.jpg)
The Florida Legislature recently adjourned its 2016 regular session, during which it adopted a number of bills that will have an impact on the provision of health care items and services in Florida. Of particular relevance and immediate impact to physicians and other healthcare professionals is HB 7087, addressing the use of telehealth to provide healthcare items and services.In recent sessions the Florida Legislature has debated the extent to which the use of telehealth (also known as "telemedicine") services should be authorized in the State. Several studies have concluded that services provided via telehealth are equivalent to those available in an in-person encounter, allaying concerns regarding the impact of this new technology on the delivery of healthcare items and services. In light of these studies and the clear trend in other states, the Florida Legislature has adopted some clear guidelines regarding the use of telehealth in this State.
House Bill 7087, created § 456.47, F.S., defining "telehealth" as "the use of synchronous or asynchronous telecommunications technology by a healthcare provider to provide health care services, including, but not limited, patient assessment, diagnosis, consultation, treatment, and monitoring; transfer of medical data; patient and professional health-related education; public health services; and health administration." Note, telehealth does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.
Professionals who use telehealth in providing health care items and services ("telehealth providers") include, among others, physicians, Physician Assistants ("PAs"), dentists, nurses, Advanced Registered Nurse Practitioners ("ARNPs"), chiropractors, optometrists, pharmacists, dentists, and midwives. The standard of care for all telehealth providers is the same as that for their counterparts who provide in-person healthcare services. Telehealth providers may not use this medium to prescribe a controlled substance to treat chronic nonmalignant pain, except for their hospital inpatients, hospice patients, and nursing home residents.
In contrast to some states, Florida telehealth providers and patients may be in any location where the services are rendered. For example, a patient could be in their home, a kiosk in a pharmacy, or walking down the street using their smart phone to receive telehealth services. The medical records and documentation requirements for telehealth providers are the same as those imposed on similarly licensed professionals for their in-person services.
The Florida Legislature also authorized the registration of out-of-state telehealth providers who are not licensed to practice in the State. In order for an out-of-state healthcare telehealth provider to treat patients located in Florida, they must register with the applicable licensing board or the Department of Health, if there is no such board. An applicant also must pay a $150 registration fee, hold an active unencumbered license to practice their profession in another state, have no disciplinary actions prior five years, and biannually re-register. The statute makes clear that a foreign licensed healthcare provider who is also a telehealth provider in Florida may not open an office in the State to provide in-person healthcare services.
Whenever telehealth services are rendered at a location other than where both the patient and the healthcare professional are located, there is always a question of the appropriate venue for any litigation. This statute makes clear that the venue is the place where the patient is located at the time the services are rendered. Thus, if a physician located in Gainesville or Atlanta provides telehealth services to a patient in Miami-Dade County, that is the venue for resolving any dispute.
One issue not addressed in this legislation is requiring private payers to reimburse for telehealth services. The Legislature established the Telehealth Advisory Council within the Agency for Health Care Administration. The purpose of the Council will be to make recommendations, based on surveys and research findings, for use in developing and administering Florida’s telehealth program in the future. Presumably, that will include requiring reimbursement for these services.
Healthcare professionals and providers that are considering adopting or expanding their use of telehealth likely will have numerous questions that are not addressed in the statute. Thus, they should work closely with legal counsel and consultants who have expertise in this area of the law in order to ensure that their activities are in compliance at the minimum risk possible.
