DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part of
the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of
the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Simon HB No. 903
Abstract: Provides for greater access to telehealth services by providing for standards of care,
confidentiality, and insurance coverage; expands the definition of telemedicine; creates
the La. Commission on Telehealth Access.
Present law defines "telemedicine" as the practice of healthcare delivery, diagnosis, consultation,
treatment, and transfer of medical data using interactive telecommunication technology that
enables a healthcare practitioner a patient at two locations separated by distance to interact via
two-way video and audio transmissions simultaneously. Neither a telephone conversation nor an
electronic mail message between a healthcare practitioner physician and patient, or a true
consultation as may be defined by rules promulgated by the Louisiana State Board Medical
Examiners (LSBME).
Proposed law defines "telemedicine" as the practice of medicine and transfer of medical data
using interactive telecommunication technology that enables a physician and a patient at two
locations separated by distance to interact via two-way video and audio transmissions
simultaneously or through the use of asynchronous store-and-forward technology. Neither a
telephone conversation nor an electronic mail message between a physician and patient, or an
informal consultation or second opinion as may be defined by rules promulgated by the LSBME.
Present law requires any person authorized by LSBME to practice telemedicine to ensure that a
licensed healthcare professional who can adequately and accurately assist is in the examination
room with the patient at the time such patient is receiving telemedicine services.
Proposed law repeals present law and requires any person authorized by LSMBE to use the same
standard of care as if the healthcare services were provided in person. Proposed law further
provides that the telemedicine provider is not required to conduct a patient history or physical
examination of the patient before engaging in a telemedicine encounter if the telemedicine
provider conducts a patient evaluation sufficient to meet the community standard of care for the
service provided. The patient evaluation may be performed using telemedicine.
Proposed law provides that a patient receiving telemedicine services may be in any location at the
time that the telemedicine services are rendered and a telemedicine provider may be in any
location when providing telemedicine services to a patient.
Proposed law requires a telemedicine provider to document the telemedicine services rendered in
the patient's medical records according to the same standard as that required for nontelemedicine
services. Medical records, including video, audio, electronic, or other records generated as a result of providing telemedicine services are considered as confidential.
Present law requires LSBME to establish by rule the requirements for licensure and requires the
rules to require the physician, when examining a patient by telemedicine, to establish a bona fide
physician-patient relationship by conducting an appropriate examination of the patient as
determined by the board.
Proposed law retains present law and further provides that the examination shall not require that
the physician or other healthcare professional be present with the patient but may include but not
be limited to review of any relevant history, examination by electronic means using a secure
video line, laboratory or diagnostic studies, review of diagnoses, or other information deemed
pertinent by the physician.
Proposed law defines "telehealth" as a mode of delivering healthcare services, including but not
limited to telemedicine, and public health that utilizes information and communication
technologies to enable the diagnosis, consultation, treatment, education, care management and
self-management of patients at a distance from healthcare providers. Telehealth allows services
to be accessed when providers are in a distant site and patients are in the originating site.
Telehealth facilitates patient self-management and caregiver support for patients and includes
synchronous interactions and asynchronous store and forward transfers.
Nothing in proposed law shall be construed to expand, diminish, or alter the scope of practice of
any healthcare provider.
Proposed law requires all laws regarding the confidentiality of healthcare information and the
patient’s right to the patient's medical information to apply to telehealth interactions.
Proposed law prohibits a healthcare service plan from requiring that in-person contact occur
between a healthcare provider and a patient before payment is made for the covered services
provided, and requires every healthcare service plan to adopt payment policies to compensate
healthcare providers who provide covered healthcare services through telehealth.
Proposed law requires payment for telehealth interactions to include reasonable compensation to
the originating site for the transmission cost incurred during the delivery of healthcare services.
Proposed law requires healthcare service plans to pay for covered healthcare services when
provided by information and communication technologies including but not limited to telephone
or Internet technologies and for asynchronous store and forward services.
Proposed law requires payment for covered services provided by telehealth to be the lower of the
usual and customary rate charged for that service or the contract amount the healthcare service
plan pays for the same service when provided in an in-person encounter with the patient.
Proposed law prohibits a healthcare service plan from limiting the type of setting where services
are provided for the patient or the provider and requires the healthcare service plan to pay providers at both the distant site and the originating site.
Proposed law shall also be operative for healthcare service plan contracts with the medical
assistance program administered by the Dept. of Health and Hospitals (DHH).
Proposed law establishes the La. Commission on Telehealth Access, composed of 13 members as
follows:
(1)The secretary of the Dept. of Health and Hospitals or his designee.
(2)The executive director of the La. State Board of Medical Examiners or his designee.
(3)A representative of the LSU Health Sciences Center at New Orleans.
(4)A representative of the LSU Health Sciences Center at Shreveport.
(5)A representative of the Tulane University School of Medicine.
(6)A representative of the La. State Medical Society.
(7)A representative of the La. Primary Care Association.
(8)A representative of the La. Health Care Quality Forum.
(9)A representative of the HomeCare Association of La.
(10)A representative of the La. Hospital Association.
(11)A representative of the La. Association of Health Plans.
(12)A representative of the La. Cable and Telecommunications Association.
(13)A representative of the TexLa Telehealth Resource Center.
Proposed law provides for the officers, compensation, and meetings of the commission.
Proposed law provides that the functions of the commission are the following:
(1)Serve as an advisory body to the legislature and DHH on policies and practices that
expand access to telehealth services in a manner that ensures quality of care and patient
safety.
(2)Serve as a coordinating forum on telehealth related matters between and among state
agencies, local government, and other nongovernmental groups.
(3)On a regular basis, research and review state regulations, guidelines, policies, and procedures that pertain in any way to telehealth and make recommendations to the
governor, the legislature, and the secretary of DHH as deemed necessary and appropriate
by the chairman.
Proposed law requires the commission to prepare and submit to the governor and the legislature,
on a semiannual basis, a report on the status of telehealth access in La.
Proposed law provides that the commission shall terminate on Sept. 1, 2018.
(Amends R.S. 37:1262(4), 1271(B)(2), and 1276.1(2)(a); Adds R.S. 36:259(Y), R.S.
37:1271(B)(3)-(5), and R.S. 40:1300.381-1300.389)