Florida Senate - 2013                        COMMITTEE AMENDMENT
       Bill No. SB 898
                                Barcode 698240                          
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                   Comm: RE            .                                
                  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 health professional,
   41  acting within the scope of the health professional’s practice,
   42  from employing the technology of telemedicine or participating
   43  in the application of telemedicine within the health
   44  professional’s practice or under the direction of another health
   45  professional with such scope of practice. Such action may not be
   46  interpreted as practicing medicine without a license.
   47         (5) The Department of Health, in consultation with those
   48  boards within the department which exercise regulatory or
   49  rulemaking functions relating to health care practitioners as
   50  defined in s. 456.001, Florida Statutes, may adopt rules, as
   51  necessary, to implement the requirements of this section
   52  relating to the provision of telemedicine services by such
   53  practitioners, and shall repeal any rules that prohibit the use
   54  of telemedicine in this state.
   55         Section 2. The Department of Health shall lead and conduct
   56  an interagency study, which also includes the Department of
   57  Children and Families and the Agency for Health Care
   58  Administration, on options for implementing telemedicine
   59  services and coverage, including multipayer coverage and
   60  reimbursement, for stroke diagnosis, high-risk pregnancies,
   61  premature births, mental health services, and emergency
   62  services. The Department of Health shall submit a final report
   63  of its findings and recommendations to the President of the
   64  Senate and the Speaker of the House of Representatives by July
   65  1, 2014.
   66         Section 3. This act shall take effect July 1, 2013.
   68  ================= T I T L E  A M E N D M E N T ================
   69         And the title is amended as follows:
   70         Delete everything before the enacting clause
   71  and insert:
   72                        A bill to be entitled                      
   73         An act relating to telemedicine; defining the term
   74         “telemedicine”; providing that a health insurance
   75         policy or Medicaid may not require face-to-face
   76         contact between a health care provider and patient as
   77         a prerequisite to coverage or reimbursement for
   78         services; authorizing the Department of Health to
   79         adopt rules and to repeal any rules that prohibit the
   80         use of telemedicine; requiring the department to
   81         conduct a study, which includes the Department of
   82         Children and Families and the Agency for Health Care
   83         Administration, on options for implementing
   84         telemedicine for certain services; requiring the
   85         Department of Health to submit a report to the
   86         Legislature; providing an effective date.
   88         WHEREAS, telemedicine services are those services that use
   89  electronic technology to overcome a geographic distance between
   90  patients and health care providers for the purposes of
   91  assessing, monitoring, intervening, clinical managing, or
   92  educating patients, and
   93         WHEREAS, the Legislature recognizes the demonstrated cost
   94  effectiveness, improvements in disease management, and improved
   95  patient outcomes that result from the provision of telemedicine
   96  services, and that studies have demonstrated significant
   97  reductions in hospitalizations and otherwise necessary medical
   98  care as a result of telemedicine intervention, and
   99         WHEREAS, geography, weather, availability to specialists,
  100  transportation, and other factors can create barriers to
  101  accessing appropriate health and mental health care, and that
  102  one way to provide, ensure, or enhance access to care given
  103  these barriers is through the appropriate use of technology to
  104  allow health care consumers access to qualified health care
  105  providers, and
  106         WHEREAS, the Legislature seeks to embrace efforts that will
  107  encourage health insurers and health providers to support the
  108  use of telemedicine and that will also encourage all state
  109  agencies to evaluate and amend their policies and rules to
  110  remove any regulatory barriers prohibiting the use of
  111  telemedicine, NOW THEREFORE,