FIRSTREGULARSESSION
[PERFECTED]
HOUSEBILLNO.825
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVESTINNETT.
2075H.01P JOSEPHENGLER,ChiefClerk
ANACT
Torepealsection191.1145,RSMo,andtoenactinlieuthereofonenewsectionrelatingto
telehealthservices.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Section191.1145,RSMo,isrepealedandonenewsectionenactedinlieu
2thereof,tobeknownassection191.1145,toreadasfollows:
191.1145.1.Asusedinsections191.1145and191.1146,thefollowingtermsshall
2mean:
3 (1)"Asynchronousstore-and-forwardtransfer",thecollectionofapatient'srelevant
4healthinformationandthesubsequenttransmissionofthatinformationfromanoriginating
5sitetoahealthcareprovideratadistantsitewithoutthepatientbeingpresent;
6 (2)"Clinicalstaff",anyhealthcareproviderlicensedinthisstate;
7 (3)"Distantsite",asiteatwhichahealthcareproviderislocatedwhileproviding
8healthcareservicesbymeansoftelemedicine;
9 (4)"Healthcareprovider",asthattermisdefinedinsection376.1350;
10 (5)"Originatingsite",asiteatwhichapatientislocatedatthetimehealthcare
11servicesareprovidedtohimorherbymeansoftelemedicine.Forthepurposesof
12asynchronousstore-and-forwardtransfer,originatingsiteshallalsomeanthelocationat
13whichthehealthcareprovidertransfersinformationtothedistantsite;
14 (6)"Telehealth"or"telemedicine",thedeliveryofhealthcareservicesbymeansof
15informationandcommunicationtechnologies, includingaudiovisualandaudio-only
16technologies,whichfacilitatetheassessment,diagnosis,consultation,treatment,education,
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 17caremanagement,andself-managementofapatient'shealthcarewhilesuchpatientisatthe
18originatingsiteandthehealthcareproviderisatthedistantsite.Telehealthortelemedicine
19shallalsoincludetheuseofasynchronousstore-and-forwardtechnology.Healthcare
20providersshallnotbelimitedintheirchoiceofelectronicplatformsusedtodeliver
21telehealthortelemedicine,providedthatallservicesdeliveredareinaccordancewith
22theHealthInsurancePortabilityandAccountabilityActof1996.
23 2.Anylicensedhealthcareprovidershallbeauthorizedtoprovidetelehealthservices
24ifsuchservicesarewithinthescopeofpracticeforwhichthehealthcareproviderislicensed
25andareprovidedwiththesamestandardofcareasservicesprovidedinperson.Thissection
26shallnotbeconstruedtoprohibitahealthcarrier,asdefinedinsection376.1350,from
27reimbursingnonclinicalstaffforservicesotherwiseallowedbylaw.
28 3.Inordertotreatpatientsinthisstatethroughtheuseoftelemedicineortelehealth,
29healthcareprovidersshallbefullylicensedtopracticeinthisstateandshallbesubjectto
30regulationbytheirrespectiveprofessionalboards.
31 4.Nothinginsubsection3ofthissectionshallapplyto:
32 (1)Informalconsultationperformedbyahealthcareproviderlicensedinanother
33state,outsideofthecontextofacontractualrelationship,andonanirregularorinfrequent
34basiswithouttheexpectationorexchangeofdirectorindirectcompensation;
35 (2)Furnishingofhealthcareservicesbyahealthcareproviderlicensedandlocatedin
36anotherstateincaseofanemergencyordisaster;providedthat,nochargeismadeforthe
37medicalassistance;or
38 (3)Episodicconsultationbyahealthcareproviderlicensedandlocatedinanother
39statewhoprovidessuchconsultationservicesonrequesttoaphysicianinthisstate.
40 5.Nothinginthissectionshallbeconstruedtoalterthescopeofpracticeofany
41healthcareproviderortoauthorizethedeliveryofhealthcareservicesinasettingorina
42mannernototherwiseauthorizedbythelawsofthisstate.
43 6.Nooriginatingsiteforservicesoractivitiesprovidedunderthissectionshallbe
44requiredtomaintainimmediateavailabilityofon-siteclinicalstaffduringthetelehealth
45services,exceptasnecessarytomeetthestandardofcareforthetreatmentofthepatient's
46medicalconditionifsuchconditionisbeingtreatedbyaneligiblehealthcareproviderwhois
47notattheoriginatingsite,hasnotpreviouslyseenthepatientinpersoninaclinicalsetting,
48andisnotprovidingcoverageforahealthcareproviderwhohasanestablishedrelationship
49withthepatient.Healthcareprovidersshallnotbelimitedintheirchoiceofelectronic
50platformsusedtodelivertelehealthortelemedicine.
HB825 2 51 7.Nothinginthissectionshallbeconstruedtoalteranycollaborativepractice
52requirementasprovidedinchapters334and335.
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HB825 3