Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. SB 898
                                Barcode 159956                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: FAV            .                                
                  04/03/2013           .                                

       The Committee on Health Policy (Joyner) recommended the
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Telemedicine services.—
    6         (1) As used in this section, the term “telemedicine
    7  services,” as it pertains to the delivery of health care
    8  services, means synchronous video conferencing, remote patient
    9  monitoring, asynchronous health images, or other health
   10  transmissions supported by mobile devices, such as mHealth, or
   11  other telecommunications technology used for the purpose of
   12  diagnosis, consultation, treatment, transfer of medical data, or
   13  exchange of medical education information by means of audio,
   14  video, or data communications. The term does not include an
   15  audio-only telephone call, e-mail message, or facsimile
   16  transmission.
   17         (2) On or after January 1, 2014, a health insurance policy
   18  that is issued, amended, or renewed may not require face-to-face
   19  contact between a health care provider and a patient as a
   20  prerequisite for payment for services appropriately provided
   21  through telemedicine in accordance with generally accepted
   22  health care practices and standards prevailing in the applicable
   23  professional community at the time the services are provided.
   24  This requirement is subject to all terms and conditions
   25  negotiated between the provider and the health insurer or health
   26  plan. Medicaid services provided through fee-for-service or a
   27  managed care delivery system may not be denied as a creditable
   28  Medicaid service on the basis that the coverage is provided
   29  through telemedicine. Health care services covered through in
   30  person consultations or through telemedicine shall be treated as
   31  equivalent services from an insurance coverage and payment
   32  perspective.
   33         (3) This section does not prevent a health insurer or
   34  health plan from imposing deductibles or copayment or
   35  coinsurance requirements for a health care service provided
   36  through telemedicine if the deductible, copayment, or
   37  coinsurance does not exceed the deductible, copayment, or
   38  coinsurance applicable to an in-person consultation for the same
   39  health care service.
   40         (4) This section does not preclude a licensed health care
   41  practitioner, as defined in s. 456.001, Florida Statutes, who is
   42  acting within the scope of his or her practice from employing
   43  the technology of telemedicine, applying telemedicine within his
   44  or her practice, or using telemedicine technology under the
   45  direction and supervision of another health care practitioner
   46  who is using telemedicine technology within the supervising
   47  practitioner’s scope of practice. When acting under the
   48  direction and supervision of another health care practitioner,
   49  the use of telemedicine technology may not be interpreted as
   50  practicing medicine without a license. However, any health care
   51  practitioner employing telemedicine technology must be trained,
   52  educated, and knowledgeable about the procedure and technology
   53  and may not perform duties for which the practitioner does not
   54  have sufficient training, education, or knowledge. Failure to
   55  have adequate training, education, and knowledge is grounds for
   56  disciplinary action by the board, or the department if there is
   57  no board.
   58         (5) The Department of Health, in consultation with those
   59  boards within the department which exercise regulatory or
   60  rulemaking functions relating to health care practitioners as
   61  defined in s. 456.001, Florida Statutes, may adopt rules, as
   62  necessary, to implement the requirements of this section
   63  relating to the provision of telemedicine services by such
   64  practitioners, and shall repeal any rules that prohibit the use
   65  of telemedicine in this state.
   66         Section 2. The Department of Health shall lead and conduct
   67  an interagency study, which also includes the Department of
   68  Children and Families and the Agency for Health Care
   69  Administration, on options for implementing telemedicine
   70  services and coverage, including multipayer coverage and
   71  reimbursement, for stroke diagnosis, high-risk pregnancies,
   72  premature births, mental health services, and emergency
   73  services. The Department of Health shall submit a final report
   74  of its findings and recommendations to the President of the
   75  Senate and the Speaker of the House of Representatives by July
   76  1, 2014.
   77         Section 3. This act shall take effect July 1, 2013.
   79  ================= T I T L E  A M E N D M E N T ================
   80         And the title is amended as follows:
   81         Delete everything before the enacting clause
   82  and insert:
   83                        A bill to be entitled                      
   84         An act relating to telemedicine; defining the term
   85         “telemedicine”; providing that a health insurance
   86         policy or Medicaid may not require face-to-face
   87         contact between a health care provider and patient as
   88         a prerequisite to coverage or reimbursement for
   89         services; clarifying that the use of telemedicine
   90         technology under the supervision of another health
   91         care practitioner may not be interpreted as practicing
   92         medicine without a license; authorizing the Department
   93         of Health to adopt rules and to repeal any rules that
   94         prohibit the use of telemedicine; requiring the
   95         department to conduct a study, which includes the
   96         Department of Children and Families and the Agency for
   97         Health Care Administration, on options for
   98         implementing telemedicine for certain services;
   99         requiring the Department of Health to submit a report
  100         to the Legislature; providing an effective date.
  102         WHEREAS, telemedicine services are those services that use
  103  electronic technology to overcome a geographic distance between
  104  patients and health care providers for the purposes of
  105  assessing, monitoring, intervening, clinical managing, or
  106  educating patients, and
  107         WHEREAS, the Legislature recognizes the demonstrated cost
  108  effectiveness, improvements in disease management, and improved
  109  patient outcomes that result from the provision of telemedicine
  110  services, and that studies have demonstrated significant
  111  reductions in hospitalizations and otherwise necessary medical
  112  care as a result of telemedicine intervention, and
  113         WHEREAS, geography, weather, availability to specialists,
  114  transportation, and other factors can create barriers to
  115  accessing appropriate health and mental health care, and that
  116  one way to provide, ensure, or enhance access to care given
  117  these barriers is through the appropriate use of technology to
  118  allow health care consumers access to qualified health care
  119  providers, and
  120         WHEREAS, the Legislature seeks to embrace efforts that will
  121  encourage health insurers and health providers to support the
  122  use of telemedicine and that will also encourage all state
  123  agencies to evaluate and amend their policies and rules to
  124  remove any regulatory barriers prohibiting the use of
  125  telemedicine, NOW THEREFORE,