Florida Senate - 2015              PROPOSED COMMITTEE SUBSTITUTE
       Bill No. CS for SB 478
       Proposed Committee Substitute by the Committee on Appropriations
       (Appropriations Subcommittee on Health and Human Services)
    1                        A bill to be entitled                      
    2         An act relating to telehealth; creating s. 456.4501,
    3         F.S.; defining the terms “telehealth” and “telehealth
    4         provider”; providing certain practice standards for
    5         telehealth providers; authorizing telehealth providers
    6         to use telehealth to prescribe controlled substances,
    7         with an exception; prohibiting the use of telehealth
    8         or specified computer-controlled devices to prescribe
    9         optical devices; providing for the maintenance and
   10         confidentiality of medical records; amending s.
   11         636.202, F.S.; excluding telehealth products from the
   12         definition of “discount medical plan”; providing an
   13         effective date.
   15  Be It Enacted by the Legislature of the State of Florida:
   17         Section 1. Section 456.4501, Florida Statutes, is created
   18  to read:
   19         456.4501Use of telehealth to provide services.—
   20         (1) DEFINITIONS.—As used in this section, the term:
   21         (a) “Telehealth” means the use of synchronous or
   22  asynchronous telecommunications technology by a telehealth
   23  provider to provide health care services, including, but not
   24  limited to, patient assessment, diagnosis, consultation,
   25  treatment, and monitoring; the transfer of medical data; patient
   26  and professional health-related education; public health
   27  services; and health care administration. The term does not
   28  include audio-only transmissions, e-mail messages, facsimile
   29  transmissions, or consultations between a telehealth provider in
   30  this state and a provider lawfully licensed in another state
   31  when the provider licensed in this state maintains
   32  responsibility for the care of a patient in this state.
   33         (b) “Telehealth provider” means a person who provides
   34  health care and related services using telehealth and who is
   35  licensed under chapter 457; chapter 458; chapter 459; chapter
   36  460; chapter 461; chapter 463; chapter 464; chapter 465; chapter
   37  466; chapter 467; part I, part III, part IV, part V, part X,
   38  part XIII, or part XIV of chapter 468; chapter 478; chapter 480;
   39  parts III and IV of chapter 483; chapter 484; chapter 486;
   40  chapter 490; or chapter 491, or who is certified under part III
   41  of chapter 401 or s. 393.17.
   42         (2) PRACTICE STANDARDS.—
   43         (a) The standard of care for a telehealth provider
   44  providing medical care to a patient is the same as the standard
   45  of care generally accepted for a health care professional
   46  providing in-person health care services to a patient. If a
   47  telehealth provider conducts a patient evaluation sufficient to
   48  diagnose and treat the patient, the telehealth provider is not
   49  required to research the patient’s medical history or conduct a
   50  physical examination of the patient before using telehealth to
   51  provide services to the patient. A telehealth provider may use
   52  telehealth to perform a patient evaluation.
   53         (b) A telehealth provider and a patient may be in separate
   54  locations when telehealth is used to provide health care
   55  services to the patient.
   56         (c) A nonphysician telehealth provider using telehealth and
   57  acting within the relevant scope of practice is not deemed to be
   58  practicing medicine without a license under any provision of law
   59  listed in paragraph (1)(b).
   60         (d) A telehealth provider who is otherwise authorized to
   61  prescribe a controlled substance named or described in Schedules
   62  I through V of s. 893.03 may use telehealth to prescribe the
   63  controlled substance, except that telehealth may not be used to
   64  prescribe a controlled substance to treat chronic nonmalignant
   65  pain as defined in ss. 458.3265 and 459.0137. This paragraph
   66  does not preclude a practitioner licensed under chapter 458 or
   67  chapter 459 or an advanced registered nurse practitioner
   68  certified under s. 464.012 from using telehealth to order a
   69  controlled substance for an inpatient admitted to a facility
   70  licensed under chapter 395 or a hospice patient under chapter
   71  400.
   72         (e) A telehealth provider may not use telehealth to
   73  prescribe lenses, spectacles, eyeglasses, contact lenses, or
   74  other optical devices or prescribe based solely on the
   75  refractive error of the human eye generated by a computer
   76  controlled device such as an autorefractor.
   77         (3) RECORDS.—A telehealth provider shall document in the
   78  patient’s medical record the health care services rendered using
   79  telehealth according to the same standard used for in-person
   80  health care services pursuant to ss. 395.3025(4) and 456.057.
   81         Section 2. Subsection (1) of section 636.202, Florida
   82  Statutes, is amended to read:
   83         636.202 Definitions.—As used in this part, the term:
   84         (1) “Discount medical plan” means a business arrangement or
   85  contract in which a person, in exchange for fees, dues, charges,
   86  or other consideration, provides access for plan members to
   87  providers of medical services and the right to receive medical
   88  services from those providers at a discount. The term “discount
   89  medical plan” does not include any product regulated under
   90  chapter 627, chapter 641, or part I of this chapter or any
   91  telehealth product regulated under s. 456.4501.
   92         Section 3. This act shall take effect July 1, 2015.