Bill Text: OR SB569 | 2013 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Relating to telemedicine; and declaring an emergency.

Spectrum: Bipartisan Bill

Status: (Passed) 2013-06-21 - Effective date, June 13, 2013. [SB569 Detail]

Download: Oregon-2013-SB569-Amended.html

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     77th OREGON LEGISLATIVE ASSEMBLY--2013 Regular Session

SA to SB 569

LC 1675/SB 569-5

                      SENATE AMENDMENTS TO
                         SENATE BILL 569

         By COMMITTEE ON HEALTH CARE AND HUMAN SERVICES

                            April 16

  On page 1 of the printed bill, line 2, delete '441.055,'.
  Delete lines 5 through 25 and delete pages 2 through 5.
  On page 6, delete lines 1 through 28 and insert:
  '  { +  SECTION 1. + }  { + Section 2 of this 2013 Act is added
to and made a part of ORS chapter 441. + }
  '  { +  SECTION 2. + }  { + (1) The Oregon Health Authority
shall prescribe by rule the information and documents that a
governing body of an originating-site hospital may use for
credentialing a telemedicine provider located at a distant-site
hospital.
  ' (2) The rules adopted by the authority under subsection (1)
of this section must:
  ' (a) Include a standard list of information and documents that
may be requested;
  ' (b) Include a list of information and documents that may be
requested in addition to the standard list of information and
documents;
  ' (c) Include a list of information and documents that may not
be requested; and
  ' (d) Be consistent with all applicable legal and accreditation
requirements of an originating-site hospital and the health plans
with which the originating-site hospital contracts.
  ' (3) Except as provided in subsection (4) of this section, an
originating-site hospital in this state must comply with the
rules adopted under this section if the telemedicine provider is
located at a distant-site hospital that is located in this state.
This section does not prevent hospitals located outside of this
state from using or require such hospitals to use the prescribed
list of information and documents in credentialing a telemedicine
provider.
  ' (4) An originating-site hospital is not limited to the
information and documents prescribed by the authority if the
originating-site hospital has a delegated credentialing agreement
with the distant-site hospital where the telemedicine provider is
located and the governing body of the originating-site hospital
accepts the recommendation of the medical staff to credential the
telemedicine provider.
  ' (5) In the adoption of the rules described in subsections (1)
and (2) of this section, the authority shall consult with
representatives of distant-site hospitals and originating-site
hospitals in this state. Once adopted, the authority may not
amend the rules to alter the prescribed lists without first
consulting representatives of distant-site hospitals and
originating-site hospitals in this state.
  ' (6) This section does not affect the responsibilities of a
governing body under ORS 441.055 and does not require a governing
body of a hospital to grant privileges to a telemedicine
provider. + }
  '  { +  SECTION 3. + } ORS 442.015 is amended to read:

  ' 442.015. As used in ORS chapter 441 and this chapter, unless
the context requires otherwise:
  ' (1) 'Acquire' or 'acquisition' means obtaining equipment,
supplies, components or facilities by any means, including
purchase, capital or operating lease, rental or donation,
 { - with intention - }  { +  for the purpose + } of using such
equipment, supplies, components or facilities to provide health
services in Oregon.  When equipment or other materials are
obtained outside of this state, acquisition is considered to
occur when the equipment or other materials begin to be used in
Oregon for the provision of health services or when such services
are offered for use in Oregon.
  ' (2) 'Affected persons' has the same meaning as given to '
party' in ORS 183.310.
  ' (3)(a) 'Ambulatory surgical center' means a facility or
portion of a facility that operates exclusively for the purpose
of providing surgical services to patients who do not require
hospitalization and for whom the expected duration of services
does not exceed 24 hours following admission.
  ' (b) 'Ambulatory surgical center' does not mean:
  ' (A) Individual or group practice offices of private
physicians or dentists that do not contain a distinct area used
for outpatient surgical treatment on a regular and organized
basis, or that only provide surgery routinely provided in a
physician's or dentist's office using local anesthesia or
conscious sedation; or
  ' (B) A portion of a licensed hospital designated for
outpatient surgical treatment.
  '  { - (4) 'Budget' means the projections by the hospital for a
specified future time period of expenditures and revenues with
supporting statistical indicators. - }
  '  { +  (4) 'Delegated credentialing agreement' means a written
agreement between an originating-site hospital and a distant-site
hospital that provides that the medical staff of the
originating-site hospital will rely upon the credentialing and
privileging decisions of the distant-site hospital in making
recommendations to the governing body of the originating-site
hospital as to whether to credential a telemedicine provider,
practicing at the distant-site hospital either as an employee or
under contract, to provide telemedicine services to patients in
the originating-site hospital. + }
  ' (5) 'Develop' means to undertake those activities that on
their completion will result in the offer of a new institutional
health service or the incurring of a financial obligation, as
defined under applicable state law, in relation to the offering
of such a health service.
  '  { +  (6) 'Distant-site hospital' means the hospital where a
telemedicine provider, at the time the telemedicine provider is
providing telemedicine services, is practicing as an employee or
under contract. + }
  '  { - (6) - }  { +  (7) + } 'Expenditure' or 'capital
expenditure' means the actual expenditure, an obligation to an
expenditure, lease or similar arrangement in lieu of an
expenditure, and the reasonable value of a donation or grant in
lieu of an expenditure but not including any interest thereon.
  '  { - (7) - }  { +  (8) + } 'Freestanding birthing center'
means a facility licensed for the primary purpose of performing
low risk deliveries.
  '  { - (8) - }  { +  (9) + } 'Governmental unit' means the
state, or any county, municipality or other political
subdivision, or any related department, division, board or other
agency.
  '  { - (9) - }  { +  (10) + } 'Gross revenue' means the sum of
daily hospital service charges, ambulatory service charges,
ancillary service charges and other operating revenue. 'Gross

revenue' does not include contributions, donations, legacies or
bequests made to a hospital without restriction by the donors.
  '  { - (10)(a) - }  { +  (11)(a) + } 'Health care facility'
means:
  ' (A) A hospital;
  ' (B) A long term care facility;
  ' (C) An ambulatory surgical center;
  ' (D) A freestanding birthing center; or
  ' (E) An outpatient renal dialysis center.
  ' (b) 'Health care facility' does not mean:
  ' (A) A residential facility licensed by the Department of
Human Services or the Oregon Health Authority under ORS 443.415;
  ' (B) An establishment furnishing primarily domiciliary care as
described in ORS 443.205;
  ' (C) A residential facility licensed or approved under the
rules of the Department of Corrections;
  ' (D) Facilities established by ORS 430.335 for treatment of
substance abuse disorders; or
  ' (E) Community mental health programs or community
developmental disabilities programs established under ORS
430.620.
  '  { - (11) - }  { +  (12) + } 'Health maintenance
organization' or 'HMO ' means a public organization or a private
organization organized under the laws of any state that:
  ' (a) Is a qualified HMO under section 1310 (d) of the U.S.
Public Health Services Act; or
  ' (b)(A) Provides or otherwise makes available to enrolled
participants health care services, including at least the
following basic health care services:
  ' (i) Usual physician services;
  ' (ii) Hospitalization;
  ' (iii) Laboratory;
  ' (iv) X-ray;
  ' (v) Emergency and preventive services; and
  ' (vi) Out-of-area coverage;
  ' (B) Is compensated, except for copayments, for the provision
of the basic health care services listed in subparagraph (A) of
this paragraph to enrolled participants on a predetermined
periodic rate basis; and
  ' (C) Provides physicians' services primarily directly through
physicians who are either employees or partners of such
organization, or through arrangements with individual physicians
or one or more groups of physicians organized on a group practice
or individual practice basis.
  '  { - (12) - }  { +  (13) + } 'Health services' means
clinically related diagnostic, treatment or rehabilitative
services, and includes alcohol, drug or controlled substance
abuse and mental health services that may be provided either
directly or indirectly on an inpatient or ambulatory patient
basis.
  '  { - (13) - }  { +  (14) + } 'Hospital' means:
  ' (a) A facility with an organized medical staff and a
permanent building that is capable of providing 24-hour inpatient
care to two or more individuals who have an illness or injury and
that provides at least the following health services:
  ' (A) Medical;
  ' (B) Nursing;
  ' (C) Laboratory;
  ' (D) Pharmacy; and
  ' (E) Dietary; or
  ' (b) A special inpatient care facility as that term is defined
by the Oregon Health Authority by rule.
  '  { - (14) - }  { +  (15) + } 'Institutional health services'
means health services provided in or through health care
facilities and includes the entities in or through which such
services are provided.
  '  { - (15) - }  { +  (16) + } 'Intermediate care facility'
means a facility that provides, on a regular basis,
health-related care and services to individuals who do not
require the degree of care and treatment that a hospital or
skilled nursing facility is designed to provide, but who because
of their mental or physical condition require care and services
above the level of room and board that can be made available to
them only through institutional facilities.
  '  { - (16) - }  { +  (17) + }  { +  (a) + } 'Long term care
facility' means a  { + permanent + } facility with
 { - permanent facilities that include - }  inpatient beds,
providing { + :
  ' (A) + } Medical services, including nursing services but
excluding surgical procedures except as may be permitted by the
rules of the Director of Human Services  { - , to provide - }
 { + ; and
  ' (B) + } Treatment for two or more unrelated patients.
  '  { +  (b) + } 'Long term care facility' includes skilled
nursing facilities and intermediate care facilities but   { - may
not be construed to - }  { +  does not + } include facilities
licensed and operated pursuant to ORS 443.400 to 443.455.
  '  { - (17) - }  { +  (18) + } 'New hospital' means { + :
  ' (a) + } A facility that did not offer hospital services on a
regular basis within its service area within the prior 12-month
period and is initiating or proposing to initiate such services
 { - .  ' New hospital' also includes - }  { + ; or
  ' (b)  + }Any replacement of an existing hospital that involves
a substantial increase or change in the services offered.
  '  { - (18) - }  { +  (19) + } 'New skilled nursing or
intermediate care service or facility' means a service or
facility that did not offer long term care services on a regular
basis by or through the facility within the prior 12-month period
and is initiating or proposing to initiate such services. 'New
skilled nursing or intermediate care service or facility' also
includes the rebuilding of a long term care facility, the
relocation of buildings that are a part of a long term care
facility, the relocation of long term care beds from one facility
to another or an increase in the number of beds of more than 10
or 10 percent of the bed capacity, whichever is the lesser,
within a two-year period.
  '  { - (19) - }  { +  (20) + } 'Offer' means that the health
care facility holds itself out as capable of providing, or as
having the means for the provision of, specified health services.
  '  { +  (21) 'Originating-site hospital' means a hospital in
which a patient is located while receiving telemedicine
services. + }
  '  { - (20) - }  { +  (22) + } 'Outpatient renal dialysis
facility' means a facility that provides renal dialysis services
directly to outpatients.
  '  { - (21) - }  { +  (23) + } 'Person' means an individual, a
trust or estate, a partnership, a corporation (including
associations, joint stock companies and insurance companies), a
state, or a political subdivision or instrumentality, including a
municipal corporation, of a state.
  '  { - (22) - }  { +  (24) + } 'Skilled nursing facility' means
a facility or a distinct part of a facility, that is primarily
engaged in providing to inpatients skilled nursing care and
related services for patients who require medical or nursing
care, or an institution that provides rehabilitation services for
the rehabilitation of individuals who are injured or sick or who
have disabilities.
  '  { +  (25) 'Telemedicine' means the provision of health
services to patients by physicians and health care practitioners
from a distance using electronic communications. + }
  '  { +  SECTION 4. + } ORS 442.807 is amended to read:

  ' 442.807. (1) Within 30 days of receiving the recommendations
of the Advisory Committee on Physician Credentialing Information,
the Administrator of the Office for Oregon Health Policy and
Research shall forward the recommendations to the Director of the
Oregon Health Authority.  The administrator shall request that
the Oregon Health Authority adopt rules to carry out the
efficient implementation and enforcement of the recommendations
of the committee.
  ' (2) The Oregon Health Authority shall:
  ' (a) Adopt administrative rules in a timely manner, as
required by the Administrative Procedures Act, for the purpose of
effectuating the provisions of ORS 442.800 to 442.807; and
  ' (b) Consult with each other and with the administrator to
ensure that the rules adopted by the Oregon Health Authority are
identical and are consistent with the recommendations developed
pursuant to ORS 442.805 for affected hospitals and health care
service contractors.
  ' (3) The uniform credentialing information required pursuant
to the administrative rules of the Oregon Health Authority
represent the minimum uniform credentialing information required
by the affected hospitals and health care service contractors.
  { - Nothing in - }  ORS 442.800 to 442.807   { - shall be
interpreted to - }  { +  do not + } prevent an affected hospital
or health care service contractor from requesting additional
credentialing information from a licensed physician { + , other
than a telemedicine provider, + } for the purpose of completing
physician credentialing procedures used by the affected hospital
or health care service contractor. { +  Hospital credentialing
requirements for telemedicine providers must be in accordance
with the list of information and documents prescribed by the
authority under section 2 of this 2013 Act. + }
  '  { +  SECTION 5. + }  { + (1) Section 2 of this 2013 Act and
the amendments to ORS 442.015 and 442.807 by sections 3 and 4 of
this 2013 Act become operative October 1, 2013.
  ' (2) The Director of the Oregon Health Authority may take any
actions necessary before October 1, 2013, in order to implement
section 2 of this 2013 Act and the amendments to ORS 442.015 and
442.807 by sections 3 and 4 of this 2013 Act on and after October
1, 2013. + } ' .
  In line 29, delete '5' and insert '6'.
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