As of March 25, 2016, there have been 133 telehealth related bills introduced in 30 states across the nation. The most common legislation addresses reimbursement, telehealth professional standards, the need for in-person examinations, prescribing, and cross-state licensing.
Various states have introduced legislation or regulations that are related to how a patient-provider relationship is formed or the need for an in-person exam, often in contact with prescribing.
In Indiana, Governor Pence signed House Bill 1263 into law on March 21, 2016. Through this legislation, the Indiana General Assembly (IGA) has created an opportunity to utilize technology to extend healthcare access and availability via telemedicine. House Enrolled Act 1263 allows for providers to deliver some health care services to patients via approved technologies of; secure videoconferencing; interactive audio-using store and forward technology; or remote patient monitoring technology.
The approved providers include a licensed physician, physician’s assistant, and advanced practice nurse, and an optometrist. The standards for health care services are the same as those services provided at an in-person setting. Prescriptions issued via telemedicine are limited to; prescriptions within the provider’s scope of practice and certification; is not a controlled substance or an abortion inducing drug; and not glasses or contacts.
Providers may issue prescriptions for patients not previously physically seen, if the provider satisfies the applicable standard of care in the treatment of the patient and create and maintain a medical record for the patient. Providers outside of Indiana, utilizing telemedicine, must agree to be subject to the jurisdiction of the courts of Indiana and Indiana substantive and procedural laws.
In Ohio, House Bill 188 became effective on March 23, 2016. This enrolled act authorized a physician to establish a physician-patient relationship by the use of appropriate technology that permits, in a manner that is consistent with the minimal standard of care for in-person care by a physician, a medical evaluation and the collection of relevant clinical history as needed to establish a diagnosis, identify any underlying conditions, and identify any contraindications to the treatment that is recommended or provided.
In South Carolina, Senate Bill 1035 would allow for the establishment of a patient-provider relationship to be established via telemedicine, but not for purposes of prescribing.
In West Virginia, House Bill 4463 was sent to the Governor on March 23, 2016. This bill would establish a patient-provider relationship via telemedicine, but includes limits on prescribing.