Alaska patients have reduced access to out-of-state telehealth appointments as emergency declarations end

It’s gotten a little harder for Alaska patients to get telehealth appointments with their doctors who are outside of the state. That’s because pandemic-era licensing waivers went away with the governor’s emergency order. It left some Seattle hospitals scrambling to reschedule Alaska patients.

Two monitors with a webcam on a cart
A telehealth computer (Divergence photo via Creative Commons)

There are a lot of reasons Alaska patients get referred to out-of-state doctors. Think specialty care, or just to get an appointment faster if all local doctors are booked. Over the course of the pandemic, Alaskans had thousands of telehealth appointments with out-of-state providers.

Doctors are usually required by the state to have a license to provide telehealth services to a patient located in Alaska. But when COVID-19 hit, the Alaska Legislature passed a bill that waived that requirement.

Now that’s over and the state has tightened its medical licensing requirements after more than a year of making exceptions during the pandemic. A representative from Virginia Mason Hospital in Washington said more than 100 providers there want Alaska licenses, but only about 20 have made it through the strenuous process.

Jared Kosin heads the Alaska State Hospital and Nursing Home Association. He says this is back to normal, but the pandemic revealed that normal needs work.

“We need to figure out how to take some of those flexibilities — not all of them because you do not want a pandemic model of care have made permanent, it doesn’t make sense in the everyday world — but can we take some of those flexibilities and the ones that make sense and reform telehealth in Alaska to incorporate them,” he said.

He says more than a year of pandemic telehealth waivers is enough time to know that it works for patients. He says the big concern is how to keep the service without sacrificing accountability.

The state requires an Alaska medical license so it has jurisdiction over medical providers who see Alaska patients. Otherwise, there’s no way for the state to stop unfit doctors from practicing.

Glen Hoskinson is a special assistant with the Department of Commerce, Community, and Economic Development, which handles licensing for the state.

“We need to make sure that these doctors don’t have any sort of major gaps in their education or experience or any disciplinary action that would be concerning,” she said.

“The last thing we want to do is have a doctor told they can’t practice in Washington anymore, because they did something atrocious. And then we didn’t check into that and we allow them to practice in Alaska. That would be a big public safety concern.”

Getting an Alaska license takes time and paperwork. And it costs over $800 to get an initial two-year license. Hoskinson says the time, effort and cost don’t pencil out for Outside doctors with just a few Alaska patients.

So the state created Emergency Courtesy Licenses to get Lower 48 practitioners licensed and serving Alaskans more quickly. They’re only valid for six months, but they’re cheaper and faster. And Hoskinson says they’re a good interim solution while those doctors wait on a real license.

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