Florida Senate - 2018                        COMMITTEE AMENDMENT
       Bill No. SB 280
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  01/16/2018           .                                

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