2023 -- S 0965 SUBSTITUTE A AS AMENDED
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LC002697/SUB A
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S T A T E O F R H O D E I S L A N D
IN GENERAL ASSEMBLY
JANUARY SESSION, A.D. 2023
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A N A C T
RELATING TO INSURANCE -- THE TELEMEDICINE COVERAGE ACT
Introduced By: Senators LaMountain, and Lauria
Date Introduced: May 02, 2023
Referred To: Senate Health & Human Services
It is enacted by the General Assembly as follows:
SECTION 1. Section 27-81-3 of the General Laws in Chapter 27-81 entitled "The 1
Telemedicine Coverage Act" is hereby amended to read as follows: 2
27-81-3. Definitions. 3
As used in this chapter: 4
(1) “Clinically appropriate” means care that is delivered in the appropriate medical setting. 5
(2) “Distant site” means a site at which a healthcare provider is located while providing 6
healthcare services by means of telemedicine. 7
(3) “Healthcare facility” means an institution providing healthcare services or a healthcare 8
setting, including, but not limited to: hospitals and other licensed, inpatient centers; ambulatory 9
surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic, 10
laboratory and imaging centers; and rehabilitation and other therapeutic health settings. 11
(4) “Healthcare professional” means a physician or other healthcare practitioner licensed, 12
accredited, or certified to perform specified healthcare services consistent with state law. 13
(5) “Healthcare provider” means a healthcare professional or a healthcare facility. 14
(6) “Healthcare services” means any services included in the furnishing to any individual 15
of medical, podiatric, or dental care, or hospitalization, or incident to the furnishing of that care or 16
hospitalization, and the furnishing to any person of any and all other services for the purpose of 17
preventing, alleviating, curing, or healing human illness, injury, or physical disability. 18
(7) “Health insurer” means any person, firm, or corporation offering and/or insuring 19
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healthcare services on a prepaid basis, including, but not limited to, a nonprofit service corporation, 1
a health maintenance organization, the Rhode Island Medicaid program, including its contracted 2
managed care entities, or an entity offering a policy of accident and sickness insurance. 3
(8) “Health maintenance organization” means a health maintenance organization as defined 4
in chapter 41 of this title. 5
(9) “Medically necessary” means medical, surgical, or other services required for the 6
prevention, diagnosis, cure, or treatment of a health-related condition, including services necessary 7
to prevent a decremental change in either medical or mental health status. 8
(10) “Nonprofit service corporation” means a nonprofit hospital service corporation as 9
defined in chapter 19 of this title, or a nonprofit medical service corporation as defined in chapter 10
20 of this title. 11
(11) “Originating site” means a site at which a patient is located at the time healthcare 12
services are provided to them by means of telemedicine, which can include a patient’s home where 13
medically necessary and clinically appropriate. 14
(12) “Patient-provider relationship” means a collaborative effort between a patient and a 15
healthcare professional for the provision of healthcare services that may be established when the 16
healthcare professional agrees to undertake diagnosis and treatment of the patient, and the patient 17
agrees to be treated, whether or not there is an in-person encounter between the healthcare 18
professional and patient. A patient-provider relationship may be established via synchronous 19
telemedicine technologies as defined in subsection (16) of this section, without any requirement of 20
a prior in-person meeting, so long as the standard of care is met, the treatment delivered to the 21
patient is within the scope of practice for which the healthcare professional is a Rhode Island 22
licensed medical professional, and is delivered pursuant to the same standard of care that would 23
apply to the delivery of the treatment in an in-person setting, including obtaining the patient's 24
informed consent to be treated using telemedicine, furnishing the patient with the healthcare 25
provider's location, contact information and licensure credentials, and providing the patient with 26
information sufficient to locate appropriate follow up care. Notwithstanding the foregoing, 27
asynchronous telemedicine technologies may be used to establish a patient-provider relationship 28
solely for orthodontic services. 29
(13) “Policy of accident and sickness insurance” means a policy of accident and sickness 30
insurance as defined in chapter 18 of this title. 31
(13)(14) “Rhode Island Medicaid program” means a state-administered, medical assistance 32
program that is funded by the state and federal governments under Title XIX and Title XXI of the 33
U.S. Social Security Act and any general or public laws and administered by the executive office 34
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of health and human services. 1
(14)(15) “Store-and-forward technology” means the technology used to enable the 2
transmission of a patient’s medical information from an originating site to the healthcare provider 3
at the distant site without the patient being present. 4
(15)(16) “Telemedicine” means the delivery of clinical healthcare services by use of real 5
time, two-way synchronous audio, video, telephone-audio-only communications or electronic 6
media or other telecommunications technology including, but not limited to: online adaptive 7
interviews, remote patient monitoring devices, audiovisual communications, including the 8
application of secure video conferencing or store-and-forward technology to provide or support 9
healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing 10
treatment, and care management of a patient’s health care while such patient is at an originating 11
site and the healthcare provider is at a distant site, consistent with applicable federal laws and 12
regulations. “Telemedicine” does not include an email message or facsimile transmission between 13
the provider and patient, or an automated computer program used to diagnose and/or treat ocular 14
or refractive conditions. 15
SECTION 2. This act shall take effect upon passage. 16
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EXPLANATION
BY THE LEGISLATIVE COUNCIL
OF
A N A C T
RELATING TO INSURANCE -- THE TELEMEDICINE COVERAGE ACT
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This act would define a patient-provider relationship as when the healthcare professional 1
agrees to undertake diagnosis and treatment of the patient and the patient agrees to be treated. This 2
act further allows for a relationship to be established without any requirement of a prior in-person 3
meeting so long as the standard of care is met. 4
This act would take effect upon passage. 5
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