FN6: (CED)

  77. (H) FN5: ZERO(DHS/DOH)

  78. (H) NR: CARPENTER, JOHNSON

  79. (H) DP: ORTIZ, EDGMON, LEBON, WOOL, MERRICK, FOSTER

  80. (H) FIN RPT CS(FIN) NEW TITLE 6DP 2NR

  81. (H) Minutes (HFIN)

  82. (H) Moved CSHB 265(FIN) Out of Committee -- Recessed to 10 Minutes Following Session --

  83. (H) FINANCE at 01:30 PM ADAMS 519

  84. (H) COSPONSOR(S): MERRICK

  85. (H) Minutes (HFIN)

  86. (H) Heard & Held

  87. (H) FINANCE at 01:30 PM ADAMS 519

  88. (H) Minutes (HFIN)

  89. (H) <Bill Hearing Canceled>

  90. (H) FINANCE at 09:00 AM ADAMS 519

  91. (H) COSPONSOR(S): ORTIZ, TARR

  92. (H) COSPONSOR(S): RASMUSSEN, SCHRAGE

  93. (H) COSPONSOR(S): MCCARTY

  94. (H) FN4: (DHS)

  95. (H) FN3: (DHS)

  96. (H) FN2: (CED)

  97. (H) FN1: ZERO(DHS)

  98. (H) AM: KURKA

  99. (H) NR: PRAX

  100. (H) DP: MCCARTY, SPOHNHOLZ, FIELDS, ZULKOSKY, SNYDER

  101. (H) HSS RPT CS(HSS) NEW TITLE 5DP 1NR 1AM

  102. (H) Moved CSHB 265(HSS) Out of Committee

  103. (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106

  104. (H) Heard & Held

  105. (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106

  106. (H) COSPONSOR(S): GILLHAM

  107. (H) Minutes (HHSS)

  108. (H) Heard & Held

  109. (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106

  110. (H) <Bill Hearing Canceled> -- MEETING CANCELED --

  111. (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106

  112. (H) <Bill Hearing Canceled> -- MEETING CANCELED --

  113. (H) HEALTH & SOCIAL SERVICES at 03:00 PM DAVIS 106

  114. (H) HSS, FIN

  115. (H) READ THE FIRST TIME - REFERRALS

  116. (H) Prefile released 1/14/22

Sponsors

Sponsorship breakdown

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1 sponsors · 17 co-sponsors · 47 not signed on

Sponsors (1)

  • SPOHNHOLZ

Co-sponsors (17)

Not signed on (47)

47 members have not signed on to this bill.

Show all 47 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

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Subjects

healthcare health-insurance technology
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Frequently asked questions

Who sponsors HB 265?
HB 265 is sponsored by SPOHNHOLZ, Gillham, McCarty, Rasmussen, Calvin Schrage (N), Ortiz, Tarr, Kelly Merrick (R), Zack Fields (D), Andi Story (D), Sara Hannan (D), Drummond, Andy Josephson (D), Patkotak, David Nelson (R), LeBon, Kevin McCabe (R), and Neal Foster (D).
What is the current status of HB 265?
This bill has been enacted into law. Introduced January 18, 2022. Enacted.
Where can I track HB 265?
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