AlaskaHB 19534th Legislature (2025-2026)HouseWALLET

PHARMACISTS; PHYSICIAN ASSOCIATES

Sponsored By: Genevieve Mina (Democratic)

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Bill Overview

Analyzed Economic Effects

14 provisions identified: 7 benefits, 0 costs, 7 mixed.

Overdose drug offers for opioid patients

Opioid prescribers must offer an overdose-drug prescription when any listed risk applies. Risks include more than three days of medicine or a total daily dose of at least 50 morphine milligram equivalents. Other triggers are a benzodiazepine prescription or a history of overdose or substance use disorder. Patients do not have to accept or fill the prescription.

Associates gain roles in forced substance-use treatment

Physician associates can apply for emergency substance-use commitment, support treatment certificates, petition for 30-day commitment, and conduct court-appointed examinations. Emergency certificates must report an examination within two days before the certificate date. Certificates for 30-day petitions require examination within two days before submission, unless refusal to be examined is alleged. A 30-day petition must allege alcohol- or drug-related incapacity, or threatened, attempted, or inflicted harm likely to recur without commitment. Existing court procedures and limits on temporary diagnostic commitment remain.

Emergency medication authority has time limits

Physician associates can order psychotropic medication without informed consent during a crisis or impending crisis. Immediate medication must be needed to preserve life or prevent significant physical harm to the patient or another person. The first order lasts 24 hours. Renewals require a personal assessment confirming the crisis continues, and total authorization cannot exceed 72 hours. The medical record must explain the crisis, staff response, alternatives considered or tried, and why they were insufficient.

Physician associates can start emergency custody

Licensed physician associates can start emergency custody with probable cause of grave disability or mental illness posing immediate serious harm. Safety needs must prevent starting ordinary commitment procedures. An officer takes the person to a designated crisis or treatment facility; the associate must apply for examination and be interviewed. Jail placement is barred except for limited protective custody while awaiting transportation. Minors cannot be placed in a jail or secure facility.

Insurance protections cover physician associate services

Group health policies and contracts covered by this law cannot unfairly discriminate against services because a physician associate provides them. The service must already be covered by the plan and fall within the associate's licensed scope. This does not set new premium, benefit, or out-of-pocket amounts.

Physician associates can handle death documentation

An authorized physician associate's opinion can establish death under medical standards for irreversible loss of circulation and breathing or all brain function. A separate rule permits qualified associates to pronounce death from irreversible loss of circulation and breathing when no physician is immediately available by radio or phone. That rule applies only if SB 89 from Alaska's Thirty-Fourth Legislature was not enacted. Associates must document findings, promptly notify the medical director or collaborating physician when communication is possible, and provide death-certificate information. An associate responsible for care of the condition causing death can sign medical certification within 24 hours, except for inquiries, inquests, and special cases set by regulation.

Physician associates support patients' end-of-life choices

Physician associates can issue do-not-resuscitate orders for their patients and must record the grounds in the medical file. The patient must consent; for patients under 18, a parent or guardian must consent. Related rules recognize these orders for identification, compliance, revocation, and resuscitation. Advance-care rules also recognize a licensed associate's judgment about whether life-sustaining treatment is effective for a patient with a qualifying condition.

Injured workers gain an attending-provider choice

Workers with compensation claims can choose a licensed physician associate as their attending provider. The associate must work under a licensed medical doctor or doctor of osteopathy. This authorization applies only if SB 89 from Alaska's Thirty-Fourth Legislature was not enacted. The provision does not change compensation amounts.

Fewer state barriers to pharmacist partnerships

State departments and boards cannot charge pharmacists fees for entering authorized collaborative practice agreements or providing care under them. They also cannot require approval, define the agreements' services, or otherwise regulate these agreements. Pharmacists prescribing or giving controlled drugs in their Alaska practice count as practitioners under laws using that term. Beginning January 1, 2027, the law repeals AS 08.80.337(c), a pharmacist practice rule. The supplied text does not show that rule, so its practical effect is unclear.

More recognized roles for physician associates

Physician associates gain recognition in public health, education, insurance, corrections, and child-protection laws; applicable licensing requirements remain. In corrections, they must work under a licensed physician or psychiatrist's direct supervision. Licensed associates can collect blood for the specified tests in a medically approved way and qualify as hospital licensed staff when employed for direct patient care. Associates licensed or exempt from licensing qualify as tier II health professionals when at least 50 percent of their time is direct care. Alaska-licensed associates, or those retired from Alaska practice, can meet the professional membership requirement on the Violent Crimes Compensation Board.

Disability paperwork expands; replacement cards cost extra

Licensed physician associates can provide proof for a voluntary disability designation on an Alaska ID card or driver's license. The designation can be canceled, and the Department cannot charge solely for it. Replacing a card or license to add or remove the designation may cost $5 per replacement. Associates can also document disability for the existing program offering qualifying people no-charge registration of one vehicle and a special plate. The vehicle program's existing eligibility requirements do not change.

Patient records can support emergency-care reviews

Licensed physician associates can share patient records requested to evaluate emergency care given by an emergency technician, paramedic, or physician. They must share only records considered necessary for that review. Recipients cannot share the information further unless the law allows it.

Physician associates expand remote care with safeguards

Licensed physician associates count as telehealth providers and care-team members, and can prescribe, dispense, or give controlled drugs remotely. State and federal drug laws apply, and the Medical Board must set remote-care guidelines using a nationally recognized model policy. Associates are protected from discipline for care without a physical exam when follow-up care is available and required safeguards are followed. When not the patient's primary provider, they must request consent to share visit records and send them if consented. They cannot prescribe through an online questionnaire or email to someone with no prior physician-patient relationship.

Physician associates gain duties with practice limits

Physician associates can examine, diagnose, and treat patients under the supervision and responsibility of a licensed or licensing-exempt physician. That work is excluded from the specified penalty for practicing medicine without a license. The Medical Board must set licensing, service, and supervision rules, including education on pain management and opioid use and addiction. Board rules must allow associates and specified practitioners to delegate routine duties; unlicensed agents must meet board standards. Duties involving pain management and opioid use and addiction cannot be delegated.

Sponsors & Cosponsors

Sponsor

Genevieve Mina
Democratic • House

Cosponsors

Ted Eischeid
Democratic • House
Andrew Gray
Democratic • House
Mike Prax
Republican • House
Andi Story
Democratic • House

Roll Call Votes

All Roll Calls

Yes: 129 • No: 51

House vote • 6/19/2026

GOVERNOR VETO OVERRIDDEN Y43 N17

Yes: 43 • No: 17

Senate vote • 5/20/2026

ADVANCED TO THIRD READING SAME DAY Y16 N4

Yes: 16 • No: 4

Senate vote • 5/20/2026

PASSED Y15 N5

Yes: 15 • No: 5

House vote • 5/15/2026

AM NO 1 TABLED Y23 N17

Yes: 23 • No: 17