| 7 | 6 | | ANACT |
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| 8 | 7 | | Torepealsection191.1145,RSMo,andtoenactinlieuthereofonenewsectionrelatingto |
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| 9 | 8 | | telehealthservices. |
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| 10 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
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| 11 | 10 | | SectionA.Section191.1145,RSMo,isrepealedandonenewsectionenactedinlieu |
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| 12 | 11 | | 2thereof,tobeknownassection191.1145,toreadasfollows: |
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| 13 | 12 | | 191.1145.1.Asusedinsections191.1145and191.1146,thefollowingtermsshall |
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| 14 | 13 | | 2mean: |
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| 15 | 14 | | 3 (1)"Asynchronousstore-and-forwardtransfer",thecollectionofapatient'srelevant |
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| 16 | 15 | | 4healthinformationandthesubsequenttransmissionofthatinformationfromanoriginating |
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| 17 | 16 | | 5sitetoahealthcareprovideratadistantsitewithoutthepatientbeingpresent; |
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| 18 | 17 | | 6 (2)"Clinicalstaff",anyhealthcareproviderlicensedinthisstate; |
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| 19 | 18 | | 7 (3)"Distantsite",asiteatwhichahealthcareproviderislocatedwhileproviding |
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| 20 | 19 | | 8healthcareservicesbymeansoftelemedicine; |
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| 21 | 20 | | 9 (4)"Healthcareprovider",asthattermisdefinedinsection376.1350; |
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| 22 | 21 | | 10 (5)"Originatingsite",asiteatwhichapatientislocatedatthetimehealthcare |
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| 23 | 22 | | 11servicesareprovidedtohimorherbymeansoftelemedicine.Forthepurposesof |
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| 24 | 23 | | 12asynchronousstore-and-forwardtransfer,originatingsiteshallalsomeanthelocationat |
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| 25 | 24 | | 13whichthehealthcareprovidertransfersinformationtothedistantsite; |
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| 26 | 25 | | 14 (6)"Telehealth"or"telemedicine",thedeliveryofhealthcareservicesbymeansof |
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| 27 | 26 | | 15informationandcommunicationtechnologies, includingaudiovisualandaudio-only |
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| 28 | 27 | | 16technologies,whichfacilitatetheassessment,diagnosis,consultation,treatment,education, |
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| 32 | 31 | | 19shallalsoincludetheuseofasynchronousstore-and-forwardtechnology.Healthcare |
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| 33 | 32 | | 20providersshallnotbelimitedintheirchoiceofelectronicplatformsusedtodeliver |
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| 34 | 33 | | 21telehealthortelemedicine,providedthatallservicesdeliveredareinaccordancewith |
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| 35 | 34 | | 22theHealthInsurancePortabilityandAccountabilityActof1996. |
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| 36 | 35 | | 23 2.Anylicensedhealthcareprovidershallbeauthorizedtoprovidetelehealthservices |
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| 37 | 36 | | 24ifsuchservicesarewithinthescopeofpracticeforwhichthehealthcareproviderislicensed |
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| 38 | 37 | | 25andareprovidedwiththesamestandardofcareasservicesprovidedinperson.Thissection |
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| 39 | 38 | | 26shallnotbeconstruedtoprohibitahealthcarrier,asdefinedinsection376.1350,from |
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| 40 | 39 | | 27reimbursingnonclinicalstaffforservicesotherwiseallowedbylaw. |
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| 41 | 40 | | 28 3.Inordertotreatpatientsinthisstatethroughtheuseoftelemedicineortelehealth, |
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| 42 | 41 | | 29healthcareprovidersshallbefullylicensedtopracticeinthisstateandshallbesubjectto |
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| 43 | 42 | | 30regulationbytheirrespectiveprofessionalboards. |
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| 44 | 43 | | 31 4.Nothinginsubsection3ofthissectionshallapplyto: |
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| 45 | 44 | | 32 (1)Informalconsultationperformedbyahealthcareproviderlicensedinanother |
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| 46 | 45 | | 33state,outsideofthecontextofacontractualrelationship,andonanirregularorinfrequent |
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| 47 | 46 | | 34basiswithouttheexpectationorexchangeofdirectorindirectcompensation; |
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| 48 | 47 | | 35 (2)Furnishingofhealthcareservicesbyahealthcareproviderlicensedandlocatedin |
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| 49 | 48 | | 36anotherstateincaseofanemergencyordisaster;providedthat,nochargeismadeforthe |
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| 50 | 49 | | 37medicalassistance;or |
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| 51 | 50 | | 38 (3)Episodicconsultationbyahealthcareproviderlicensedandlocatedinanother |
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| 52 | 51 | | 39statewhoprovidessuchconsultationservicesonrequesttoaphysicianinthisstate. |
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| 53 | 52 | | 40 5.Nothinginthissectionshallbeconstruedtoalterthescopeofpracticeofany |
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| 54 | 53 | | 41healthcareproviderortoauthorizethedeliveryofhealthcareservicesinasettingorina |
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| 55 | 54 | | 42mannernototherwiseauthorizedbythelawsofthisstate. |
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| 56 | 55 | | 43 6.Nooriginatingsiteforservicesoractivitiesprovidedunderthissectionshallbe |
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| 57 | 56 | | 44requiredtomaintainimmediateavailabilityofon-siteclinicalstaffduringthetelehealth |
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| 58 | 57 | | 45services,exceptasnecessarytomeetthestandardofcareforthetreatmentofthepatient's |
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| 59 | 58 | | 46medicalconditionifsuchconditionisbeingtreatedbyaneligiblehealthcareproviderwhois |
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| 60 | 59 | | 47notattheoriginatingsite,hasnotpreviouslyseenthepatientinpersoninaclinicalsetting, |
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| 61 | 60 | | 48andisnotprovidingcoverageforahealthcareproviderwhohasanestablishedrelationship |
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| 62 | 61 | | 49withthepatient.Healthcareprovidersshallnotbelimitedintheirchoiceofelectronic |
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| 63 | 62 | | 50platformsusedtodelivertelehealthortelemedicine. |
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