SLS 23RS-82 ORIGINAL
2023 Regular Session
SENATE BILL NO. 66
BY SENATOR FRED MILLS
Prefiled pursuant to Article III, Section 2(A)(4)(b)(i) of the Constitution of Louisiana.
HEALTH CARE. Provides relative to telehealth services. (1/1/24)
1 AN ACT
2 To amend and reenact R.S. 22:11(C)(1)(a)(i), 1821(F)(1) and (2), 1841(3), 1842(A)(1) and
3 (B), and 1843(A)(2) and (B)(1)(a)(ii) and (b)(i) and (iv), R.S. 28:53(B)(1), the
4 introductory paragraph of 53(B)(4), 53(F), (G)(2), the introductory paragraph of
5 53(G)(7)(a), the introductory paragraph of 53(G)(7)(b) and 53(G)(7)(b)(ii), and
6 (J)(1), R.S. 37:1262(4), 1271, the introductory paragraph of 1271.1(A) and
7 1271.1(A)(2) and (3), and 1285.2(D)(2), R.S. 40:1046(K), 1165.2(B), 1167.2(6),
8 1167.4(E) and (F), 1223.2(3), 1223.3(3) and (5), 1223.4(A) and (B)(3), 1223.5,
9 1237.1(A)(9)(a)(ii)(bb), and 2195.1(A)(6), and R.S. 46:978.1(2), to enact R.S.
10 40:1223.4(B)(5), (6), and (7), and to repeal R.S. 22:1841(6) and R.S. 37:1276.1,
11 relative to telehealth services; to provide for the practice of medicine through
12 telehealth; to provide for definitions; to provide for updated terminology; to provide
13 for rulemaking by occupation regulatory entities; to repeal provisions regarding
14 telemedicine; to provide for an effective date; and to provide for related matters.
15 Be it enacted by the Legislature of Louisiana:
16 Section 1. R.S. 22:11(C)(1)(a)(i), 1821(F)(1) and (2), 1841(3), 1842(A)(1) and (B),
17 and 1843(A)(2) and (B)(1)(a)(ii) and (b)(i) and (iv) are hereby amended and reenacted to
Page 1 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 read as follows:
2 §11. Rules and regulations by commissioner
3 * * *
4 C.(1) When the governor declares a state of emergency pursuant to R.S.
5 29:724 or a public health emergency pursuant to R.S. 29:766, the commissioner may
6 issue emergency rules or regulations that address any of the following related to
7 insurance policies or health maintenance organization contracts in this state:
8 (a) Medical coverage relative to each of the following:
9 (i) Removal of telehealth and telemedicine access restraints.
10 * * *
11 §1821. Payment of claims; health and accident policies; prospective review;
12 penalties; self-insurers; telemedicine telehealth reimbursement by
13 insurers; prohibitions
14 * * *
15 F.(1) Notwithstanding any provision of any policy or contract of insurance
16 or health benefits issued, whenever such the policy provides for payment, benefit,
17 or reimbursement for any health care healthcare service, including but not limited
18 to diagnostic testing, treatment, referral, or consultation, and such health care the
19 healthcare service is performed via transmitted electronic imaging or telemedicine,
20 telehealth, such a the payment, benefit, or reimbursement under such the policy or
21 contract shall not be denied to a licensed physician conducting or participating in the
22 transmission at the originating health care healthcare facility or terminus who is
23 physically present with the individual who is the subject of such the electronic
24 imaging transmission and is contemporaneously communicating and interacting with
25 a licensed physician at the receiving terminus of the transmission. The payment,
26 benefit, or reimbursement to such a the licensed physician at the originating facility
27 or terminus shall not be less than seventy-five percent of the reasonable and
28 customary amount of payment, benefit, or reimbursement which that licensed
29 physician receives for an intermediate office visit.
Page 2 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 (2) Any health care healthcare service proposed to be performed or
2 performed via transmitted electronic imaging or telemedicine under telehealth
3 pursuant to this Subsection shall be subject to the applicable utilization review
4 criteria and requirements of the insurer. Terminology in a health and accident
5 insurance policy or contract that either discriminates against or prohibits such a
6 method of transmitted electronic imaging or telemedicine telehealth shall be void
7 as against public policy of providing the highest quality health care to the citizens
8 of the state.
9 * * *
10 SUBPART B-1. MEDICAL CLAIMS FOR SERVICES
11 PROVIDED THROUGH TELEHEALTH AND TELEMEDICINE
12 §1841. Definitions
13 For purposes of this Subpart, the following definitions apply:
14 * * *
15 (3) "Platform" means the technology, system, software, application, modality,
16 or other method through which a healthcare provider remotely interfaces with a
17 patient when providing a healthcare service or procedure as a telemedicine medical
18 service or telehealth healthcare service.
19 * * *
20 §1842. Telemedicine medical services and telehealth Telehealth healthcare services
21 statement
22 A.(1) Each issuer of a health coverage plan shall display in a conspicuous
23 manner on the health coverage plan issuer's website information regarding how to
24 receive covered telemedicine medical services , telehealth healthcare services, and
25 remote patient monitoring services.
26 * * *
27 B. This Section shall not require an issuer of a health coverage plan to display
28 negotiated contract payment rates for healthcare providers who contract with the
29 issuer to provide telemedicine medical services or telehealth healthcare services.
Page 3 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 §1843. Remote patient monitoring services
2 A. The legislature hereby finds all of the following:
3 * * *
4 (2) The goal of remote patient monitoring services provided through
5 telemedicine or telehealth is to coordinate primary, acute, behavioral, and long-term
6 social service needs for high need, high cost patients.
7 B. To receive reimbursement for the delivery of remote patient monitoring
8 services through telehealth, all of the following conditions shall be met:
9 (1) The services shall consist of all of the following:
10 (a) An assessment, problem identification, and evaluation which includes all
11 of the following:
12 * * *
13 (ii) Detection of condition changes based on the telemedicine or telehealth
14 encounter that may indicate the need for a change in the plan of care.
15 (b) Implementation of a management plan through one or more of the
16 following:
17 (i) Teaching regarding medication management as appropriate based on the
18 telemedicine or telehealth findings for that encounter.
19 * * *
20 (iv) Coordination of care with the ordering healthcare provider regarding the
21 telemedicine or telehealth findings.
22 * * *
23 Section 2. R.S. 28:53(B)(1), the introductory paragraph of 53(B)(4), 53(F), (G)(2),
24 the introductory paragraph of 53(G)(7)(a), the introductory paragraph of 53(G)(7)(b) and
25 53(G)(7)(b)(ii), and (J)(1) are hereby amended and reenacted to read as follows:
26 §53. Admission by emergency certificate; extension; payment for services rendered
27 * * *
28 B.(1) Any physician licensed or permitted by the Louisiana State Board of
29 Medical Examiners, physician assistant when acting in accordance with their
Page 4 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 respective clinical practice guidelines, psychiatric mental health nurse practitioner,
2 other nurse practitioner who acts in accordance with a collaborative practice
3 agreement and receives verbal approval for executing the certificate from his
4 collaborating physician, or psychologist may execute an emergency certificate only
5 after an actual examination of a person alleged to have a mental illness or be
6 suffering from a substance-related or addictive disorder who is determined to be in
7 need of immediate care and treatment in a treatment facility because the examining
8 physician, physician assistant when acting in accordance with their respective
9 clinical practice guidelines, psychiatric mental health nurse practitioner, other nurse
10 practitioner who acts in accordance with a collaborative practice agreement and
11 receives verbal approval for executing the certificate from his collaborating
12 physician, or psychologist determines the person to be dangerous to self or others or
13 to be gravely disabled. The actual examination of the person by a psychiatrist or
14 psychiatric mental health nurse practitioner may be conducted by telemedicine
15 telehealth utilizing video conferencing technology provided that a licensed
16 healthcare professional who can adequately and accurately assist with obtaining any
17 necessary information including but not limited to the information listed in
18 Paragraph (4) of this Subsection shall be in the examination room with the patient
19 at the time of the video conference. A patient examined in such a manner shall be
20 medically cleared prior to admission to a mental health treatment facility. Failure to
21 conduct an examination prior to the execution of the certificate will be evidence of
22 gross negligence.
23 * * *
24 (4) In the case of an emergency certificate issued pursuant to an examination
25 conducted by telemedicine telehealth pursuant to Paragraph (1) of this Subsection
26 and Paragraph (J)(1) of this Section, the licensed healthcare professional present
27 during the actual examination shall be responsible for obtaining, recording, and
28 attaching to the emergency certificate the following information regarding the video
29 conference:
Page 5 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 * * *
2 F. An emergency certificate shall constitute legal authority to transport a
3 patient to a treatment facility and shall permit the director of such treatment facility
4 to detain the patient for diagnosis and treatment for a period not to exceed fifteen
5 days, and to return the patient to the facility if he is absent with or without
6 permission during authorized periods of detention. If necessary, peace officers shall
7 apprehend and transport, or ambulance services, under appropriate circumstances,
8 may locate and transport, a patient on whom an emergency certificate has been
9 completed to a treatment facility at the request of either the director of the facility,
10 the certifying physician, physician assistant when acting in accordance with their
11 respective clinical practice guidelines, psychiatric mental health nurse practitioner,
12 other nurse practitioner who acts in accordance with a collaborative practice
13 agreement and receives verbal approval for executing the certificate from his
14 collaborating physician, or psychologist, the patient's next of kin, the patient's
15 curator, or the agency legally responsible for his welfare. In the case of an
16 emergency certificate issued pursuant to an examination conducted by telemedicine
17 telehealth pursuant to Paragraph (B)(1) of this Section, or where the valid original
18 is not provided to the transporter, a copy transmitted by facsimile or other electronic
19 device shall be sufficient authority for the peace officer or ambulance worker to
20 transport the patient to a treatment facility and for the director to accept such patient.
21 The psychiatrist shall cause the original certificate to be deposited in the United
22 States mail properly addressed to the director of the treatment facility by the next
23 business day following the date of examination. The director of the treatment facility
24 shall notify the patient's nearest relative, if known, or designated responsible party,
25 if any, in writing, of the patient's admission by emergency certificate as soon as
26 reasonably possible.
27 G. * * *
28 (2) Within seventy-two hours of admission, the person shall be independently
29 examined by the coroner or his deputy who shall execute an emergency certificate,
Page 6 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 pursuant to Subsection B of this Section, which shall be a necessary precondition to
2 the person's continued confinement. Except as provided in Paragraph (7) of this
3 Subsection, if the actual examination by the psychiatrist referred to in Paragraph
4 (B)(1) of this Section is conducted by telemedicine, telehealth, the seventy-two-hour
5 independent examination by the coroner shall be conducted in person.
6 * * *
7 (7) As it relates to the parish of St. Tammany, all of the following shall apply:
8 (a) The coroner or deputy coroner, who is a physician, preferably a
9 psychiatrist, may conduct an examination and execute an emergency certificate, as
10 provided in Subparagraph (b) of this Paragraph, by telemedicine telehealth utilizing
11 video conferencing equipment, provided that all of the following are met:
12 * * *
13 (b) The coroner or deputy coroner, who is a physician, preferably a
14 psychiatrist, may conduct an examination and execute an emergency certificate, as
15 provided in Subparagraph (a) of this Paragraph by telemedicine telehealth under all
16 of the following circumstances:
17 * * *
18 (ii) If the coroner conducted the initial examination, pursuant to Paragraph
19 (3) of this Subsection, by telemedicine telehealth and has executed the first
20 emergency commitment certificate, a second examination shall be made in person
21 within the seventy-two hour period set forth in this Part by any psychiatrist,
22 psychiatric mental health nurse practitioner, or a psychologist at the treatment
23 facility where the person is confined.
24 * * *
25 J.(1) Upon the request of a credible person of legal age who is financially
26 unable to afford a private physician or who cannot immediately obtain an
27 examination by a physician, the parish coroner may render, or the coroner or a judge
28 of a court of competent jurisdiction may cause to be rendered by a physician, an
29 actual examination of a person alleged to have a mental illness or be suffering from
Page 7 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 a substance-related or addictive disorder and in need of immediate medical treatment
2 because he is dangerous to himself or others or is gravely disabled. The actual
3 examination of the person by a psychiatrist may be conducted by telemedicine
4 telehealth utilizing video conferencing technology provided that a licensed
5 healthcare professional who can adequately and accurately assist with obtaining any
6 necessary information including but not limited to the information listed in
7 Paragraph (B)(4) of this Section shall be in the examination room with the patient
8 at the time of the video conference. If the coroner is not a physician he may deputize
9 a physician to perform this examination. To accomplish the examination authorized
10 by this Subsection, if the coroner or the judge is apprehensive that his own safety or
11 that of the deputy or other physician may be endangered thereby, he shall issue a
12 protective custody order pursuant to R.S. 28:53.2.
13 * * *
14 Section 3. R.S. 37:1262(4), 1271, the introductory paragraph of 1271.1(A) and
15 1271.1(A)(2) and (3), and 1285.2(D)(2) are hereby amended and reenacted to read as
16 follows:
17 §1262. Definition
18 As used in this Part the following words and phrases shall have the meanings
19 ascribed to them:
20 * * *
21 (4) "Telemedicine" means the practice of health care delivery, diagnosis,
22 consultation, treatment, and transfer of medical data by a physician using technology
23 that enables the physician and a patient at two locations separated by distance to
24 interact. Such technology may include electronic communications, information
25 technology, asynchronous store-and-forward transfer technology, or technology that
26 facilitates synchronous interaction between a physician at a distant site and a patient
27 at an originating site. The term "telemedicine" shall not include any of the following:
28 (a) Electronic mail messages and text messages that are not compliant with
29 applicable requirements of the Health Insurance Portability and Accountability Act
Page 8 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 of 1996, as amended 42 U.S.C. 1320d et seq.
2 (b) Facsimile transmissions.
3 "Telehealth" shall have the same meaning as that term defined in R.S.
4 40:1223.3.
5 * * *
6 §1271. License to practice medicine or telemedicine required
7 A. No Except as provided in the Louisiana Telehealth Access Act, R.S.
8 40:1223.1 et seq., no person shall practice medicine as defined in this Part until he
9 possesses a duly recorded license issued pursuant to this Part, a permit or registration
10 as provided for in this Part, or a certificate issued pursuant to Part I-D of this
11 Chapter.
12 B.(1) No person shall practice or attempt to practice medicine across state
13 lines without first complying with the provisions of this Part and without being a
14 holder of either an unrestricted license to practice medicine in Louisiana or a
15 telemedicine license entitling him to practice medicine pursuant to R.S. 37:1276.1.
16 (2) Except as provided in R.S. 37:1271.1 and 1276.1, all of the following
17 shall apply to any physician practicing telemedicine as defined in this Part:
18 (a) The physician practicing telemedicine shall use the same standard of care
19 as if the healthcare services were provided in person.
20 (b) The physician practicing telemedicine shall not be required to conduct an
21 in-person patient history or physical examination of the patient before engaging in
22 a telemedicine encounter if the physician satisfies all of the following conditions:
23 (i) Holds an unrestricted license to practice medicine in Louisiana.
24 (ii) Has access to the patient's medical records upon consent of the patient.
25 (iii) Creates a medical record on each patient and makes such record available
26 to the board upon request.
27 (iv) If necessary, provides a referral to a physician in this state or arranges for
28 follow-up care in this state as may be indicated.
29 (3) Except as authorized by R.S. 37:1271.1 or otherwise by rule promulgated
Page 9 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 by the board, no physician practicing telemedicine pursuant to this Subsection shall
2 prescribe any controlled dangerous substance prior to conducting an appropriate
3 in-person patient history or physical examination of the patient as determined by the
4 board.
5 (4) (a) A patient receiving telemedicine services may be in any location at the
6 time that the telemedicine services are rendered. A physician practicing telemedicine
7 may be in any location when providing telemedicine services to a patient.
8 (b) A physician practicing telemedicine may utilize interactive audio without
9 the requirement of video if, after access and review of the patient's medical records,
10 the physician determines that he is able to meet the same standard of care as if the
11 healthcare services were provided in person.
12 (5) A physician practicing telemedicine shall document the telemedicine
13 services rendered in the patient's medical records according to the same standard as
14 that required for nontelemedicine services. Medical records including but not limited
15 to video, audio, electronic, or other records generated as a result of providing
16 telemedicine services shall be considered as confidential and shall be subject to all
17 applicable state and federal laws and regulations relative to the privacy of health
18 information.
19 (6) Venue in any suit filed involving care rendered via telemedicine shall be
20 in accordance with the provisions of R.S. 40:1223.5.
21 §1271.1. Practice of telemedicine telehealth in licensed healthcare facilities
22 A. All of the following restrictions and authorizations apply to a physician
23 who holds an unrestricted license to practice medicine from the board and who
24 practices telemedicine telehealth upon any patient who is being treated at a
25 healthcare facility that is required to be licensed pursuant to the laws of this state and
26 which holds a current registration with the United States Drug Enforcement
27 Administration:
28 * * *
29 (2) The physician shall be authorized to may prescribe any controlled
Page 10 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 dangerous substance without necessity of conducting an appropriate in-person
2 patient history or physical examination of the patient as otherwise would be required
3 by R.S. 37:1271(B)(2).
4 (3) The physician shall not be subject to any regulatory prohibition or
5 restriction on the practice of telemedicine, telehealth, including prohibitions or
6 restrictions related to prescribing controlled dangerous substances, which are in any
7 manner more restrictive than the prohibitions and restrictions that are otherwise
8 applicable to the entire practice of medicine.
9 * * *
10 §1285.2. Investigations and adjudications; staff; complaints; board procedure;
11 rulemaking authority
12 * * *
13 D. * * *
14 (2) The provisions of Paragraph (1) of this Subsection shall apply to practice
15 performance reviews of physicians practicing telemedicine. telehealth.
16 * * *
17 Section 4. R.S. 40:1046(K), 1165.2(B), 1167.2(6), 1167.4(E) and (F), 1223.2(3),
18 1223.3(3) and (5), 1223.4(A) and (B)(3), 1223.5, 1237.1(A)(9)(a)(ii)(bb), and 2195.1(A)(6)
19 are hereby amended and reenacted and R.S. 40:1223.4(B)(5), (6), and (7) are hereby enacted
20 to read as follows:
21 §1046. Recommendation and dispensing of marijuana for therapeutic use; rules and
22 regulations of the Louisiana Board of Pharmacy; production facility
23 licensing; permitting by the Louisiana Department of Health
24 * * *
25 K. Nothing in this Part shall be construed or enforced in any manner that
26 prevents a physician a clinician authorized by Subsection A of this Section to
27 recommend therapeutic marijuana from recommending therapeutic marijuana
28 through telemedicine, telehealth, as defined in R.S. 37:1262, R.S. 40:1223.3 in this
29 state.
Page 11 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 * * *
2 §1165.2. Health Care Information Technology and Infrastructure Advisory
3 Collaborative; membership; powers and duties; annual report
4 * * *
5 B. The legislature hereby establishes the Health Care Information
6 Technology and Infrastructure Collaborative to be composed of LARHIX, the Health
7 Information Technology Committee of the Louisiana Health Care Quality Forum and
8 any other current or future regional health information exchange, hereinafter referred
9 to in this Section as "collaborative." The collaborative shall advise the secretary of
10 the Louisiana Department of Health on strategies for the advancement of the use of
11 electronic health information technology through the identification of state laws and
12 regulations that impede such advancement, including but not limited to those laws
13 and regulations that concern the form of consent to medical treatment and
14 authorization for other health care transactions, and matters related to facilitation of
15 telemedicine telehealth consultations.
16 * * *
17 §1167.2. Legislative findings; purpose
18 The legislature finds that:
19 * * *
20 (6) In 2007, the state authorized the secretary to enter into a Cooperative
21 Endeavor Agreement ("CEA") with the Rural Hospital Coalition, Inc. (the
22 "Coalition"), for the establishment of the Louisiana Rural Health Information
23 Exchange (LARHIX), a multi-regional health care information exchange. With the
24 funding provided, seven rural hospitals acquired EHR technology and were linked
25 to Louisiana State University Health Sciences Center - Shreveport (LSUHSC-S) via
26 a state-of-the-art integration engine, permitting a panel of specialists to access a rural
27 patient's medical record in real time while consulting with the patient over the
28 telemedicine telehealth equipment located at the rural hospital. In 2008, the state
29 entered into a five-year CEA with the Coalition and provided funding to expand the
Page 12 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 network to seven additional rural hospitals. LARHIX has been honored as a network
2 model with multiple award nominations by national technology organizations.
3 * * *
4 §1167.4. Establishment of the Electronic Health Records Loan Program
5 * * *
6 E. The secretary is authorized to enter into CEAs to facilitate with any entity
7 access to the ARRA loan program funding and to make loans to eligible providers
8 to provide for the acquisition and implementation of certified EHR technology by
9 eligible providers, and where integrated, telemedicine telehealth technology.
10 F. To provide for the expansion and administration of LARHIX and other
11 related matters, the secretary shall enter into a CEA with the Coalition, the terms of
12 which shall govern the program's loans made available to rural hospitals, and with
13 the secretary's approval, to other rural health care providers who have elected to
14 partner with rural hospitals in the acquisition of certified EHR technology. For
15 purposes of this Subsection and to the extent permitted by the ARRA, certified EHR
16 technology will include telemedicine telehealth technology which such technology
17 is fully integrated with the certified EHR technology acquired by the hospital.
18 * * *
19 §1223.2. Legislative findings
20 The legislature hereby finds and declares the following:
21 * * *
22 (3) Telehealth services could potentially address a great unmet need for
23 health care by persons who have limited access to both traditional healthcare settings
24 and to telemedicine as currently defined in Louisiana law.
25 * * *
26 §1223.3. Definitions
27 As used in this Part, the following terms have the meaning ascribed in this
28 Section:
29 * * *
Page 13 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 (3) "Healthcare provider" means a person, partnership, limited liability
2 partnership, limited liability company, corporation, facility, or institution licensed
3 or certified by this state to practice medicine or provide healthcare health care or
4 healthcare professional services as a physician assistant; hospital; nursing home;
5 dentist; registered nurse; advanced practice registered nurse; licensed dietitian or
6 nutritionist; licensed practical nurse; certified nurse assistant; offshore health service
7 provider; ambulance service; licensed midwife; pharmacist; speech-language
8 pathologist; audiologist; optometrist; podiatrist; chiropractor; physical therapist;
9 occupational therapist; certified or licensed athletic trainer; psychologist; medical
10 psychologist; social worker; licensed professional counselor; licensed perfusionist;
11 licensed respiratory therapist; licensed radiologic technologist; licensed hearing aid
12 dealer; licensed, certified, or registered addiction counselor; licensed, certified, or
13 registered prevention professional; certified compulsive gambling counselor;
14 behavioral health provider who works for a licensed agency or credentialed provider
15 which provides community psychiatric support and treatment services or
16 psychosocial rehabilitation services as defined in R.S. 40:2162; or licensed clinical
17 laboratory scientist which may be provided by telehealth in the ordinary course
18 of business or practice of a profession.
19 * * *
20 (5) "Synchronous interaction" means communication through interactive
21 technology that enables a healthcare provider and a patient at two locations separated
22 by distance to interact via two-way video and audio transmissions simultaneously.
23 The healthcare provider may utilize interactive audio without the requirement of
24 video if, after access and review of the patient's medical records, the provider
25 determines that he is able to meet the same standard of care as if the healthcare
26 services were provided in person.
27 * * *
28 §1223.4. Telehealth; rulemaking required
29 A. Each state agency or professional or occupational licensing board or
Page 14 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 commission that regulates the practice of a healthcare provider, as defined in this
2 Part, may shall promulgate, in accordance with the Administrative Procedure Act,
3 any rules necessary to provide for, promote, and regulate the use of telehealth in the
4 delivery of healthcare services within the scope of practice regulated by the licensing
5 entity. However, any rules and regulations shall be consistent with and no more
6 restrictive than the provisions contained in this Section.
7 B. The rules shall, at a minimum, provide for all of the following:
8 * * *
9 (3)(a) Licensing or registration of out-of-state healthcare providers who seek
10 to furnish healthcare services via telehealth to persons at originating sites in
11 Louisiana. The rules shall ensure that any such the healthcare provider possesses, at
12 a minimum, an unrestricted and unencumbered license in good standing to perform
13 the healthcare service in the state in which the healthcare provider is located, and that
14 the license is comparable to its corresponding license in Louisiana as determined by
15 the respective Louisiana licensing agency, board, or commission.
16 (b) Each state agency and professional or occupational licensing board or
17 commission is authorized to may provide by rule for a reasonable fee for the license
18 or registration provided for in this Subsection.
19 * * *
20 (5) Except as otherwise provided in Paragraph (6) of this Subsection, a
21 healthcare provider shall not be required to conduct an in-person patient
22 history or physical examination of the patient before engaging in a telehealth
23 encounter but shall provide a referral to a healthcare provider in this state or
24 arrange for follow-up care in this state as necessary.
25 (6) Except as authorized by R.S. 37:1271.1 or otherwise by rule
26 promulgated by a state agency or professional or occupational licensing board
27 or commission, no healthcare provider shall prescribe any controlled dangerous
28 substance prior to conducting an appropriate in-person patient history or
29 physical examination of the patient as determined by the appropriate state
Page 15 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 agency or professional or occupational licensing board or commission.
2 (7) A healthcare provider may use interactive audio without the
3 requirement of video if, after access and review of the patient's medical records,
4 the healthcare provider determines that he is able to meet the same standard of
5 care as if the healthcare services were provided in person.
6 * * *
7 §1223.5. Venue; telehealth and telemedicine
8 Venue in any suit filed involving care rendered via telehealth pursuant to the
9 provisions of this Part or telemedicine pursuant to the provisions of R.S. 37:1271(B)
10 shall be proper and instituted before the district court of the judicial district in which
11 the patient resides or in the district court having jurisdiction in the parish where the
12 patient was physically located during the provision of the telehealth or telemedicine
13 service. The patient is considered physically located at the originating site as defined
14 in R.S. 40:1223.3.
15 * * *
16 §1237.1. Definitions and general application
17 A. As used in this Part:
18 * * *
19 (9)(a) "State health care provider" or "person covered by this Part" means:
20 * * *
21 (ii) A person acting in a professional capacity in providing health care
22 services, by or on behalf of the state, including but not limited to a physician,
23 psychologist, coroner, and assistant coroner who is a licensed physician when acting
24 solely in accordance with the Behavioral Health Law as provided in R.S. 28:50 et
25 seq., provided that the premium costs of such malpractice coverage shall be the
26 responsibility of the coroner's office, dentist, a licensed dietician or licensed
27 nutritionist employed by, referred by, or performing work under contract for, a state
28 health care provider or other person already covered by this Part, registered nurse,
29 licensed practical nurse, nurse practitioner, clinical nurse specialist, pharmacist,
Page 16 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
1 optometrist, podiatrist, physical therapist, occupational therapist, licensed respiratory
2 therapist, licensed radiologic technologist, licensed clinical laboratory scientist,
3 social worker, hospital administrator, or licensed professional counselor, who is
4 either:
5 * * *
6 (bb) Performing voluntary professional or telemedicine telehealth services
7 in a health care facility or institution for or on behalf of the state.
8 * * *
9 §2195.1. State office of rural health
10 A. Within the Louisiana Department of Health, the Louisiana state office of
11 rural health shall:
12 * * *
13 (6) Provide statewide technical assistance in conjunction with the Louisiana
14 Rural Health Association on establishment of rural health clinics and on grant
15 writing, especially related to rural health outreach grants, telemedicine telehealth
16 grants, and other grants available to increase rural health access.
17 * * *
18 Section 5. R.S. 46:978.1(2) is hereby amended and reenacted to read as follows:
19 §978.1. Definitions
20 As used in this Chapter, the following definitions shall apply:
21 * * *
22 (2) "Health information technology" shall mean information technology used
23 in health care, including but not limited to electronic health records/electronic
24 records or electronic medical records, computerized physician order entry, health
25 information exchange, telemedicine telehealth, and other relevant information
26 technology deemed appropriate by the secretary of the department.
27 * * *
28 Section 6. R.S. 22:1841(6) and R.S. 37:1276.1 are hereby repealed.
29 Section 7. This Act shall become effective on January 1, 2024.
Page 17 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions. SB NO. 66
SLS 23RS-82 ORIGINAL
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Brandi Cannon.
DIGEST
SB 66 Original 2023 Regular Session Fred Mills
Present law provides for the practice of telemedicine by physicians and the practice of
telehealth by all other healthcare providers. Proposed law repeals provisions relative to
telemedicine and specifies that telehealth includes a physician's practice of medicine when
conducted through electronic communications.
Present law authorizes each state agency or professional or occupational licensing board or
commission that regulates the practice of a healthcare provider to promulgate any rules
necessary to provide for, promote, and regulate the use of telehealth in the delivery of
healthcare services within the scope of practice regulated by the licensing entity. Proposed
law changes the authorization to a requirement for the state agency or professional or
occupational licensing board or commission to promulgate rules for telehealth.
Present law provides for the minimum content of the rules to be promulgated by the
regulatory state agency or professional or occupational licensing board or commission.
Proposed law retains present law and adds a prohibition on any requirement for an in-person
patient history or physical examination of the patient before engaging in a telehealth
encounter unless the healthcare provider is prescribing a controlled dangerous substance.
Proposed law further provides for exceptions to the requirement for an in-person patient
history or physical examination when prescribing a controlled dangerous substance.
Proposed law makes technical changes in present law to update references from telemedicine
to telehealth to conform with proposed law.
Effective January 1, 2024.
(Amends R.S. 22:11(C)(1)(a)(i), 1821(F)(1) and (2), 1841(3), 1842(A)(1) and (B), and
1843(A)(2) and (B)(1)(a)(ii) and (b)(i) and (iv), R.S. 28:53(B)(1), 53(B)(4)(intro para),
53(F), (G)(2), 53(G)(7)(a)(intro para) and 53(G)(7)(b)(intro para) and 53(G)(7)(b)(ii), and
(J)(1), R.S. 37:1262(4), 1271, 1271.1(A)(intro para), 1271.1(A)(2) and (3), 1285.2(D)(2),
R.S. 40:1046(K), 1165.2(B), 1167.2(6), 1167.4(E) and (F), 1223.2(3), 1223.3(3) and (5),
1223.4(A) and (B)(3), 1223.5, 1237.1(A)(9)(a)(ii)(bb), and 2195.1(A)(6), and R.S.
46:978.1(2); adds R.S. 40:1223.4(B)(5)-(7); repeals R.S. 22:1841(6) and R.S. 37:1276.1)
Page 18 of 18
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.