*SB0284.1*
January 21, 2022
SENATE BILL No. 284
_____
DIGEST OF SB 284 (Updated January 19, 2022 2:18 pm - DI 92)
Citations Affected: IC 12-7; IC 12-15; IC 25-1.
Synopsis: Telehealth matters. Consolidates Medicaid telehealth
language. Adds specified health care providers, students, and fellows
to the definition of "practitioner" for purposes of practicing telehealth.
Allows behavior health analysts to temporarily perform telehealth
during the time when the professional licensing agency is preparing to
implement licensure for the profession. Exempts certain actions from
the definition of "telehealth", allowing for a practitioner to delegate
consultation, treatment, and monitoring of a patient if the delegated
health service is within the practitioner's scope of practice and allowed
to be delegated by the practitioner in an in-person setting.
Effective: July 1, 2022.
Charbonneau
January 10, 2022, read first time and referred to Committee on Health and Provider
Services.
January 20, 2022, amended, reported favorably — Do Pass.
SB 284—LS 6719/DI 104 January 21, 2022
Second Regular Session of the 122nd General Assembly (2022)
PRINTING CODE. Amendments: Whenever an existing statute (or a section of the Indiana
Constitution) is being amended, the text of the existing provision will appear in this style type,
additions will appear in this style type, and deletions will appear in this style type.
Additions: Whenever a new statutory provision is being enacted (or a new constitutional
provision adopted), the text of the new provision will appear in this style type. Also, the
word NEW will appear in that style type in the introductory clause of each SECTION that adds
a new provision to the Indiana Code or the Indiana Constitution.
Conflict reconciliation: Text in a statute in this style type or this style type reconciles conflicts
between statutes enacted by the 2021 Regular Session of the General Assembly.
SENATE BILL No. 284
A BILL FOR AN ACT to amend the Indiana Code concerning
professions and occupations.
Be it enacted by the General Assembly of the State of Indiana:
1 SECTION 1. IC 12-7-2-190.3, AS AMENDED BY P.L.85-2021,
2 SECTION 1, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
3 JULY 1, 2022]: Sec. 190.3. (a) "Telehealth activities", for purposes of
4 IC 12-15-5-11, has the meaning set forth in IC 12-15-5-11(a).
5 (b) "Telehealth services", for purposes of IC 12-15-5-11, has the
6 meaning set forth in IC 12-15-5-11(b). IC 12-15-5-11(a).
7 SECTION 2. IC 12-15-5-11, AS AMENDED BY P.L.207-2021,
8 SECTION 8, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
9 JULY 1, 2022]: Sec. 11. (a) As used in this section, "telehealth
10 activities" means the use of telecommunications and information
11 technology to provide access to:
12 (1) health assessment;
13 (2) diagnosis;
14 (3) intervention;
15 (4) consultation;
16 (5) supervision; and
17 (6) information;
SB 284—LS 6719/DI 104 2
1 across a distance.
2 (b) As used in this section, "telehealth services" has the meaning set
3 forth for "telehealth" in IC 25-1-9.5-6.
4 (c) The office shall reimburse a Medicaid provider who is licensed
5 as a home health agency under IC 16-27-1 for telehealth activities.
6 (d) (b) The office shall reimburse the following Medicaid providers
7 for medically necessary telehealth services:
8 (1) A federally qualified health center (as defined in 42 U.S.C.
9 1396d(l)(2)(B)).
10 (2) A rural health clinic (as defined in 42 U.S.C. 1396d(l)(1)).
11 (3) A community mental health center certified under
12 IC 12-21-2-3(5)(C).
13 (4) A critical access hospital that meets the criteria under 42 CFR
14 485.601 et seq.
15 (5) A home health agency licensed under IC 16-27-1.
16 (5) (6) A provider, as determined by the office to be eligible,
17 providing a covered telehealth service.
18 (e) (c) The office may not impose any distance restrictions on
19 providers of telehealth activities or telehealth services. Before
20 December 31, 2017, the office shall do the following:
21 (1) Submit a Medicaid state plan amendment with the United
22 States Department of Health and Human Services that eliminates
23 distance restrictions for telehealth activities or telehealth services
24 in the state Medicaid plan.
25 (2) Issue a notice of intent to adopt a rule to amend any
26 administrative rules that include distance restrictions for the
27 provision of telehealth activities or telehealth services.
28 (f) (d) Subject to federal law, the office may not impose any location
29 requirements concerning the originating site or distant site in which a
30 telehealth service is provided to a Medicaid recipient.
31 (g) (e) A Medicaid recipient waives confidentiality of any medical
32 information discussed with the health care provider that is:
33 (1) provided during a telehealth visit; and
34 (2) heard by another individual in the vicinity of the Medicaid
35 recipient during a health care service or consultation.
36 (h) (f) For purposes of a community mental health center, telehealth
37 services satisfy any face to face meeting requirement between a
38 clinician and consumer.
39 (i) (g) The office shall implement any part of this section that is
40 approved by the United States Department of Health and Human
41 Services.
42 (j) (h) The office may adopt rules under IC 4-22-2 necessary to
SB 284—LS 6719/DI 104 3
1 implement and administer this section.
2 SECTION 3. IC 25-1-9.5-2.5, AS ADDED BY P.L.85-2021,
3 SECTION 11, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
4 JULY 1, 2022]: Sec. 2.5. As used in this chapter, "health care services"
5 includes the following:
6 (1) The following concerning a patient:
7 (A) Assessment.
8 (B) Diagnosis.
9 (C) Evaluation.
10 (D) Consultation.
11 (E) Treatment. and
12 (F) Monitoring of a patient.
13 (2) Transfer of medical data.
14 (3) Patient health related education.
15 (4) Health administration.
16 SECTION 4. IC 25-1-9.5-3.5, AS AMENDED BY P.L.207-2021,
17 SECTION 25, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
18 JULY 1, 2022]: Sec. 3.5. (a) As used in this chapter, "practitioner"
19 means an individual who holds an unlimited license to practice as any
20 of the following in Indiana:
21 (1) An athletic trainer licensed under IC 25-5.1.
22 (2) A chiropractor licensed under IC 25-10.
23 (3) A dental hygienist licensed under IC 25-13.
24 (4) The following:
25 (A) A dentist licensed under IC 25-14.
26 (B) An individual who holds a dental residency permit issued
27 under IC 25-14-1-5.
28 (C) An individual who holds a dental faculty license under
29 IC 25-14-1-5.5.
30 (5) A diabetes educator licensed under IC 25-14.3.
31 (6) A dietitian licensed under IC 25-14.5.
32 (7) A genetic counselor licensed under IC 25-17.3.
33 (8) The following:
34 (A) A physician licensed under IC 25-22.5.
35 (B) An individual who holds a temporary permit under
36 IC 25-22.5-5-4.
37 (9) A nurse licensed under IC 25-23.
38 (10) The following:
39 (A) An occupational therapist licensed under IC 25-23.5.
40 (B) An occupational therapy assistant licensed under
41 IC 25-23.5.
42 (11) Any behavioral health and human services professional
SB 284—LS 6719/DI 104 4
1 licensed under IC 25-23.6.
2 (12) An optometrist licensed under IC 25-24.
3 (13) A pharmacist licensed under IC 25-26.
4 (14) A physical therapist licensed under IC 25-27.
5 (15) A physician assistant licensed under IC 25-27.5.
6 (16) A podiatrist licensed under IC 25-29.
7 (17) A psychologist licensed under IC 25-33.
8 (18) A respiratory care practitioner licensed under IC 25-34.5.
9 (19) A speech-language pathologist or audiologist licensed under
10 IC 25-35.6, including a clinical fellow in speech-language
11 pathology.
12 (20) A veterinarian licensed under IC 25-38.1.
13 (21) A behavior analyst licensed under IC 25-8.5.
14 (22) A school psychologist licensed by the department of
15 education.
16 (23) A case manager employed by a provider who has been
17 approved by the division of disability and rehabilitative
18 services to provide case management services to individuals
19 on the community integration habilitation and family support
20 Medicaid waiver.
21 (24) A student who is:
22 (A) pursuing a course of study of a profession specified in
23 subdivisions (1) through (23); and
24 (B) providing services directed by an individual who holds
25 a license in Indiana for that profession.
26 (b) The term includes a behavior analyst during the time in
27 which the professional licensing agency is preparing to implement
28 licensure of behavioral analysts under IC 25-8.5. This subsection
29 expires January 1, 2025.
30 SECTION 5. IC 25-1-9.5-6, AS AMENDED BY P.L.207-2021,
31 SECTION 26, IS AMENDED TO READ AS FOLLOWS [EFFECTIVE
32 JULY 1, 2022]: Sec. 6. (a) As used in this chapter, "telehealth" means
33 the delivery of health care services using interactive electronic
34 communications and information technology, in compliance with the
35 federal Health Insurance Portability and Accountability Act (HIPAA),
36 including:
37 (1) secure videoconferencing;
38 (2) store and forward technology; or
39 (3) remote patient monitoring technology;
40 between a provider in one (1) location and a patient in another location.
41 (b) The term does not include the use of the following unless the
42 practitioner has an established relationship with the patient:
SB 284—LS 6719/DI 104 5
1 (1) Electronic mail.
2 (2) An instant messaging conversation.
3 (3) Facsimile.
4 (4) Internet questionnaire.
5 (5) Internet consultation.
6 (c) The term does not include a health care service provided by:
7 (1) an employee of a practitioner; or
8 (2) an individual who is employed by the same entity that
9 employs the practitioner;
10 who is performing a health care service listed in section 2.5(1)(D)
11 through 2.5(1)(F), 2.5(2), 2.5(3), or 2.5(4) of this chapter under the
12 direction and that is customarily within the specific area of practice of
13 the practitioner. In order to be excluded from the term under this
14 subsection, the health care services being delegated by the
15 practitioner must be within the practitioner's scope of practice and
16 allowed to be delegated by the practitioner to another individual
17 described in this subsection in the same manner as the health care
18 service is allowed to be delegated by the practitioner in an
19 in-person setting.
SB 284—LS 6719/DI 104 6
COMMITTEE REPORT
Madam President: The Senate Committee on Health and Provider
Services, to which was referred Senate Bill No. 284, has had the same
under consideration and begs leave to report the same back to the
Senate with the recommendation that said bill be AMENDED as
follows:
Page 3, line 38, after "(10)" insert "The following:
(A)".
Page 3, between lines 38 and 39, begin a new line double block
indented and insert:
"(B) An occupational therapy assistant licensed under
IC 25-23.5.".
Page 4, line 7, delete "25-35.6." and insert "25-35.6, including a
clinical fellow in speech-language pathology.".
Page 5, line 7, delete "(F)," and insert "2.5(1)(F),".
and when so amended that said bill do pass.
(Reference is to SB 284 as introduced.)
CHARBONNEAU, Chairperson
Committee Vote: Yeas 12, Nays 0.
SB 284—LS 6719/DI 104