Florida Senate - 2018 COMMITTEE AMENDMENT Bill No. SB 280 Ì8560922Î856092 LEGISLATIVE ACTION Senate . House Comm: RCS . 01/16/2018 . . . . ————————————————————————————————————————————————————————————————— ————————————————————————————————————————————————————————————————— The Committee on Banking and Insurance (Bean) recommended the following: 1 Senate Amendment (with title amendment) 2 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. 90 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.