CS for SB 280                                   First Engrossed 
    1                        A bill to be entitled                      
    2         An act relating to telehealth; creating s. 456.4501,
    3         F.S.; defining terms; establishing the standard of
    4         care for telehealth providers; authorizing telehealth
    5         providers to use telehealth to perform patient
    6         evaluations; providing that telehealth providers,
    7         under certain circumstances, are not required to
    8         research a patient’s history or conduct physical
    9         examinations before providing services through
   10         telehealth; providing that a nonphysician telehealth
   11         provider using telehealth and acting within his or her
   12         relevant scope of practice is not deemed to be
   13         practicing medicine without a license; authorizing
   14         certain telehealth providers to use telehealth to
   15         prescribe specified controlled substances; providing
   16         for construction; requiring the Department of Health
   17         to develop and disseminate certain educational
   18         materials to specified licensees by a specified date;
   19         providing recordkeeping requirements for telehealth
   20         providers; providing requirements for patient consent
   21         for telehealth treatment; providing an effective date.
   23  Be It Enacted by the Legislature of the State of Florida:
   25         Section 1. Section 456.4501, Florida Statutes, is created
   26  to read:
   27         456.4501 Use of telehealth to provide services.—
   28         (1) DEFINITIONS.—As used in this section, the term:
   29         (a) “Information and telecommunications technologies” means
   30  those secure electronic applications used by health care
   31  practitioners and health care providers to provide health care
   32  services, evaluate health care information or data, provide
   33  remote patient monitoring, or promote healthy behavior through
   34  interactions that include, but are not limited to, live video
   35  interactions, text messages, or store and forward transmissions.
   36         (b) “Store and forward” means the type of telehealth
   37  encounter which uses still images of patient data for rendering
   38  a medical opinion or patient diagnosis. The term includes the
   39  asynchronous transmission of clinical data from one site to
   40  another site.
   41         (c) “Synchronous” means live or two-way interactions using
   42  a telecommunications system between a provider and a person who
   43  is a patient, caregiver, or provider.
   44         (d) “Telecommunications system” means the transfer of
   45  health care data through advanced information technology using
   46  compressed digital interactive video, audio, or other data
   47  transmission; clinical data transmission using computer image
   48  capture; and other technology that facilitates access to health
   49  care services or medical specialty expertise.
   50         (e) “Telehealth” means the mode of providing health care
   51  services and public health services by a Florida licensed
   52  practitioner, within the scope of his or her practice, through
   53  synchronous and asynchronous information and telecommunications
   54  technologies where the practitioner is located at a site other
   55  than the site where the recipient, whether a patient or another
   56  licensed practitioner, is located.
   57         (f) “Telehealth provider” means a person who provides
   58  health care services and related services through telehealth and
   59  who is licensed under chapter 457; chapter 458; chapter 459;
   60  chapter 460; chapter 461; chapter 462; chapter 463; chapter 464;
   61  chapter 465; chapter 466; chapter 467; part I, part III, part
   62  IV, part V, part X, part XIII, or part XIV of chapter 468;
   63  chapter 478; chapter 480; parts III and IV of chapter 483;
   64  chapter 484; chapter 486; chapter 490; or chapter 491; or who is
   65  certified under s. 393.17 or part III of chapter 401.
   66         (2) PRACTICE STANDARDS.—
   67         (a) The standard of care for a telehealth provider
   68  providing medical care to a patient is the same as the standard
   69  of care generally accepted for a health care professional
   70  providing in-person health care services to a patient. A
   71  telehealth provider may use telehealth to perform a patient
   72  evaluation. If a telehealth provider conducts a patient
   73  evaluation sufficient to diagnose and treat the patient, the
   74  telehealth provider is not required to research the patient’s
   75  medical history or conduct a physical examination of the patient
   76  before using telehealth to provide services to the patient.
   77         (b) A telehealth provider and a patient may be in separate
   78  locations when telehealth is used to provide health care
   79  services to the patient.
   80         (c) A nonphysician telehealth provider using telehealth and
   81  acting within his or her relevant scope of practice is not
   82  deemed to be practicing medicine without a license under any
   83  provision of law listed in paragraph (1)(f).
   84         (d) A telehealth provider who is authorized to prescribe a
   85  controlled substance named or described in Schedules I through V
   86  of s. 893.03 may use telehealth to prescribe a controlled
   87  substance, except that telehealth may not be used to prescribe a
   88  controlled substance to treat chronic nonmalignant pain as
   89  defined in ss. 458.3265(1)(a) and 459.0137(1)(a) or to issue a
   90  physician certification for marijuana pursuant to s. 381.986.
   91  This paragraph does not prohibit a physician from using
   92  telehealth to order a controlled substance for an inpatient
   93  admitted to a facility licensed under chapter 395 or a patient
   94  of a hospice licensed under chapter 400.
   95         (e) By January 1, 2019, the department, in coordination
   96  with the applicable boards, shall develop and disseminate
   97  educational materials for the licensees listed in paragraph
   98  (1)(f) on the use of telehealth modalities to treat patients.
   99         (3) RECORDS.—A telehealth provider shall document in the
  100  patient’s medical record the health care services rendered using
  101  telehealth according to the same standard used for in-person
  102  health care services pursuant to ss. 395.3025(4) and 456.057.
  103         (4) CONSENT.—Patients are not required to provide specific
  104  authorization for treatment through telehealth, but must
  105  authorize treatment that meets the requirements of the
  106  applicable practice acts and s. 766.103, and must be allowed to
  107  withhold consent for any specific procedure or treatment through
  108  telehealth.
  109         Section 2. This act shall take effect July 1, 2018.