Senate Bill 1718c1

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    Florida Senate - 2000                           CS for SB 1718

    By the Committee on Health, Aging and Long-Term Care; and
    Senator Campbell




    317-2120-00

  1                      A bill to be entitled

  2         An act relating to telehealth; creating s.

  3         455.5641, F.S.; providing legislative findings

  4         and intent; providing a definition; requiring

  5         separate licensure to provide telehealth

  6         services to patients in this state; providing

  7         that telehealth licensure requirements and

  8         responsibilities shall be identical to those

  9         provided for full licensure in the applicable

10         profession; requiring certain information to be

11         provided in all telehealth communications;

12         providing responsibility for confidentiality of

13         medical records; providing for prosecution of

14         unlicensed and other criminal activity;

15         authorizing certain consultative services

16         without a license; requiring licensure to order

17         out-of-state electronic communications

18         diagnostic-imaging or treatment services for

19         persons in this state; providing exemption from

20         telehealth licensure for health care

21         practitioners treating visitors to this state

22         under certain conditions; providing exemption

23         from telehealth licensure for registered

24         nonresident pharmacies and their employees;

25         providing applicability to regulation of

26         Florida licensees; providing rulemaking

27         authority; amending s. 766.102, F.S.;

28         authorizing the bringing of telehealth

29         malpractice actions in this state regardless of

30         provider location; providing an effective date.

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1  Be It Enacted by the Legislature of the State of Florida:

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  3         Section 1.  Section 455.5641, Florida Statutes, is

  4  created to read:

  5         455.5641  Telehealth; findings and intent; licensure.--

  6         (1)  The Legislature finds that there is a great and

  7  recognizable potential for harm if persons without the

  8  appropriate level of education, training, experience,

  9  supervision, and competence are allowed to provide health care

10  services to the people of this state. The potential for harm

11  could arise through substandard care or fraud, or both. The

12  Legislature further finds that there is a compelling state

13  interest in protecting the health, safety, and welfare of the

14  public from incompetent, impaired, or unscrupulous

15  practitioners and that no less restrictive means are available

16  to effectively protect the public than through licensure in

17  this state. Therefore, it is the intent of the Legislature

18  that the use of untested, ineffective, and potentially harmful

19  health care services be prohibited and that the delivery of

20  all health care services to the people of this state be

21  regulated through the licensure of health care practitioners.

22         (2)  The Legislature finds that the methods for

23  delivering health care services to the people of this state

24  are rapidly changing due to advances in technology and

25  telecommunications. However, the Legislature finds that the

26  compelling state interest in protecting the public health,

27  safety, and welfare exists regardless of the method of

28  communication or the method of delivery of services.

29  Therefore, it is the intent of the Legislature that all health

30  care practitioners providing health care services to the

31  people of this state should be regulated in a similar manner

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1  regardless of the method of communication or the method of

  2  delivery of services.

  3         (3)  For purposes of this section, "health care

  4  services" means providing, attempting to provide, or offering

  5  to provide a diagnosis, treatment plan, prescription,

  6  examination, or any other activity limited to persons licensed

  7  or otherwise legally authorized to practice medicine as

  8  defined in s. 458.305(3), practice osteopathic medicine as

  9  defined in s. 459.003(3), practice chiropractic medicine as

10  defined in s. 460.403(9), practice podiatric medicine as

11  defined in s. 461.003(5), practice natureopathy or naturopathy

12  as defined in s. 462.01(1), practice optometry as defined in

13  s. 463.002(5), practice professional nursing as defined in s.

14  464.003(3)(a), practice practical nursing as defined in s.

15  464.003(3)(b), practice advanced or specialized nursing

16  practice as defined in s. 464.003(3)(c), practice pharmacy as

17  defined in s. 465.003(13), practice dentistry as defined in s.

18  466.003(3), practice dental hygiene as defined in s.

19  466.003(4), practice midwifery as defined in s. 467.003(8),

20  practice audiology as defined in s. 468.1125(6)(a), practice

21  speech-language pathology as defined in s. 468.1125(7)(a),

22  practice nursing home administration as defined in s.

23  468.1655(4), practice occupational therapy as defined in s.

24  468.203(4), practice respiratory care as defined in s.

25  468.352(5), practice dietetics and nutrition as defined in s.

26  468.503(4), practice athletic training as defined in s.

27  468.701(5), practice orthotics as defined in s. 468.80(7),

28  practice pedorthics as defined in s. 468.80(10), practice

29  prosthetics as defined in s. 468.80(13), practice electrolysis

30  or electrology as defined in s. 478.42(5), practice massage as

31  defined in s. 480.033(3), practice as clinical laboratory

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1  personnel as provided in s. 483.803, practice medical physics

  2  as defined in s. 483.901(3)(j), practice opticianry as defined

  3  s. 484.002(3), dispense hearing aids as defined in s.

  4  484.041(3), practice physical therapy as defined in s.

  5  486.021(11), practice psychology as defined in s. 490.003(4),

  6  practice school psychology as defined in s. 490.003(5),

  7  practice clinical social work as defined in s. 491.003(7),

  8  practice marriage and family therapy as defined in s.

  9  491.003(8), and practice mental health counseling as defined

10  in s. 490.003(9).

11         (4)  A person who is not licensed in this state as a

12  health care practitioner who wishes to provide health care

13  services, as defined herein, to patients located in this state

14  by means of telecommunication only, must apply to the

15  appropriate regulatory board, or the department when there is

16  no board, for a Florida telehealth license and subsequently

17  for renewal of such license. The requirements for an initial

18  telehealth license and subsequent renewal of such license

19  shall be identical to the requirements for full licensure as

20  set forth in the appropriate practice act in this state for

21  the applicable profession, including requirements such as

22  profiling, credentialing, informed consent, and financial

23  responsibility and malpractice insurance. Telehealth licensees

24  must comply with all Florida laws and rules regulating the

25  practice of that profession.

26         (5)  All telehealth communications, including, but not

27  limited to, Internet web sites, advertisements, e-mail, and

28  other offers to provide health care services to the people of

29  this state, must clearly identify the practitioner's Florida

30  license number and must include a disclaimer which clearly

31  states that only Florida-licensed health care practitioners

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1  may provide health care services directly to persons located

  2  in this state. The disclaimer must also include the

  3  department's mailing and Internet addresses. It is the

  4  responsibility of the health care practitioner to ensure the

  5  confidentiality of electronic medical records as required by

  6  the laws of this state.

  7         (6)  The provision of telehealth services to patients

  8  in this state without holding an active Florida license to

  9  practice that profession may be prosecuted as unlicensed

10  activity in accordance with this chapter. In addition, any act

11  performed through telehealth communication that would

12  constitute a criminal violation if performed physically in

13  this state may be prosecuted under Florida law as if the crime

14  were physically carried out in this state.

15         (7)  Notwithstanding any other provision of law to the

16  contrary, persons holding a valid, active license to practice

17  in another jurisdiction may provide episodic consultative

18  services to a Florida licensee without being licensed in this

19  state so long as the out-of-state practitioner does not

20  exercise primary authority for the care or diagnosis of the

21  Florida patient.

22         (8)  Only practitioners licensed in this state or

23  otherwise authorized to practice in this state may order, from

24  a person located outside this state, electronic communications

25  diagnostic-imaging or treatment services for a person located

26  in this state.

27         (9)  Nothing in this section shall be construed to

28  prohibit or restrict a health care practitioner who is not

29  licensed in this state from providing health care services

30  through telecommunications to a patient temporarily visiting

31  this state with whom the health care practitioner has an

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1  established practitioner-patient relationship so long as the

  2  treatment provided is for a nonacute chronic or recurrent

  3  illness previously diagnosed and treated by that practitioner

  4  and so long as the practitioner holds an active unrestricted

  5  license to practice in another state or in another recognized

  6  jurisdiction.

  7         (10)  The provisions of subsection (3) do not apply to

  8  nonresident pharmacies registered pursuant to s. 465.0156 or

  9  the employees thereof.

10         (11)  Nothing in this section shall be construed to

11  prohibit or limit the board, or the department when there is

12  no board, from regulating Florida licensees regardless of the

13  location of the patient.

14         (12)  The board, or the department when there is no

15  board, may adopt rules pursuant to ss. 120.536(1) and 120.54

16  necessary to administer this section.

17         Section 2.  Subsection (7) is added to section 766.102,

18  Florida Statutes, to read:

19         766.102  Medical negligence; standards of recovery.--

20         (7)  If the injury or death is alleged to have resulted

21  from health care provided to a patient located in this state

22  through means of telecommunications, the action for recovery

23  of damages may be brought in this state regardless of the

24  location of the provider alleged to have caused the injury.

25         Section 3.  This act shall take effect July 1, 2000.

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    Florida Senate - 2000                           CS for SB 1718
    317-2120-00




  1          STATEMENT OF SUBSTANTIAL CHANGES CONTAINED IN
                       COMMITTEE SUBSTITUTE FOR
  2                         Senate Bill 1718

  3

  4  The committee substitute (CS) replaces the original contents
    of SB 1218 with provisions relating to "telehealth."  The CS
  5  provides for the regulation of any person who provides health
    care services that are delivered or provided to persons in
  6  Florida via telecommunications, provides legislative findings
    and intent, and specifies exceptions to its requirements for
  7  persons who must obtain a telehealth license. The CS limits to
    Florida-licensed health care professionals or those otherwise
  8  authorized to practice in Florida, the ability to order, from
    a person located outside Florida, electronic communications
  9  diagnostic-imaging or treatment services for a person located
    in Florida. The CS provides for the recovery of damages in
10  Florida for any injury or death of a person that results from
    health care provided to a patient located in Florida through
11  the means of telecommunication. The action may be brought in
    Florida regardless of the location of the provider.
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