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New and Updated Laws and Pending Legislation, October 1998, supplementing
Telemedicine: Emerging Legal Issues
authored by
Alan S. Goldberg and Jocelyn F. Gordon
and published in April 1998 by
The assistance of Adam Hundley, candidate for admission to the bar of the Commonwealth of Massachusetts, is gratefully acknowledged in connection with the preparation of these materials.
[Note: the following are only summaries for general informational purposes, and reference should always be made to the actual bill or statute.]
H.R. 337: The Managed Care Consumer Protection Act of 1997, among other things, directs the Secretary of Health and Human Services to consider “telemedicine and other innovative means to provide follow-up care” when promulgating regulations regarding appropriate post-care delivery settings.
Last Action and Status: January 27, 1998 cosponsors were added. The bill is currently pending in the House Commerce Committee and the House Ways and Means Committee.
H.R. 1189: The Rural Health Improvement Act of 1997 directs the Secretary of Health and Human Services to “implement a methodology for making payments under Part B of the Medicare program for telemedicine services.”
Last Action and Status: February 26, 1998 cosponsors were added. The bill is currently pending in the House Commerce Committee and the House Ways and Means Committee.
H.R. 1415: The Patient Access to Responsible Care Act of 1997 requires that health insurance issuers maintain adequate arrangements with a sufficient number, mix, and distribution of health providers to ensure that covered items and services are available and accessible to each enrollee under health insurance coverage. For an issuer in a rural area, use of telemedicine shall be considered in determining whether these requirements have been met.
Last Action and Status: July 22, 1998 cosponsors were added. The bill is currently pending in the House Commerce Committee and the House Education and the Workforce Committee.
H.R. 1670: The Airline Passenger Safety Act of 1997 states that each airline carrier must enter into a contract with a clinic, hospital, or other appropriate and accredited medical care facility to provide the air carrier with medical advice or assistance at any time in the case of an in-flight medical emergency.
Last Action and Status: March 11, 1998 cosponsors were added. The bill is currently pending in the House Transportation and Infrastructure Committee.
H.R. 1715: The National Institute of Biomedical Imaging Establishment Act of 1997 establishes a National Institute to conduct and support research, training, and the dissemination of health information. Activities include research into technologies to expand applications of telemedicine.
Last Action and Status: June 6, 1998 cosponsors were added. The bill is currently pending in the House Commerce Committee.
H.R. 2160: The bill appropriates money in the Treasury pursuant to 7 USC 950aaa, not otherwise appropriated, for Agricultural, Rural Development, Federal Drug Administration, and Related Agencies programs for 1998 fiscal year, including funds for loans and grants for telemedicine and distance learning services in rural areas.
Last Action and Status: November 18, 1997 the bill was signed by the President. The legislation was enacted as Public Law 105-86.
H.R. 2905: The Comprehensive Managed Health Care Reform Act of 1997 states that managed care organizations that serve a medically underserved area must maintain adequate arrangements with a sufficient number, mix, and distribution of health care professionals and providers have a history of serving such areas. The use of telemedicine to provide covered items and services will be considered in determining if this requirement has been met.
Last Action and Status: March 11, 1998 cosponsors were added. The bill is currently pending in the House Commerce Committee, the House Education and the Workforce Committee, and the House Ways and Means Committee.
H.R. 4101: The bill provides $10,180,000, to remain available until expended, for loans and grants relating to telemedicine and distance learning services in rural areas.
Last Action and Status: October 2, 1998 a conference report was agreed to in the House. The bill has passed in the Senate and is awaiting further action in the House.
S. 2208: The Healthcare Quality Enhancement Act of 1998 establishes the Agency for Healthcare Quality. Among other things, the Agency will support and advance training for healthcare practitioners in the use of information systems, the creation of effective linkages between various sources of health information, the evaluation and use of computer-based health records, and the delivery and coordination of evidence-based healthcare services using real-time decision-support programs.
Last Action and Status: June 23, 1998 the bill was referred to committee. The bill is currently pending in the Senate Committee on Labor and Human Resources.
H.B. 592: Authorizes the Board of Optometry to issue a special purpose license to practice optometry across state lines. The Bill outlines the terms and conditions of such a license, and provides an exemption from the licensure requirements for “irregular and infrequent” practice across state lines.
Last Action and Status: May 1, 1998 the bill was signed by the Governor.
H.B. 2422: Appropriates $250,000 in fiscal year 1998-1999 for telemedicine pilot projects. Such projects must be designed to facilitate the provision of medical services to persons living in medically underserved areas.
Last Action and Status: May 29, 1998 the bill was signed by the Governor.
H.B. 2001: Appropriates $1,256,300 for the University of Arizona telemedicine network.
Last Action and Status: May 20, 1998 the bill was line item vetoed by the Governor.
S.B. 1133: Would have directed the state to adopt a comprehensive public policy that serves to facilitate the development, success, and prosperity of the encryption industry, recognizing that effective encryption will aid in the development of, inter alia, the telemedicine industry.
Last Action and Status: January 30, 1998 the bill died pursuant to Art. IV, sec. 10(c) of the Constitution.
A.B. 2780: The Assembly Bill revises the definition of telemedicine to include “the practice of health care delivery, diagnosis, consultation, treatment, transfer or medical data, and education using interactive audio, video, or data communications,” but excludes telephone conversations and electronic mail messages between a practitioner and patient from the definition. The bill also establishes minimum standards for audio and visual systems used in the provision of health care services under the Medi-Cal Program through telemedicine.
Last Action and Status: August 18, 1998 the bill was signed by the Governor.
S.B. 36: Defines the practice of medicine as “holding out one’s self to the public within this state as being able to diagnose, treat, prescribe for, palliate, or prevent any human disease, ailment, pain, injury, deformity, or physical or mental condition, whether by the use of drugs, surgery, manipulation, electricity, telemedicine, the interpretation of tests, images, or photographs, or any physical, mechanical, or other means whatsoever.” A license to practice medicine is not required for occasional rendering of services in Colorado by a physician licensed and residing in another state.
Last Action and Status: June 1, 1998 the bill was signed by the Governor.
S.B. 122: Would have created the Department of Communication and Information Resources (DCIR) as a principal department to coordinate communication and information resources management within state government. Such resources would have included telemedicine projects and applications.
Last Action and Status: June 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
E.O. 19: The Executive Order establishes the Multi-Use Network Task Force to encourage the aggregation of the state’s purchases for telecommunications services, promote the compatibility of equipment and software among state departments, and encourage private telecommunications carriers to invest in the infrastructure necessary to link a series of aggregated network access points. The efforts are intended, among other things, to support distance learning and telemedicine.
S.B. 325: Would have required a special purpose license for the practice of medicine in Delaware from across state lines. The bill defined the practice of medicine across state lines as giving a medical opinion, rendering a medical treatment, or determining an appropriate treatment by an out-of-state physician for a Delaware patient “by electronic or other means.” A license would not have been required for such activities if they occurred on an “irregular and infrequent” basis, defined as less than once monthly.
Last Action and Status: September 8, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.B. 1855: Would have required licensure of any physician, wherever located, who had primary authority over the care or diagnosis of a patient located in Florida. The bill exempted any nonresident physician who consulted with a physician licensed in Florida and who did not exercise such authority. The bill would have regarded a physician as exercising such authority who provides, through an ongoing regular arrangement, official authenticated interpretations of radiographic images to any health care practitioner or patient located in Florida.
Last Action and Status: July 16, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 1798: Would have required Florida licensure for out-of-state physicians that have primary authority over the care and diagnosis of a Florida patient.
Last Action and Status: July 20, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.B. 1903: Related generally to telemedicine.
Last Action and Status: September 8, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 1537: Related generally to telemedicine.
Last Action and Status: September 8, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 2258: Would have appropriated $500,000 to plan and develop the Hawaii Geriatric Research and Training Center at Kula Hospital, including funding for telemedicine.
Last Action and Status: September 8, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 2855: Would have provided for reimbursement for telehealth services by insurance plans, mutual benefit societies, and health maintenance organizations.
Last Action and Status: September 8, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.F. 2214: Would have authorized use of the Iowa Communications Network for telemedical purposes.
Last Action and Status: July 9, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.F. 2372: Stated that a policy or contract providing for third-party payment or pre-payment of health or medical expenses must provide coverage for costs associated with services provided through the use of telemedicine.
Last Action and Status: July 9, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.B. 321: A section of the bill appropriates $1,000,000 for telemedicine equipment and systems.
Last Action and Status: April 14, 1998 the bill was enacted as part of a line item veto by the Governor.
S.B. 447: Would have defined the practice of medicine to include diagnosing or treating ailments “through electronic transmission or other mechanisms of interstate commerce.” The bill would have provided that individuals may practice medicine without a Maryland license who reside in another jurisdiction and engage in consultation with physicians licensed in Maryland.
Last Action and Status: June 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.F. 100: Would have directed the Minnesota Office of Technology to attempt to establish Minnesota as a national and international leader in electronic commerce, including in the telemedicine field.
Last Action and Status: May 19, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 2259: The bill authorizes the State Department of Health to promulgate rules and regulations and to collect data for the implementation of telemedicine programs.
Last Action and Status: March 16, 1998 the bill was signed by the Governor.
S.B. 383: Establishes a committee to study the use of telemedicine, including issues related to licensing, professional standards, and reimbursement. The committee must report on its findings by November 1, 1998.
Last Action and Status: June 9, 1998 the bill was signed by the Governor.
H.B. 2868: Creates the Oklahoma Telehealth Act to provide for the “continued statewide development and implantation of a system for the delivery of medical and other health care services through the statewide telecommunications system.”
Last Action and Status: June 10, 1998 the bill was signed by the Governor.
S.B. 832: Creates the Telemedicine Advisory Council. Among other things, the Council will: (1) study the apparent barriers to the development of effective telemedicine services, and make recommendations for the overcoming of these barriers; (2) encourage agreements whereby individuals and organizations needing telemedicine services can obtain them on reasonable terms and conditions; and (3) advise and assist the governor and other officials in developing and furthering telemedicine services.
Last Action and Status: June 11, 1998 the bill was signed by the Governor.
H.B. 4358: The bill authorizes licensed practical nurses to provide certain services in residential settings and public schools without the on-site supervision of a nurse, doctor, or dentist if a registered nurse is available on call by telecommunications.
Last Action and Status: April 8, 1998 the bill became law without the Governor’s signature.
S.B. 146: The bill establishes Utah’s participation in the interstate compact on nurse licensure. The bill recognizes that advanced communication technologies require greater cooperation among the states in the area of nurse licensure. Therefore, a license to practice registered nursing issued by a home state to a resident in that state will be recognized by each party state as authorizing the practice of nursing in each party state.
Last Action and Status: March 14, 1998 the bill was signed by the Governor.
H.B. 351: The bill repeals and reenacts the Utah Nurse Practice Act, including an exemption from licensure for nurses licensed in a state that is a party to the interstate compact on nurse licensure.
Last Action and Status: March 21, 1998 the bill was signed by the Governor.
S.B. 245: Would have defined the practice of medicine across state lines to include the rendering of diagnostic or treatment services to a Vermont patient by a person located outside Vermont by transmission of individual patient data by electronic or other means. This definition does not include “irregular and infrequent” practice of medicine across state lines, nor “informal” practice without compensation. No person may engage in the practice of medicine across state lines without a special purpose license.
Last Action and Status: May 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.J.R. 210: Requests the Joint Commission on Health Care to study quality of care and reimbursement issues related to telemedicine.
Last Action and Status: March 10, 1998 the bill passed the Senate. The bill has passed in both houses and is awaiting further action.
H.B. 1216: A nonresident physician who provides direct care through tele-electronic means to a patient residing in Washington must be sponsored by a physician licensed to practice and residing in Washington. The medical quality assurance commission may define by rule the parameters for providing direct care through tele-electronic means, including guidelines for sponsoring nonresident licensed physicians.
Last Action and Status: May 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
H.B. 4073: Would have amended the West Virginia Medical Practice Act. The bill defines telemedicine and provides that no person may practice telemedicine without a West Virginia license. This rule does not apply to physicians in other states who are consulting with physicians licensed in West Virginia, if the period of consultation is not more than three months.
Last Action and Status: May 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
S.B. 385: Requires West Virginia licensure for physicians and podiatrists practicing across state lines.
Last Action and Status: May 18, 1998 the Regular Session ended with no carryover. The bill is currently dead.
A.B. 855: Would have established a new licensure category, the nonresident physician consultant license. The bill would have required that nonresident physician consultants receive this license prior to providing consultative services. The prohibition would not have applied to a person who provided less than 12 consultations per year or who provided consultations regarding less than 10 patients per year.
Last Action and Status: April 2, 1998 the bill failed to pass pursuant to Senate Joint Resolution 1.
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Copyright © 1998, Alan S. Goldberg, All Rights Reserved.
Last revised: 10/12/98