Missouri HB 2165: Modifies provisions relating to telemedicine

Bill Text

SECOND REGULAR SESSION
HOUSE BILL NO. 2165
101ST GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE BUCHHEIT-COURTWAY.
4606H.01I DANA RADEMAN MILLER, Chief Clerk
AN ACT
To repeal sections 191.1145, 191.1146, 334.108, and 376.1900, RSMo, and to enact in lieu
thereof four new sections relating to telemedicine services.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Sections 191.1145, 191.1146, 334.108, and 376.1900, RSMo, are repealed
2 and four new sections enacted in lieu thereof, to be known as sections 191.1145, 191.1146,
3 334.108, and 376.1900, to read as follows:
191.1145. 1. As used in sections 191.1145 and 191.1146, the following terms shall
2 mean:
3 (1) "Asynchronous store-and-forward transfer", the collection of a patient's relevant
4 health information and the subsequent transmission of that information from an originating
5 site to a health care provider at a distant site without the patient being present;
6 (2) "Clinical staff", any health care provider licensed in this state;
7 (3) "Distant site", a site at which a health care provider is located while providing
8 health care services by means of telemedicine;
9 (4) "Health care provider", as that term is defined in section 376.1350;
10 (5) "Originating site", a site at which a patient is located at the time health care
11 services are provided to him or her by means of telemedicine. For the purposes of
12 asynchronous store-and-forward transfer, originating site shall also mean the location at
13 which the health care provider transfers information to the distant site;
14 (6) "Telehealth" or "telemedicine", the delivery of health care services by means of
15 information and communication technologies which facilitate the assessment, diagnosis,
16 consultation, treatment, education, care management, and self-management of a patient's
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language.

17 health care while such patient is at the originating site and the health care provider is at the
18 distant site. Telehealth or telemedicine shall also include the use of asynchronous store-and-
19 forward technology, including the use of such technology through an adaptive
20 questionnaire.
21 2. Anylicensed healthcare providershall be authorizedto provide telehealthservices
22 if such services are within the scope of practice for which the health care provider is licensed
23 and are provided with the same standard of care as services provided in person. This section
24 shall not be construed to prohibit a health carrier, as defined in section 376.1350, from
25 reimbursing nonclinical staff for services otherwise allowed by law.
26 3. In order to treat patients in this state through the use of telemedicine or telehealth,
27 health care providers shall be fully licensed to practice in this state and shall be subject to
28 regulation by their respective professional boards.
29 4. Nothing in subsection 3 of this section shall apply to:
30 (1) Informal consultation performed by a health care provider licensed in another
31 state, outside of the context of a contractual relationship, and on an irregular or infrequent
32 basis without the expectation or exchange of direct or indirect compensation;
33 (2) Furnishingofhealthcareservicesbyahealthcareproviderlicensedandlocatedin
34 another state in case of an emergency or disaster; provided that, no charge is made for the
35 medical assistance; or
36 (3) Episodic consultation by a health care provider licensed and located in another
37 state who provides such consultation services on request to a physician in this state.
38 5. Nothing in this section shall be construed to alter the scope of practice of any
39 health care provider or to authorize the delivery of health care services in a setting or in a
40 manner not otherwise authorized by the laws of this state.
41 6. No originating site for services or activities provided under this section shall be
42 required to maintain immediate availability of on-site clinical staff during the telehealth
43 services, except as necessary to meet the standard of care for the treatment of the patient's
44 medical condition if such condition is being treated by an eligible health care provider who is
45 not at the originating site, has not previously seen the patient in person in a clinical setting,
46 and is not providing coverage for a health care provider who has an established relationship
47 with the patient.
48 7. Nothing in this section shall be construed to alter any collaborative practice
49 requirement as provided in chapters 334 and 335.
191.1146. 1. Physicians licensed under chapter 334 who use telemedicine shall
2 ensure that a properly established physician-patient relationship exists with the person who
3 receives the telemedicine services. The physician-patient relationship may be est