Healthcare (Primary Care)

HB 347 clarifies and expands the scope of practice for occupational therapists (OTs) and occupational therapy assistants (OTAs) in Alaska. It allows OTs to provide services directly to patients without requiring a referral from another healthcare provider and defines specific services OTs may offer, including pain management, rehabilitation for daily activities, adaptive equipment training, and preventive care. The bill directly affects OTs, OTAs, and patients seeking these services by enabling more direct access to care. Key provisions (Section 08.84.095) detail how OTs can evaluate, treat, and support patients’ functional abilities across daily living, work, and community participation. The bill does not alter licensing or fees but streamlines service delivery within existing regulatory frameworks.

HB 273 establishes rules for "direct health care agreements" between dental/primary care providers and patients, where patients pay a periodic fee for services instead of using traditional insurance. It requires agreements to detail services, fees, locations, and complaint procedures, while explicitly stating patients lose protections under standard health insurance laws (AS 21.07). The bill prohibits Medicaid-eligible patients (under AS 47.07/47.08) from using these agreements and allows providers to decline new patients if they can’t provide needed services or lack capacity. It also permits termination based solely on inability to provide required services. This affects dental/primary care providers and patients seeking fee-for-service arrangements outside insurance systems.

SB 121 establishes rules for how health insurance companies in Alaska set reimbursement rates for healthcare providers when no specific contract exists. It requires the state insurance director to set standards based on the 75th percentile of actual provider charges in the state (or higher), with primary care rates also needing to be at least 450% of Medicare's rates. Insurers must use statistically valid methods, apply rates uniformly, and undergo regular audits to ensure compliance. This directly affects health insurers and healthcare providers by standardizing payment calculations and preventing inconsistent or unfairly low reimbursements. The law takes effect January 1, 2026.