Florida Senate - 2014 SB 70 By Senator Joyner 19-00018-14 201470__ 1 A bill to be entitled 2 An act relating to telemedicine; defining the term 3 “telemedicine”; providing that a health insurance 4 policy or Medicaid may not require face-to-face 5 contact between a health care provider and patient as 6 a prerequisite to coverage or reimbursement for 7 services; clarifying that the use of telemedicine 8 technology under the supervision of another health 9 care practitioner may not be interpreted as practicing 10 medicine without a license; authorizing the Department 11 of Health to adopt rules and requiring the department 12 to repeal any rules that prohibit the use of 13 telemedicine; requiring the department to conduct a 14 study, which includes the Department of Children and 15 Families and the Agency for Health Care 16 Administration, on options for implementing 17 telemedicine for certain services; requiring the 18 Department of Health to submit a report to the 19 Legislature; providing an effective date. 20 21 WHEREAS, telemedicine services are those services that use 22 electronic technology to overcome geographic distance between 23 patients and health care providers for the purposes of 24 assessing, monitoring, intervening, clinical managing, or 25 educating patients, and 26 WHEREAS, the Legislature recognizes that telemedicine 27 services can result in cost-effectiveness, improvements in 28 disease management, and improved patient outcomes and that 29 studies have demonstrated significant reductions in 30 hospitalizations and otherwise necessary medical care as a 31 result of telemedicine intervention, and 32 WHEREAS, geography, weather, availability of specialists, 33 transportation, and other factors can create barriers to 34 accessing appropriate health and mental health care, and given 35 these barriers, one way to provide, ensure, or enhance access to 36 qualified health care providers is through the appropriate use 37 of technology, and 38 WHEREAS, the Legislature seeks to embrace efforts that will 39 encourage health insurers and health providers to support the 40 use of telemedicine and that will also encourage all state 41 agencies to evaluate and amend their policies and rules to 42 remove regulatory barriers prohibiting the use of telemedicine, 43 NOW THEREFORE, 44 45 Be It Enacted by the Legislature of the State of Florida: 46 47 Section 1. Telemedicine services.— 48 (1) As used in this section, the term “telemedicine 49 services,” as it relates to the delivery of health care 50 services, means synchronous video conferencing, remote patient 51 monitoring, asynchronous health images, or other health 52 transmissions supported by mobile devices, such as mHealth, or 53 other telecommunications technology used for the purpose of 54 diagnosis, consultation, treatment, transfer of medical data, or 55 exchange of medical education information by means of audio, 56 video, or data communications. The term does not include an 57 audio-only telephone call, e-mail message, or facsimile 58 transmission. 59 (2) On or after January 1, 2015, a health insurance policy 60 that is issued, amended, or renewed may not require face-to-face 61 contact between a health care provider and a patient as a 62 prerequisite for payment for services appropriately provided 63 through telemedicine in accordance with generally accepted 64 health care practices and standards prevailing in the applicable 65 professional community at the time the services are provided. 66 The provision of health care services through telemedicine is 67 subject to all terms and conditions negotiated between the 68 provider and the health insurer or health plan for the provision 69 of health care services. A Medicaid service that is provided 70 through a fee-for-service or managed care program may not be 71 denied as a creditable Medicaid service on the basis that the 72 service is provided through telemedicine. Health care services 73 covered through in-person consultations or through telemedicine 74 shall be treated as equivalent services for the purposes of 75 health insurance coverage and payment. 76 (3) This section does not prevent a health insurer or 77 health plan from imposing deductibles or copayment or 78 coinsurance requirements for a health care service provided 79 through telemedicine if the deductible, copayment, or 80 coinsurance does not exceed the deductible, copayment, or 81 coinsurance applicable to an in-person consultation for the same 82 health care service. 83 (4) This section does not preclude a health care 84 practitioner, as defined in s. 456.001, Florida Statutes, who 85 acts within the scope of his or her practice from using the 86 technology of telemedicine within his or her practice, or using 87 telemedicine technology under the direction and supervision of 88 another health care practitioner who is using telemedicine 89 technology within the supervising practitioner’s scope of 90 practice. A health care practitioner acting under the direction 91 and supervision of a physician through the use of telemedicine 92 technology may not be interpreted as practicing medicine without 93 a license. However, a health care practitioner using 94 telemedicine technology must be trained in, educated on, and 95 knowledgeable about the procedure and technology and may not 96 perform duties for which the practitioner does not have 97 sufficient training, education, or knowledge. Failure to have 98 adequate training, education, and knowledge is grounds for 99 disciplinary action by the board, or the department if there is 100 no board. 101 (5) The Department of Health, in consultation with those 102 boards within the department which exercise regulatory or 103 rulemaking functions relating to health care practitioners as 104 defined in s. 456.001, Florida Statutes, may adopt rules, as 105 necessary, to administer the requirements of this section 106 relating to the provision of telemedicine services by such 107 practitioners, and shall repeal any rules that prohibit the use 108 of telemedicine in this state. 109 Section 2. The Department of Health shall lead and conduct 110 an interagency study, which also includes the Department of 111 Children and Families and the Agency for Health Care 112 Administration, on options for implementing telemedicine 113 services and coverage, including multi-payer coverage and 114 reimbursement, for stroke diagnosis, high-risk pregnancies, 115 premature births, mental health services, and emergency 116 services. The Department of Health shall submit a final report 117 of its findings and recommendations to the President of the 118 Senate and the Speaker of the House of Representatives by July 119 1, 2015. 120 Section 3. This act shall take effect July 1, 2014.