State Medical Board Frequently Asked Questions Address of Record Application Forms Application for Licensure by Examination Application for Licensure by Credentials Application Processing and Status Updates Application Submittal Board Review of Applications Certified True Copies Code of Ethics Confidentiality Continuing Medical Education Credentialing, Staffing or Employment Agencies DEA Clearance Report Denial of Application Duplicate License Examination Scores Expedited application review Facilities Fees Federation Credentials Verification Service (FCVS) Foreign Language Documents Initial Licensure in Second Year of Two-Year Cycle International Medical School Graduates Licensing Application Process Licensing Staff Malpractice Reporting Name Change Online Application Online License Verification Opioid Education Requirements Out of State Practice Payment of Child Support and Student Loans Personal Interviews Physician Assistant Practice and Collaborative Plans Prescription Drug Monitoring Program (PDMP) Practicing in Alaska Primary Source Verification Public Information Renewing a License Reinstating a Lapsed License Social Security Numbers Stale Documents State Business Licenses Statutes and Regulations Telemedicine Business Registry Telephone Queries Temporary Permit Tribal Health Programs Threshold Qualifications Uniform Application (UA) for Physician Licensure Withdrawal or Abandonment of Applications “Yes” Responses Address of Record You are required by law to keep your current address on file with the Division. This is the address to which you would like us to send all communications, including your permit or license. You may not use third party addresses, telephone numbers, or email addresses, as this creates difficulties when we are trying to reach you. The Board will not accept applications that list an agency address as the practice address, and will likewise not accept the telephone numbers or email addresses for such agencies as the applicant’s own. The Board may only accept those addresses, phone numbers, and email addresses if the applicant is actually practicing in that office. Alaska law requires the applicant to provide their information, not the agency information. Notify the Division in writing if you have changed your address. You may use the form: Name Change, Address Change, and/or Duplicate License Application Forms The application and instructions for licensure in Alaska can be found on our web site . When completing applications forms, help us do a good job processing your application: type or print legibly all application documents. Read the instructions and give careful thought before answering the questions in the application. Remember — you are certifying that the information is truthful and correct. Make sure all notary seals are properly affixed on the application and all documentation has been properly certified as required. Provide all documents requested in the application; incomplete applications will delay processing. Each question in the application must be answered. Attach separate sheets of paper, labeled with your name and signed by you, for any question for which you have provided a YES response. Failure to answer all questions completely and accurately, or the omission or falsification of information may be cause for denial of your application or disciplinary action. When in doubt, disclose and explain. Application for Licensure by Examination The Alaska State Medical Board requires the USMLE examination series and has contracted with the Federation of State Medical Board for administration of the examination. To request examination information, please call or write to the Federation at: United States Medical Licensing Examination™ (USMLE) Step 3 The Federation of State Medical Boards 400 Fuller Wiser Rd., Suite 300 Euless, TX 76039-3856 817/868-4000 or 817/868-4041 Application for Licensure by Credentials The Alaska State Medical Board may waive the written examination requirement and license an applicant by credentials to a physician who holds an active license issued after written examination in another state or territory of the United States or province of Canada. Such examination must be equivalent to the USMLE examination series or must include passing the following examinations with at least a minimum passing score as defined by regulation (12 AAC 40.020): the National Board of Medical Examiners (NBME), the Federation Licensing Examination (FLEX), or the National Board of Osteopathic Medical Examiners (NBOME). Application Processing and Status Updates Licensing staff will send you a written status update upon the initial screening of the application, and periodically throughout the application process. It is your responsibility to provide your documents and to request or order documents from other agencies and organizations. In general, average processing time for a temporary permit is from twelve to fourteen weeks. Please plan accordingly. Application processing time depends to a large extent on the response time from other organizations. Time required also depends upon our workload and the volume of applications being processed. Because the length of processing time for your application may vary considerably, we urge you to be patient until processing is complete and the permit is issued. If there are any “yes” responses or if adverse information is received, it will typically take longer to gather and evaluate the additional data. If the application is referred to the Investigations Unit for investigation of a particular issue, processing time is extended by the time required to complete an investigation. Since investigations must be prioritized, it may take longer to complete the file. Application Submittal Use our convenient online services by registering with MyLicense. The online features will help you apply for a new license (as available), renew an existing license, update your email and mailing address, and receive electronic communication about application status, licensure, regulations changes, and other important news. Use the Uniform Application (UA) for initial licensure offered through the Federation of State Medical Boards (FSMB). This application process may benefit physicians applying for licensure in multiple states. FSMB customer service: Phone 800-793-7939. Email: firstname.lastname@example.org Use a traditional paper application. You may still opt in to receive electronic communication about application status. Visit our website for additional information. Submit application forms and supporting documents by U.S. Mail to: Alaska State Medical Board PO Box 110806 Juneau, AK 99811-0806 If you are using a courier delivery service, the physical address for delivery is: 333 Willoughby Ave.-Ninth Floor, Juneau, Alaska The U.S. Post Office will not deliver to the physical address. Board Review of Applications Only the Board is authorized to grant licenses. Your application will be presented to the Board for review and approval of your license at a regularly-scheduled board meeting. In most cases, you will be notified via a completion status letter from the licensing examiner that your file has been forwarded to the executive administrator for review and when the next scheduled board meeting will occur. In some cases, if there is an issue that requires resolution in your application, your file may be delayed for a period of time and your file may not be reviewed by the Board immediately. If you wish to know when your application will be considered by the Board, please contact the office and advise us as early as possible so that we may accommodate your request. Certified True Copies To obtain a certified, true copy, take the original document and a photocopy to a notary public so he/she may compare the original to the photocopy of the document. You or the notary must write, “I certify this to be a true copy of the original document” on the photocopy. You will sign this statement, and the notary will attest the fact by notarizing the document. Each certified true copy must have a notary signature and seal. Code of Ethics Under state law it is considered unprofessional conduct to violate any code of ethics adopted by the Board. The Alaska State Medical Board has adopted the following codes of ethics for practice in the State of Alaska: Code of Medical Ethics, published by the American Medical Association Code of Ethics of the American Osteopathic Association Code of Ethics of the American Podiatric Medical Association Code of Ethics of the Physician Assistant Profession of the American Academy of Physician Assistants EMT Code of Ethics of the National Association of EMT’s Confidentiality The contents of licensing files are considered public records, unless required to be kept confidential by state or federal law. If you believe that the additional information you are attaching to explain a “yes” answer should be considered confidential, state that in the attachment. A request for confidentiality may or may not be granted. Continuing Medical Education In following with the State Medical Board’s Order to reduce the continuing medical education requirement by fifty percent, physicians must complete a total of 25 hours of CME for the current licensing period. Only those CME hours awarded between January 1, 2019 and December 31, 2020 may be used to satisfy the requirements for this license renewal. Courses must be Category 1 of AMA-approved education, or Category 1 or 2 of AOA-approved education. Licenses initially issued after January 1, 2019 are not required to document CMEs for this licensing period only. Individuals who are renewing their licenses in “Retired” status are not required to complete continuing medical education (CME) requirements. IMPORTANT CLARIFICATION: All licensees with a valid federal Drug Enforcement Administration registration number are required to complete at least 2 hours of Category 1 AMA-, AOA, or CPME-approved education in pain management and opioid use and addiction. For a podiatrist, it may instead be earned in a continuing medical education program from a provider that is approved by the Council on Podiatric Medical Education (CPME). The Alaska Department of Health and Social Services also published a resource page for opioid, pain management and addiction CME. Physician Assistants Physician assistants must maintain a current active NCCPA certification to qualify for renewal. Paramedics Paramedics must complete a total of 60 CMEs for the January 1, 2019 – December 31, 2020 licensing period to be eligible to renew their license. CME hours must include current ACLS and BLS, as well as 3 hours of pediatric emergency education. Additional clarification regarding paramedic CME will be posted following the Board’s August 20-21 meeting. Only those CME hours awarded during the concluding licensing period may be used to satisfy the requirements for a license renewal. If you have not met the requirements of law for continuing medical education, you are not eligible to renew your license. After renewal is completed, the Board will conduct a random audit of license application renewals. If your license is randomly selected for audit, you will be contacted by separate letter within 60 days after renewal. You will be required to submit copies of your certificates and other documentation that proves that you have satisfied the continuing education requirements as you have so affirmed on the renewal form. Retain your documents on file for at least four years so you can respond to audits. Do not submit your CME documents until they are requested. Credentialing, Staffing or Employment Agencies Medical Board staff is authorized to communicate only with the applicant. If the applicant is using a credentialing agency, or is accepting assistance from a staffing or employment agency, then Board staff must have a signed release from the applicant to discuss the application and share information. The release applies to status updates and documents and information required to complete my application for licensure in the State of Alaska, and expires when the license is issued. Online applications MUST be completed by the applicant. It is a criminal offense to falsify an application. An applicant must create their own user account through the State secure portal called MYALASKA, where they will be able to submit their application online. Do not share verification codes or sign-on information. Agencies will need to create your own account through MYALASKA with your own sign-on information. Once an applicant has provided us with a signed “Authorization to Discuss Application and Share Information” form, our staff will be able to provide you with an access code so that you can add that application to your account. Each of your clients will have different numbers. You will be able to go into your MYALASKA account, add the information and see all of your client’s information in one secure place. Do not share verification codes or sign-on information In addition, the Board will not accept applications that list an agency address as the practice address and will likewise not accept the telephone numbers or email addresses for such agencies as the applicant’s own. The Board may only accept those addresses, phone numbers, and email addresses if the applicant is actually practicing in that office. Alaska law requires the applicant to provide their information, not the agency information. DEA Clearance Report To qualify for a license, you are required to request a clearance report from the Drug Enforcement Administration for your DEA registration. Send your request to: Drug Enforcement Administration 300 5th Avenue, Suite 1300 Seattle, WA 98104 Denial of Application If an application is not approved for licensure, a written explanation of the basis of that denial and information on how to appeal the decision will be provided. The denial of an application of licensure may be reported to any person, professional licensing board, federal, state, or local governmental agency, or other entity making a relevant inquiry, or as may be required by law. Duplicate License To order a duplicate license, you may use the form: Name Change, Address Change and/or Duplicate License Examination Scores Regardless of your application, whether by credentials or examination, you must pass each component of your examinations with a minimum two-digit score of 75. If you are applying for licensure by examination and fail any component more than once, you will be required to complete a supervised course of study acceptable to the Board before permission to retake the step will be given. You must request exam scores be sent directly to the Board from the appropriate organization. Expedited application review Applications are reviewed in date order received. The average processing time is approximately 12-14 weeks from receipt of an application, depending on how quickly the required documents are received from other agencies. We have developed a process to help identify critical need applicants so we can provide them with priority attention. The process is available for use by facility executives to request expedited screening of license applications when a lack of licensed personnel will result in a termination of service to patients. To maintain fairness to applicants awaiting review, only executives of the affected facility may request expedited application review. You may use the form: Request for Expedited Review Facilities The Alaska State Medical Board does not license or regulate health care facilities. A health care facility may not practice medicine or delegate practice to unlicensed personnel - that would be the scope of practice of health care professionals practicing under their Alaska license. For information about that program and requirements, contact the Alaska Department of Health and Social Services , Division of Health Care Services. For information about business licensing and corporate registration, please visit their website. Fees Initial Physician License Application: $400 Nonrefundable Application Fee $425 Permanent License Fee $825 Total Due Initial Physician Assistant License Application: $200 Nonrefundable Application Fee $75 Temporary Permit Fee $250 Permanent License Fee $125 Collaborative Plan Fee $650 Total Due Initial Mobile Intensive Care Paramedic License Application: $100 Nonrefundable Application Fee $75 Temporary or Provisional Permit Fee $75 Permanent License Fee $250 Total Due Federation Credentials Verification Service (FCVS) The Federation of State Medical Boards offers a credentials verification service that is accepted by the Alaska Board. This verification process is conducted separately and independently by the FCVS in accordance with established policies and procedures set forth by the Board. By participation in the FCVS process, you will establish a permanent, lifetime portfolio of primary-source verified credentials allowing for quick and easy access to your important medical credentials. To utilize this service, you must first enroll by submitting an application to the FCVS. For more information on this service, go to fsmb.org/licensure/fcvs, or call toll free 1 888/275-3287. When the FCVS receives your information and documentation, a non-interpretive “Physician Information Profile” containing certified photocopies of your credentials is forwarded directly to the Board. Please do not contact the Alaska State Medical Board regarding your FCVS application. Foreign Language Documents All foreign language documents must be certified true copies and must be accompanied by a certified translation into English by a recognized translator. Initial Licensure in Second Year of Two-Year Cycle If you were initially licensed in the second year of the two-year licensure period, within 12 months of the expiration date (December 31 of even-number years), you will pay the entire license fee. When renewing your license your license fee will be pro-rated for the upcoming licensing period. The pro-rated fee will be one-half of the required license renewal fee at the time of renewal. If your initial license was first issued to you after October 1 of the second year of the licensing period, you will pay the initial full license fee; however, your license will be issued showing the expiration date of the next biennial licensing period. (For example, if your initial license was issued October 18, 2016, the expiration date will automatically be entered as December 31, 2018.) International Medical School Graduates In order to qualify for licensure in Alaska, you must meet all of the requirements of Alaska law. The mandate to the Board is to protect the public through the licensure and disciplining of physicians, and to do so in accordance with the laws of the state. The Board is unable to assure licensure of any physician in the State of Alaska; each application is considered on an individual basis. As one of its criteria for licensure for international medical school graduates, the Alaska State Medical Board adopted the Medical Board of California’s 2006 List of Approved Medical Schools. In order to qualify for licensure in Alaska, an applicant’s medical school must be included on that specific list. In addition, you would need to have completed at least three years of ACGME-accredited (or RCPSC-accredited) postgraduate training, have your ECFMG certification, and passed all components of the USMLE examination. You may NOT have a license to practice medicine in another state, territory, province or international licensing jurisdiction that is suspended, revoked, or otherwise disciplined. Additional information is available in the application and instructions for licensure in Alaska. Licensing Application Process Submit your complete application to the Board with fees and pertinent documents. Licensing staff will assemble the documents for your application file and advise you of the application status. Upon the completion of the application file when all documents have been received from other organizations, the file is forwarded to the Board’s administrator who reviews the entire file. At the discretion of the administrator, a temporary permit may be issued. The complete application file is presented to the Board at its next regularly-scheduled meeting. The Board meets four times each year. Following the Board’s review and approval, the licensing examiner will issue the permanent license. Applications will be processed in the order in which they are received in the Board’s office. Please ensure that you apply well in advance of your need for the permit or license. Board staff will not expedite one application before another. Licensing Staff Contact Information Physicians whose last name begins with the letters A through I, O through R and Physician Assistants may contact: Licensing Examiner: Jason Kaeser Phone: (907) 465-2781 Email: email@example.com Physicians whose last name begins with the letters J through T and Paramedics may contact: Licensing Examiner: Steven Alvarado Phone: (907) 465-1077 Email: firstname.lastname@example.org Physicians whose last name begins with the letters U through Z may contact: Licensing Examiner: Natalie Norberg Phone: (907) 465-6243 Email: email@example.com Medical licensing general contact: Phone: (907) 269-8163 Email: firstname.lastname@example.org Malpractice Reporting Alaska law requires you to submit a report of all malpractice settlements or judgments, on the Board’s form, within 30 days of the date of settlement. Failure to comply with reporting requirements may result in disciplinary sanctions. The required form for malpractice reporting is available on the Applications & Formsweb page. Name Change The name appearing on your license must be your current legal name. If you have changed your name, you must submit a copy of the legal document (marriage certificate, divorce decree, etc.) supporting your name change. You may use the form: Name Change, Address Change, and/or Duplicate License Online Application The Alaska State Medical Board is pleased to offer a new online application process for physician licenses. The application may be filed through your MYALASKA account, and is submitted directly to staff. As your application is processed, you will be able to see real time updates as documents are received and reviewed by staff. You may opt in for email notifications and will receive an email notification each time your file is updated. You will also have the ability to upload some of the required documents. Online applications will be launched for other license types as soon as available. Online applications MUST be completed by the applicant. It is a criminal offense to falsify an application. An applicant must create their own user account through MYALASKA, where they will be able to submit their application online. Do not share verification codes or sign-on information. See additional information for credentialing, staffing or employment agencies above. Online License Verification All states require physicians to verify all licenses ever held (past and current) when applying for a license in another state. The Alaska State Medical Board uses the license verification service offered by VeriDoc. If you need to have a license verification sent to any other organization, you may use the form: Request for License Verification. You may verify license information for physicians, physician assistants, or mobile intensive care paramedics who are licensed by the Alaska State Medical Board by doing a license search on the Division's web site. Opioid Education Requirements New applicants and existing licensees with a DEA registration must earn a minimum of 2 hours of education in pain management and opioid use and addiction. New applications: A two hour education course (equivalent to a continuing medical education program) is required to qualify for a new license for a physician, podiatrist, physician assistant, or mobile intensive care paramedic. Renewals: Starting with the December 2018 renewal for physicians, podiatrists and physician assistants, at least two of the total hours of continuing medical education required to qualify for renewal must be specific to pain management and opioid use and addiction (unless you do not hold a valid DEA registration.) See the FAQs for additional information. Courses must be Category 1 of AMA-approved education, or Category 1 or 2 of AOA-approved education. For a podiatrist, it may instead be CPME-approved education. For a physician assistant, it may instead be NCCPA-approved education. For an MICP, it may instead be NREMT-accepted education or education offered by a Board-approved paramedic training program. To fully document compliance with the opioid education requirement, the title/description of the program on your Certificate of Completion should specifically reference all three areas of the required subject matter: pain management, opioid use, addiction. The Alaska Department of Health and Social Services also published a resource page for opioid, pain management and addiction CME. Out of State Practice In order to provide care for a patient in the State of Alaska (including reading and interpreting films, samples, or images, or otherwise diagnosing, treating or rendering an opinion), an out-of-state physician must be licensed by the Alaska State Medical Board. This requirement also applies to second opinions if the physician is charging a fee for providing the opinion. The only exception is for a “curbside” opinion given as a courtesy to a colleague (an Alaska-licensed physician) for which there is no charge. The following practices are considered unprofessional conduct under state law: providing treatment, rendering a diagnosis, or prescribing medications based solely on a patient-supplied history that a physician licensed in this state received by telephone, facsimile, or electronic format; or prescribing, dispensing, or furnishing a prescription medication to a person without first conducting a physical examination of that person; Exception: a physician practicing under the provisions of AS 08.64.364, as long as the physician complies with the American Medical Association (AMA) guiding principles for telemedicine practice (adopted June 2014), and the Federation of State Medical Boards (FSMB) Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine (adopted April 2014). Payment of Child Support and Student Loans If the Alaska Child Support Enforcement Division has determined that you are in arrears on child support, or if the Alaska Commission on Postsecondary Education has determined you are in loan default, you may be issued a nonrenewable temporary license valid for 150 days. The 150-day temporary license period is your opportunity to work with these agencies to obtain a release. Contact Child Support Services at (907) 269-6900, or the Postsecondary Education office at (907) 465-2962 or (800) 441-2962 to resolve payment issues. Personal Interviews Applicants for medical licensure in Alaska may be required to have a personal interview with the Board. Should an interview be required, you will be notified and an interview scheduled. An interview may be required if, during the processing of your application, a question arises for which the Board determines it requires additional information from you. Physician Assistant Practice and Collaborative Plans Physician assistants derive their scope of practice through a collaborative plan with a supervising physician; without that, they are not authorized to practice. The physician assistant may do any task for which they are appropriately educated, trained, and skilled to do as long as they are authorized by their supervising physician to perform that task, and as long as long as the supervising physician has the appropriate education, training and experience to perform the task. A collaborative plan must include a primary collaborating physician, and at least one alternate collaborating physician. A collaborative plan may be cancelled by either the Physician Assistant or the collaborating physician. To cancel, please provide a written notice to the Board, with clear instructions about the cancellation, and note whether a new plan will be submitted. A license without a collaborative plan on file will be reissued as “not authorized to practice” until a valid collaborative plan is filed with the Board. Board-issued guidelines regarding physician assistant scope of practice and collaborating with physician assistants Physician Assistant Collaborative Plan form Addendum to Collaborative Plan Form Authorization for Prescriptive Authority/Physician Assistant - Certified Prescription Drug Monitoring Program (PDMP) Mandatory registration: All Alaska health care practitioners who have a DEA registration and prescribe schedule II, III, and IV controlled substances must register with the PDMP. Practitioners must review PDMP information before dispensing, prescribing, or administering a federal schedule II or III controlled substance. The exception(s) are: receiving treatment in an inpatient setting; at the scene of an emergency or in an ambulance; in an emergency room; immediately before, during, or within the first 48 hours after surgery or a medical procedure; in a hospice or nursing home that has an in house pharmacy; a nonrefillable prescription of a controlled substance in a quantity intended to last for not more than three days. PDMP Web Page: Register | Sign In | Submit Data | Find Information Guideline Regarding Prescribing Controlled Substances issued by the State Medical Board Joint Committee on Prescriptive Guidelines Report to Alaska State Legislature Learn more about reducing addiction at: Opioids.Alaska.Gov Practicing in Alaska For information on practice opportunities, please contact: Alaska State Medical Association 4107 Laurel Street Anchorage, AK 99508-5334 (907) 562-0304 Primary Source Verification The Alaska State Medical Board conducts primary source verification of each applicant’s education requirements prior to issuing a license to Physicians (MD and DO), Podiatrists (DPM), Physician Assistants (PA), and Mobile Intensive Care Paramedics (MICP). The information is obtained directly from the accredited medical school (MD, DO, DPM), accredited professional training program (PA, MICP), and accredited post-graduate training program, as required by state law. You may verify license information for physicians, physician assistants, or mobile intensive care paramedics who are licensed by the Alaska State Medical Board by doing a license search on the Division's web site. Public Information The contents of licensing files are considered public records, unless required to be kept confidential by state or federal law. Information about current licensees, including mailing addresses, is available on the Division’s website under License Search. Renewing a License All medical licenses in Alaska are on a two-year cycle, with all licenses expiring December 31 of even-numbered years. Notification for license renewal is mailed out to license holders of record at least 30 days prior to expiration, usually in late October. You are required by law to keep your current address on file with the division (12 AAC 02.900). Failure to receive a renewal notice is not considered an excuse for nonrenewal. It is illegal to practice medicine in Alaska with an inactive or lapsed license or permit. Active status: An active license is required to in order to practice medicine in Alaska, no matter how infrequently. Renewing an active license requires submittal of a completed renewal application, payment of the full license fee, and completion of the CME requirements. Inactive status: If you do not intend to practice in Alaska, you may convert your license to an inactive status. There is a lower fee for an inactive license renewal. You may not practice medicine or write prescriptions in Alaska with an inactive license. In order to resume practice in Alaska, the inactive license must be reactivated. That requires submitting an application for reactivation, paying the required license fees, proof of meeting the CME requirements, and submittal of license verification and clearance documents. You may wish to review the statutes and regulations regarding inactive licenses; relevant sections include Alaska Statute 08.64.313 and Professional Regulations 12 AAC 40.033. Retired license: When retiring from practice in Alaska, you may convert your license to a retired status. There is a one-time fee for the remainder of the licensee’s lifetime, and there is no CME requirement. A physician may not practice medicine with a retired license. In order to resume practice in Alaska, the retired status license must be reactivated. That requires submitting an application for reactivation, paying the required license fees, proof of meeting CME requirements, submittal of license verification and clearance documents, passing the SPEX exam, documentation of mental and physical competency to practice, and a full Board interview. You may wish to review the statutes and regulations regarding retired licenses; relevant sections include Alaska Statutes 08.64.276 and Professional Regulations 12 AAC 40.031. Reinstating a Lapsed License It is illegal to practice medicine in Alaska with an inactive or lapsed license or permit. To apply for reinstatement of a license that has been lapsed for less than one year, an applicant must submit: A completed renewal application Payment of the license renewal fee Proof of meeting the continuing medical education requirements Clearance from the Federation of State Medical Board (FSMB) To apply for reinstatement of a license that has been lapsed for one to five years, an applicant must continue to qualify for a license, and must submit A completed application (this is the same form that is used to apply for an initial license) Payment of the license renewal fee Proof of meeting the continuing medical education requirements Clearance from the Federation of State Medical Board (FSMB) and Drug Enforcement Administration (DEA) Arrange for verification of licensure to be sent from each state where the applicant is or has been licensed as a physician Arranges for a verification of hospital privileges to be sent from each hospital where the applicant has held privileges within the past five years. A license that has been lapsed for five year or more is considered expired and may not be reinstated, an applicant must apply for a new license. Social Security Numbers Alaska law requires applicants for a professional license to provide a United States social security number before a professional license is issued or renewed. Applicants who are foreign citizens and are unable to obtain a social security number may complete the Request for Exception from Social Security Number Requirement form. Stale Documents If during the license application process certain documents become older than six months from the date the document was received in our office, that document is considered to be stale and must be resubmitted. Affected documents include the application, verifications of licensure from other licensing jurisdictions, hospital privileges verifications, the DEA clearance report, and the FSMB Board Action Data Bank report. State Business Licenses Physicians who are employees do not need to obtain an Alaska state business license; physicians who are independent contractors must obtain a state business license. Information about business licenses is available on the Business Licensing website. Statutes and Regulations The complete set of statutes and regulations for this program are available on our website. If you would like to receive notice of all proposed regulation changes relevant to the State Medical Board, you may send a written request to add your name to the “Medical Interested Parties List” to the Regulations Specialist. Include your name and preferred contact method (mail or email.) Department of Commerce, Community, and Economic Development Division of Corporations, Business and Professional Licensing P.O. Box 110806 Juneau, Alaska 99811-0806 Email: RegulationsAndPublicComment@Alaska.Gov Telemedicine Business Registry Before providing telemedicine services to a patient located in the State of Alaska, a business performing telemedicine services must register on the telemedicine business registry. Medical practitioners must be licensed by the State Medical Board before providing care to a patient in the State of Alaska. Telemedicine Business Registry Guideline Regarding Telemedicine Practice issued by the State Medical Board Telephone Queries We have a small staff and work hard to process applications as quickly as possible. Unnecessary telephone calls to our offices delay processing. If the licensing examiner must spend time answering numerous telephone queries, application processing time is affected. Because of the huge volume of telephone calls regarding the status of applications and because of privacy issues, we must restrict our telephone responses to the applicant only. We will not discuss your application with others. If you are concerned about your application being received in our office, mail it “certified – return receipt requested.” You will have a verification of delivery returned to you by the post office. Temporary Permit After your application for a permanent license is complete, it is forwarded to the Board’s executive administrator, who may authorize the issuance of a temporary permit. Since the Board only meets four times each year, the temporary permit is a courtesy to you to allow you to practice until the next board meeting when your file will be considered. The permit will be mailed to you at the address you specify in your application. Should a personal interview be required, the temporary permit may not be issued until the conclusion of the interview. Tribal Health Programs Health care practitioners who practice in a tribal health program in Alaska must be licensed in Alaska, unless they qualify for a federal exemption. To practice under the federal exemption, the practitioner must notify the State Medical Board that they are practicing under another state license in accordance with federal law. A person practicing under the exemption may not practice beyond the scope of the other state license. The notice must be received no later than 14 days after employment at a tribal health program, and must include proof of a current active license in another state; and proof of employment by a tribal health program that is operating under an agreement with the federal Indian Health Service (Indian Self-Determination and Education Assistance Act). Threshold Qualifications Threshold Qualifications For Physician Licensure (Graduate of U.S. medical school) Successful graduation from an accredited medical school Successful completion of post-graduate training in accredited programs in recognized hospitals: If graduated from medical school prior to 01/01/1995 – 1 year of postgraduate training If graduated from medical school on or after 01/01/1995 – 2 years of postgraduate training Successful passage of the appropriate national licensing examination Evidence of active licensed clinical practice of medicine for at least the past two years; if inactive or retired for greater than two years, must submit recent CME and pass the SPEX examination. Submit a complete application, authorization for release of records, and fees Submit a list of malpractice settlements/claims with an explanation of the basis for each claim or settlement Arrange for verification of credentials, licenses, hospital privileges, and clearance reports from DEA and FSMB, to be sent directly to Board staff NOT have a license to practice medicine in another state, territory, province or international licensing jurisdiction suspended or revoked or otherwise disciplined Threshold Qualifications For Physician Licensure (Graduate of international medical school) Successful graduation from a medical school listed in the Medical Board of California’s List of Approved Schools. Successful completion of three (3) years of postgraduate training in accredited programs in recognized hospitals in the United States or Canada Successful passage of the appropriate national licensing examination ECFMG Certificate Evidence of active licensed clinical practice of medicine for at least the past two years; if inactive or retired for greater than two years, must submit recent CME and pass the SPEX examination. Submit a complete application, authorization for release of records, and fees Submit a list of malpractice settlements/claims with an explanation of the basis for each claim or settlement Arrange for verification of credentials, licenses, hospital privileges, and clearance reports from DEA and FSMB, to be sent directly to Board staff NOT have a license to practice medicine in another state, territory, or province suspended or revoked or otherwise disciplined Uniform Application (UA) for Physician Licensure The Uniform Application (UA) for Physician Licensure is offered through the Federation of State Medical Boards (FSMB.) The UA will benefit physicians by reducing redundancy in filling out multiple applications when applying for licensure in multiple states. Click Here for the Uniform Application . If you experience difficulty with the uniform application, please contact FSMB customer service: Phone: (800) 793-7939 E-mail: email@example.com Withdrawal or Abandonment of Applications The Board permits the withdrawal of an application that it has not yet considered at a board meeting. Should you wish to withdraw your application, please submit a request in writing stating the reason for the withdrawal. Requests must be received before the first time the Board reviews and considers the application. All withdrawals are reported to the Federation of State Medical Boards stating the reason for the withdrawal. An application is considered abandoned when 12 months have elapsed since correspondence was last received from or on behalf of the applicant. An abandoned application is denied without prejudice. At the time of abandonment, the Division will send notification to the last known address of the applicant, who has 30 days to submit a written request for a refund of biennial license and other fees paid. The application fee will not be refunded. If no request for refund is received within that timeframe, no refund will be issued and all fees will be forfeited. “Yes” Responses A “Yes” response on an application does not mean your application will be denied. If you have responded “Yes” to any question in the application, additional time will be required for the gathering and assessment of pertinent information. You can expedite this process by providing with your application complete explanations and documentation for any “Yes” responses. When in doubt, disclose and explain.