FIRST REGULAR SESSION
SENATE BILL NO. 94
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR LEWIS.
0749S.01I KRISTINA MARTIN, Secretary
AN ACT
To repeal section 191.1145, RSMo, and to enact in lieu thereof one new section relating to
telehealth services.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Section 191.1145, RSMo, is repealed and one 1
new section enacted in lieu thereof, to be known as section 2
191.1145, to read as follows:3
191.1145. 1. As used in sections 191.1145 and 1
191.1146, the following terms shall mean: 2
(1) "Asynchronous store-and-forward transfer", the 3
collection of a patient's relevant health information and 4
the subsequent transmission of that information from an 5
originating site to a health care provider at a distant site 6
without the patient being present; 7
(2) "Clinical staff", any health care provider 8
licensed in this state; 9
(3) "Distant site", a site at which a health care 10
provider is located while providing health care services by 11
means of telemedicine; 12
(4) "Health care provider", as that term is defined in 13
section 376.1350; 14
(5) "Originating site", a site at which a patient is 15
located at the time health care services are provided to him 16
or her by means of telemedicine. For the purposes of 17
asynchronous store-and-forward transfer, originating site 18 SB 94 2
shall also mean the location at which the health care 19
provider transfers information to the distant site; 20
(6) "Telehealth" or "telemedicine", the delivery of 21
health care services by means of information and 22
communication technologies , including audiovisual and audio - 23
only technologies, which facilitate the assessment, 24
diagnosis, consultation, treatment, education, care 25
management, and self -management of a patient's health care 26
while such patient is at the originating site and the health 27
care provider is at the distant site. Telehealth or 28
telemedicine shall also include the use of asynchronous 29
store-and-forward technology. Health care providers shall 30
not be limited in their choice of electronic platforms used 31
to deliver telehealth or telemedicine, provided that all 32
services delivered are in accordance with the Health 33
Insurance Portability and Accountability Act of 1996. 34
2. Any licensed health care provider shall be 35
authorized to provide telehealth services if such services 36
are within the scope of practice for whi ch the health care 37
provider is licensed and are provided with the same standard 38
of care as services provided in person. This section shall 39
not be construed to prohibit a health carrier, as defined in 40
section 376.1350, from reimbursing nonclinical staf f for 41
services otherwise allowed by law. 42
3. In order to treat patients in this state through 43
the use of telemedicine or telehealth, health care providers 44
shall be fully licensed to practice in this state and shall 45
be subject to regulation by thei r respective professional 46
boards. 47
4. Nothing in subsection 3 of this section shall apply 48
to: 49 SB 94 3
(1) Informal consultation performed by a health care 50
provider licensed in another state, outside of the context 51
of a contractual relationship, and on an irregular or 52
infrequent basis without the expectation or exchange of 53
direct or indirect compensation; 54
(2) Furnishing of health care services by a health 55
care provider licensed and located in another state in case 56
of an emergency or disaster ; provided that, no charge is 57
made for the medical assistance; or 58
(3) Episodic consultation by a health care provider 59
licensed and located in another state who provides such 60
consultation services on request to a physician in this 61
state. 62
5. Nothing in this section shall be construed to alter 63
the scope of practice of any health care provider or to 64
authorize the delivery of health care services in a setting 65
or in a manner not otherwise authorized by the laws of this 66
state. 67
6. No originating site for services or activities 68
provided under this section shall be required to maintain 69
immediate availability of on -site clinical staff during the 70
telehealth services, except as necessary to meet the 71
standard of care for the treatment of the patient's medical 72
condition if such condition is being treated by an eligible 73
health care provider who is not at the originating site, has 74
not previously seen the patient in person in a clinical 75
setting, and is not providing coverage for a health care 76
provider who has an established relationship with the 77
patient. Health care providers shall not be limited in 78
their choice of electronic platforms used to deliver 79
telehealth or telemedicine. 80 SB 94 4
7. Nothing in this section shall be construed to alter 81
any collaborative practice requirement as provided in 82
chapters 334 and 335. 83