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| 7 | 7 | | LC002697/SUB A |
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| 8 | 8 | | ======== |
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| 9 | 9 | | S TATE OF RHODE IS LAND |
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| 10 | 10 | | IN GENERAL ASSEMBLY |
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| 11 | 11 | | JANUARY SESSION, A.D. 2023 |
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| 12 | 12 | | ____________ |
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| 13 | 13 | | |
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| 14 | 14 | | A N A C T |
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| 15 | 15 | | RELATING TO INSURANCE -- THE TELEMEDICINE COVERAGE ACT |
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| 16 | 16 | | Introduced By: Senators LaMountain, and Lauria |
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| 17 | 17 | | Date Introduced: May 02, 2023 |
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| 18 | 18 | | Referred To: Senate Health & Human Services |
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| 19 | 19 | | |
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| 20 | 20 | | |
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| 21 | 21 | | It is enacted by the General Assembly as follows: |
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| 22 | 22 | | SECTION 1. Section 27-81-3 of the General Laws in Chapter 27-81 entitled "The 1 |
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| 23 | 23 | | Telemedicine Coverage Act" is hereby amended to read as follows: 2 |
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| 24 | 24 | | 27-81-3. Definitions. 3 |
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| 25 | 25 | | As used in this chapter: 4 |
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| 26 | 26 | | (1) “Clinically appropriate” means care that is delivered in the appropriate medical setting. 5 |
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| 27 | 27 | | (2) “Distant site” means a site at which a healthcare provider is located while providing 6 |
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| 28 | 28 | | healthcare services by means of telemedicine. 7 |
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| 29 | 29 | | (3) “Healthcare facility” means an institution providing healthcare services or a healthcare 8 |
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| 30 | 30 | | setting, including, but not limited to: hospitals and other licensed, inpatient centers; ambulatory 9 |
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| 31 | 31 | | surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic, 10 |
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| 32 | 32 | | laboratory and imaging centers; and rehabilitation and other therapeutic health settings. 11 |
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| 33 | 33 | | (4) “Healthcare professional” means a physician or other healthcare practitioner licensed, 12 |
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| 34 | 34 | | accredited, or certified to perform specified healthcare services consistent with state law. 13 |
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| 35 | 35 | | (5) “Healthcare provider” means a healthcare professional or a healthcare facility. 14 |
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| 36 | 36 | | (6) “Healthcare services” means any services included in the furnishing to any individual 15 |
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| 37 | 37 | | of medical, podiatric, or dental care, or hospitalization, or incident to the furnishing of that care or 16 |
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| 38 | 38 | | hospitalization, and the furnishing to any person of any and all other services for the purpose of 17 |
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| 39 | 39 | | preventing, alleviating, curing, or healing human illness, injury, or physical disability. 18 |
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| 40 | 40 | | (7) “Health insurer” means any person, firm, or corporation offering and/or insuring 19 |
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| 41 | 41 | | |
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| 42 | 42 | | |
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| 43 | 43 | | LC002697/SUB A - Page 2 of 4 |
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| 44 | 44 | | healthcare services on a prepaid basis, including, but not limited to, a nonprofit service corporation, 1 |
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| 45 | 45 | | a health maintenance organization, the Rhode Island Medicaid program, including its contracted 2 |
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| 46 | 46 | | managed care entities, or an entity offering a policy of accident and sickness insurance. 3 |
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| 47 | 47 | | (8) “Health maintenance organization” means a health maintenance organization as defined 4 |
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| 48 | 48 | | in chapter 41 of this title. 5 |
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| 49 | 49 | | (9) “Medically necessary” means medical, surgical, or other services required for the 6 |
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| 50 | 50 | | prevention, diagnosis, cure, or treatment of a health-related condition, including services necessary 7 |
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| 51 | 51 | | to prevent a decremental change in either medical or mental health status. 8 |
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| 52 | 52 | | (10) “Nonprofit service corporation” means a nonprofit hospital service corporation as 9 |
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| 53 | 53 | | defined in chapter 19 of this title, or a nonprofit medical service corporation as defined in chapter 10 |
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| 54 | 54 | | 20 of this title. 11 |
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| 55 | 55 | | (11) “Originating site” means a site at which a patient is located at the time healthcare 12 |
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| 56 | 56 | | services are provided to them by means of telemedicine, which can include a patient’s home where 13 |
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| 57 | 57 | | medically necessary and clinically appropriate. 14 |
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| 58 | 58 | | (12) “Patient-provider relationship” means a collaborative effort between a patient and a 15 |
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| 59 | 59 | | healthcare professional for the provision of healthcare services that may be established when the 16 |
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| 60 | 60 | | healthcare professional agrees to undertake diagnosis and treatment of the patient, and the patient 17 |
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| 61 | 61 | | agrees to be treated, whether or not there is an in-person encounter between the healthcare 18 |
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| 62 | | - | professional and patient. A patient-provider relationship may be established via synchronous 19 |
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| 63 | | - | telemedicine technologies as defined in subsection (16) of this section, without any requirement of 20 |
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| 64 | | - | a prior in-person meeting, so long as the standard of care is met, the treatment delivered to the 21 |
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| 65 | | - | patient is within the scope of practice for which the healthcare professional is a Rhode Island 22 |
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| 66 | | - | licensed medical professional, and is delivered pursuant to the same standard of care that would 23 |
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| 67 | | - | apply to the delivery of the treatment in an in-person setting, including obtaining the patient's 24 |
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| 68 | | - | informed consent to be treated using telemedicine, furnishing the patient with the healthcare 25 |
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| 69 | | - | provider's location, contact information and licensure credentials, and providing the patient with 26 |
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| 70 | | - | information sufficient to locate appropriate follow up care. Notwithstanding the foregoing, 27 |
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| 71 | | - | asynchronous telemedicine technologies may be used to establish a patient-provider relationship 28 |
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| 72 | | - | solely for orthodontic services. 29 |
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| 73 | | - | (13) “Policy of accident and sickness insurance” means a policy of accident and sickness 30 |
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| 74 | | - | insurance as defined in chapter 18 of this title. 31 |
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| 75 | | - | (13)(14) “Rhode Island Medicaid program” means a state-administered, medical assistance 32 |
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| 76 | | - | program that is funded by the state and federal governments under Title XIX and Title XXI of the 33 |
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| 77 | | - | U.S. Social Security Act and any general or public laws and administered by the executive office 34 |
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| 62 | + | professional and patient. A patient-provider relationship may be established via either synchronous 19 |
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| 63 | + | or asynchronous telemedicine technologies without any requirement of a prior in-person meeting, 20 |
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| 64 | + | so long as the standard of care is met, the treatment delivered to the patient is within the scope of 21 |
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| 65 | + | practice for which the healthcare professional is a Rhode Island licensed medical professional, and 22 |
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| 66 | + | is delivered pursuant to the same standard of care that would apply to the delivery of the treatment 23 |
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| 67 | + | in an in-person setting, including obtaining the patient's informed consent to be treated using 24 |
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| 68 | + | telemedicine, furnishing the patient with the healthcare provider's location, contact information and 25 |
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| 69 | + | licensure credentials, and providing the patient with information sufficient to locate appropriate 26 |
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| 70 | + | follow up care. 27 |
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| 71 | + | (13) “Policy of accident and sickness insurance” means a policy of accident and sickness 28 |
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| 72 | + | insurance as defined in chapter 18 of this title. 29 |
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| 73 | + | (13)(14) “Rhode Island Medicaid program” means a state-administered, medical assistance 30 |
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| 74 | + | program that is funded by the state and federal governments under Title XIX and Title XXI of the 31 |
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| 75 | + | U.S. Social Security Act and any general or public laws and administered by the executive office 32 |
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| 76 | + | of health and human services. 33 |
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| 77 | + | (14)(15) “Store-and-forward technology” means the technology used to enable the 34 |
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| 81 | | - | of health and human services. 1 |
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| 82 | | - | (14)(15) “Store-and-forward technology” means the technology used to enable the 2 |
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| 83 | | - | transmission of a patient’s medical information from an originating site to the healthcare provider 3 |
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| 84 | | - | at the distant site without the patient being present. 4 |
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| 85 | | - | (15)(16) “Telemedicine” means the delivery of clinical healthcare services by use of real 5 |
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| 86 | | - | time, two-way synchronous audio, video, telephone-audio-only communications or electronic 6 |
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| 87 | | - | media or other telecommunications technology including, but not limited to: online adaptive 7 |
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| 88 | | - | interviews, remote patient monitoring devices, audiovisual communications, including the 8 |
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| 89 | | - | application of secure video conferencing or store-and-forward technology to provide or support 9 |
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| 90 | | - | healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing 10 |
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| 91 | | - | treatment, and care management of a patient’s health care while such patient is at an originating 11 |
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| 92 | | - | site and the healthcare provider is at a distant site, consistent with applicable federal laws and 12 |
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| 93 | | - | regulations. “Telemedicine” does not include an email message or facsimile transmission between 13 |
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| 94 | | - | the provider and patient, or an automated computer program used to diagnose and/or treat ocular 14 |
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| 95 | | - | or refractive conditions. 15 |
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| 96 | | - | SECTION 2. This act shall take effect upon passage. 16 |
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| 81 | + | transmission of a patient’s medical information from an originating site to the healthcare provider 1 |
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| 82 | + | at the distant site without the patient being present. 2 |
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| 83 | + | (15)(16) “Telemedicine” means the delivery of clinical healthcare services by use of real 3 |
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| 84 | + | time, two-way synchronous audio, video, telephone-audio-only communications or electronic 4 |
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| 85 | + | media or other telecommunications technology including, but not limited to: online adaptive 5 |
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| 86 | + | interviews, remote patient monitoring devices, audiovisual communications, including the 6 |
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| 87 | + | application of secure video conferencing or store-and-forward technology to provide or support 7 |
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| 88 | + | healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing 8 |
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| 89 | + | treatment, and care management of a patient’s health care while such patient is at an originating 9 |
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| 90 | + | site and the healthcare provider is at a distant site, consistent with applicable federal laws and 10 |
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| 91 | + | regulations. “Telemedicine” does not include an email message or facsimile transmission between 11 |
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| 92 | + | the provider and patient, or an automated computer program used to diagnose and/or treat ocular 12 |
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| 93 | + | or refractive conditions. 13 |
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| 94 | + | SECTION 2. This act shall take effect upon passage. 14 |
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