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.
   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,
   45  Be It Enacted by the Legislature of the State of Florida:
   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.