Bill Text: MS HB1177 | 2016 | Regular Session | Introduced
Bill Title: Telemedicine; revise provisions defining and regulating the practice of.
Spectrum: Partisan Bill (Republican 1-0)
Status: (Failed) 2016-02-23 - Died In Committee [HB1177 Detail]
Download: Mississippi-2016-HB1177-Introduced.html
MISSISSIPPI LEGISLATURE
2016 Regular Session
To: Public Health and Human Services
By: Representative Steverson
House Bill 1177
AN ACT TO AMEND SECTION 73-25-34, MISSISSIPPI CODE OF 1972, TO REVISE THE PROVISIONS THAT DEFINE AND REGULATE THE PRACTICE OF TELEMEDICINE IN MISSISSIPPI; AND FOR RELATED PURPOSES.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:
SECTION 1. Section 73-25-34, Mississippi Code of 1972, is amended as follows:
73-25-34. * * *
(1) Definitions. The following words and phrases shall
be defined as provided in this section, unless the context requires otherwise:
(a) "Chronic nonmalignant pain" means pain that has persisted after reasonable medical efforts have been made to relieve the pain or cure its cause and that has continued, either continuously or episodically, for longer than three continuous months. The term "chronic nonmalignant pain" does not include pain associated with a terminal condition or illness or with a progressive disease that, in the normal course of progression, may reasonably be expected to result in a terminal condition or illness.
(b) "Physician" means any doctor who is licensed to practice in Mississippi by the State Board of State Medical Licensure.
(c) "Store and forward telemedicine" means the asynchronous computer-based communication of medical data and/or images from an originating location to a physician at another site for the purpose of diagnostic and/or therapeutic assistance.
(d) "Telemedicine" means the practice of medicine using tools such as electronic communication, information technology, store and forward telecommunication, or other means of interaction between a physician in one location and a patient in another location, with or without an intervening health care provider.
(e) "Telemedicine technologies" means technologies and devices that enable secure electronic communications and information exchange in the practice of telemedicine, and typically involve the application of secure real-time video conferencing or similar secure video services, remote monitoring, or store and forward digital image technology to provide for support health care delivery by replicating the interaction of a traditional in-person encounter between a physician and a patient.
(2) Licensure.
(a) The practice of medicine occurs where the patient is located at the time the telemedicine technologies are used.
(b) A physician who uses telemedicine technologies to engage in the practice of medicine on patients located in this state must be licensed to practice medicine in the State of Mississippi and shall be subject to regulation by the State Board of Medical Licensure.
(c) This subsection does not apply to:
(i) An informational consultation or second opinion, at the request of a physician who is licensed to practice medicine in this state, provided that the physician requesting the opinion retains authority and responsibility for the patient's care; and
(ii) Furnishing of medical assistance by a physician in case of an emergency or disaster if no charge is made for the medical assistance.
(3) Establishing a Physician-Patient Relationship Through Telemedicine Encounter.
(a) "Professional relationship" means at minimum a relationship established between a health care professional and a patient when:
(i) The health care professional has previously conducted an in-person examination and is available to provide appropriate follow-up care, when necessary, at medically necessary intervals;
(ii) The health care professional personally knows the patient and the patient's relevant health status through an ongoing personal or professional relationship and is available to provide appropriate follow-up care when necessary at medically necessary intervals;
(iii) The treatment is provided by a health care professional in consultation with, or upon referral by, another health care professional who has an ongoing relationship with the patient and who has agreed to supervise the patient's treatment, including follow-up care;
(iv) An on-call or cross-coverage arrangement exists with the patient's regular treating health care professional;
(v) A relationship exists in other circumstances as defined by rule of the State Board of Medical Licensure for health care professionals under its jurisdiction and their patients; or
(vi) A relationship exists in other circumstances as defined by rule of the licensing or certification board for other health care professionals under the jurisdiction of the appropriate board and their patients if the rules are no less restrictive than the rules of the State Board of Medical Licensure.
(b) A physician-patient relationship may not be established through:
(i) Audio-only communication;
(ii) Text-based communications such as e-mail, Internet questionnaires, text-based messaging or other written forms of communication; or
(iii) Any combination thereof.
(c) If an existing physician-patient relationship is not present, telemedicine technologies may only be used in the case that the patient's situation is deemed to be an emergency by all usual medical standards.
(d) Once a physician-patient relationship has been established, either through an in-person encounter or in accordance with paragraph (a) of this subsection, the physician, with the informed consent of the patient, may use any telemedicine technology that meets the standard of care and is appropriate for the particular patient presentation.
(4) Telemedicine Practice. A physician using telemedicine technologies to practice medicine shall:
(a) Verify the identity and location of the patient;
(b) Provide the patient with confirmation of the identity, location, and qualifications of the physician;
(c) Establish and/or maintain a physician-patient relationship that conforms to the standard of care;
(d) Determine whether telemedicine technologies are appropriate for the particular patient presentation for which the practice of medicine is to be rendered;
(e) Obtain from the patient informed consent for the use of telemedicine technologies in the practice of medicine to the patient;
(f) Conduct all appropriate evaluations and history of the patient consistent with traditional standards of care for the particular patient presentation; and
(g) Create and maintain health care records for the patients that justify the course of treatment and that verify compliance with the requirements of this section.
(h) The requirements of paragraph (b) and (e) of this subsection do not apply to the practice of pathology or radiology medicine through store and forward telemedicine.
(5) Standard of Care.
(a) The practice of medicine provided via telemedicine technologies, including the establishment of a physician-patient relationship and issuing a prescription via electronic means as part of a telemedicine encounter, are subject to the same standard of care, professional practice requirements and scope of practice limitations as traditional in-person physician-patient encounters. Treatment, including issuing a prescription, based solely on an online questionnaire does not constitute an acceptable standard of care.
(b) The use of telemedicine technologies to practice medicine on a patient for whom the standard of care requires an in-person, physical examination shall constitute dishonorable, unethical and unprofessional conduct.
(6) Patient Records. The patient record established during the use of telemedicine technologies shall be accessible and documented for both the physician and the patient, consistent with the laws and legislative rules governing patient health care records and shall include a copy of the informed consent to the practice of medicine via telemedicine technologies. All laws governing the confidentiality of health care information and governing patient access to medical records shall apply to records of practice of medicine provided through telemedicine technologies. A physician solely providing services using telemedicine technologies shall make documentation of the encounter easily available to the patient, and subject to the patient's consent, to any identified care provider of the patient.
(7) Prescribing Limitations.
(a) A physician who practices medicine to a patient solely through the use of telemedicine technologies may not prescribe to that patient any controlled substances listed in Schedules I or II of the Uniform Controlled Substances Act.
(b) A physician may not prescribe any pain-relieving controlled substance listed in Schedules II through V of the Uniform Controlled Substance Act as part of a course of treatment for chronic nonmalignant pain based upon, or as a result of, a telemedicine encounter.
(8) Exceptions. This section does not prohibit the use of audio-only or text-based communications by a physician who is:
(a) Responding to call for patients with whom a physician-patient relationship has been established through an in-person encounter by the physician;
(b) Providing cross coverage for a physician who has established a physician-patient relationship with the patient through an in-person encounter; or
(c) Responding to an emergency situation or providing emergency services.
(9) Preservation of the Traditional Physician-Patient Relationship. Nothing in this section changes the rights, duties, privileges, responsibilities, and liabilities incident to the physician-patient relationship, nor is it meant or intended to change in any way the personal character of the physician-patient relationship. This subsection does not alter the scope of practice of any health care provider or authorize the delivery of health care services in a setting or in a manner, not otherwise authorized by law.
SECTION 2. This act shall take effect and be in force from and after July 1, 2016.
