Alaska Expands Physician Assistant Practice Scope, Aims to Improve Healthcare Access

JUNEAU – The Alaska Senate has passed Senate Bill 89, a measure designed to streamline healthcare delivery and address access challenges, particularly in rural areas, by modifying the requirements for physician assistants (PAs). The bill, which passed with unanimous support on Wednesday, removes the current mandate for PAs to operate under formal collaborative agreements with physicians.

Easing Administrative Burdens for PAs

Currently, Alaska law requires physician assistants to practice under a collaborative plan with a licensed physician. These plans detail the scope of practice for the PA and necessitate ongoing physician oversight. Senate Bill 89 allows PAs working in facilities directed by a licensed physician, those licensed by the Department of Health, or those operated by the federal government or a tribal organization to practice without a specific collaborative plan.

Addressing Healthcare Challenges in Rural Alaska

Proponents of the bill emphasize that the change will reduce administrative burdens that can delay care and increase costs. Mary Swain, CEO of Cama’i Community Health Center in Bristol Bay, testified in support of the bill in March 2025, noting the difficulty her practice faces in maintaining collaborative plans due to the limited availability of physicians in the region. As reported by the Anchorage Daily News, Swain stated that neither of the physicians maintaining collaborative plans for her PAs lived in the community, with the primary physician residing out of state.

Financial Implications of Collaborative Agreements

The financial impact of maintaining collaborative agreements was also highlighted during legislative discussions. Jared Wallace, a physician assistant and owner of Odyssey Family Practice in Kenai, testified that he pays a collaborative physician approximately $2,000 per PA per month—roughly $96,000 annually—simply to maintain the required agreement. He argued that these agreements do not necessarily improve patient care but rather create a barrier to healthcare access in rural communities. News-USA Today reported on these concerns.

Concerns Regarding Patient Safety and Training

While the bill received unanimous support in the Senate, some opposition was voiced during earlier committee hearings. Dr. Nicholas Cosentino, an internal medicine physician, expressed concerns that PAs do not receive the same depth of training as physicians, particularly in diagnosing complex cases. He emphasized the importance of the extensive training medical doctors receive in critical thinking and differential diagnosis.

Bill Progression and Next Steps

The current version of the bill, as passed by the Senate, allows physician assistants to function without operating under a specific collaborative agreement, but does not allow for independent licensure. According to the Alaska State Legislature website, the bill now heads to House committees for consideration before a potential vote on the House floor. The bill was sponsored by Anchorage Democratic Sen. Löki Tobin.

Key Takeaways

• Senate Bill 89 removes the requirement for physician assistants in Alaska to operate under formal collaborative agreements with physicians.
• The change aims to reduce administrative burdens and improve healthcare access, particularly in rural areas.
• Concerns were raised regarding the depth of training for PAs compared to physicians, but the bill passed with unanimous Senate support.
• The bill does not grant independent licensure to PAs but allows them to practice without a specific collaborative agreement in certain facilities.