Alaska Governor Bill Walker signed SB 74 into law on June 21, 2016, expanding the use of telemedicine in the Last Frontier state. Specifically, SB 74 removes Alaska’s previous in-state presence requirements for prescribing via telemedicine, and authorizes the use of telemedicine in certain clinical practices, including licensed audiologists, speech language pathologists, counselors, marriage and family therapists, psychologists, social workers, physical therapists, and occupational therapists.

Prior to SB 74, the controlling law was Alaska Statutes Section 08.64.364, which allowed physicians licensed and located in Alaska to prescribe drugs without conducting a physical exam under certain conditions. While that law expanded the availability of telehealth services in Alaska, it only applied to licensed physicians who were located in Alaska.

SB 74 expands the availability of telehealth services in Alaska by eliminating the requirement that physicians be located in Alaska to practice telemedicine in the state. The new law treats out-of-state physicians the same as in-state physicians, giving Alaskans access to out-of-state, Alaska-licensed physicians who have met identical standards for licensure as Alaska’s in-state physicians. Additionally, SB 74 authorizes the Alaska State Medical Board to promulgate regulations establishing standard of care guidelines for physicians diagnosing, treating or prescribing, dispensing or administering prescription drugs to a person without a physical examination.

Other highlights of the new statute include the following:

• Telemedicine is defined as “the delivery of health care services using the transfer of medical data through audio, visual, or data communications that are performed over two or more locations by a provider who is physically separated from the recipient of health care services.”

• Providers rendering a diagnosis, providing treatment, or prescribing or administering a non-controlled substance, without a physical examination, must be personally available for follow-up care or have another licensed provider or physician in the physician’s group practice available for follow-up care. The physician must request that the patient if he or she wants the physician to send a copy of all records of the encounter to the patient’s primary care provider (if the prescribing physician is not the patient’s primary care provider), and must send the records if the patient requests it.

• Providers prescribing or administering a controlled substance, or botulinum toxin, must have an appropriate licensed health care practitioner present with the patient to assist the provider with the examination, diagnosis and treatment.

• Providers may not prescribe, dispense, or administer an abortion-inducing drug unless the provider complies with Alaska’s abortion laws found in § 18.16.010, Alaska Statutes.

• Providers may not prescribe, dispense, or administer a prescription drug in response to an internet questionnaire or e-mail to a person with whom the provider does not have a prior provider-patient relationship.

• SB 74 adds a new section in Title 44 requiring the Department of Commerce, Community and Economic Development to adopt regulations to establish and maintain a registry of businesses performing telemedicine services in Alaska.

Commercial Insurance Coverage of Telehealth Services

SB 74 is not the only recent telemedicine development in Alaska. On June 14, 2016, the governor signed HB 234 into law which requires insurance plans in Alaska to cover telemental health services the same as in-person mental health services and without the need for a prior in-person visit between the health care provider and patient. While HB 234 is limited to telemental health services, the law is a step forward. Twenty-nine other states plus the District of Columbia have laws requiring commercial health insurance companies cover services provided via telehealth to the same extent those services are covered if provided in-person. Continued expansions in coverage allow providers to enhance telehealth offerings, both for the immediate cost savings and growing opportunities for revenue generation, to say nothing of patient quality and satisfaction. Commercial insurance reimbursement is among the five telemedicine trends driving health care transformation in 2016 and beyond.