2023 -- S 0965 SUBSTITUTE A AS AMENDED

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     STATE OF RHODE ISLAND

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

Telemedicine Coverage Act" is hereby amended to read as follows:

     27-81-3. Definitions.

     As used in this chapter:

     (1) “Clinically appropriate” means care that is delivered in the appropriate medical setting.

     (2) “Distant site” means a site at which a healthcare provider is located while providing

healthcare services by means of telemedicine.

     (3) “Healthcare facility” means an institution providing healthcare services or a healthcare

setting, including, but not limited to: hospitals and other licensed, inpatient centers; ambulatory

surgical or treatment centers; skilled nursing centers; residential treatment centers; diagnostic,

laboratory and imaging centers; and rehabilitation and other therapeutic health settings.

     (4) “Healthcare professional” means a physician or other healthcare practitioner licensed,

accredited, or certified to perform specified healthcare services consistent with state law.

     (5) “Healthcare provider” means a healthcare professional or a healthcare facility.

     (6) “Healthcare services” means any services included in the furnishing to any individual

of medical, podiatric, or dental care, or hospitalization, or incident to the furnishing of that care or

hospitalization, and the furnishing to any person of any and all other services for the purpose of

preventing, alleviating, curing, or healing human illness, injury, or physical disability.

     (7) “Health insurer” means any person, firm, or corporation offering and/or insuring

healthcare services on a prepaid basis, including, but not limited to, a nonprofit service corporation,

a health maintenance organization, the Rhode Island Medicaid program, including its contracted

managed care entities, or an entity offering a policy of accident and sickness insurance.

     (8) “Health maintenance organization” means a health maintenance organization as defined

in chapter 41 of this title.

     (9) “Medically necessary” means medical, surgical, or other services required for the

prevention, diagnosis, cure, or treatment of a health-related condition, including services necessary

to prevent a decremental change in either medical or mental health status.

     (10) “Nonprofit service corporation” means a nonprofit hospital service corporation as

defined in chapter 19 of this title, or a nonprofit medical service corporation as defined in chapter

20 of this title.

     (11) “Originating site” means a site at which a patient is located at the time healthcare

services are provided to them by means of telemedicine, which can include a patient’s home where

medically necessary and clinically appropriate.

     (12) “Patient-provider relationship” means a collaborative effort between a patient and a

healthcare professional for the provision of healthcare services that may be established when the

healthcare professional agrees to undertake diagnosis and treatment of the patient, and the patient

agrees to be treated, whether or not there is an in-person encounter between the healthcare

professional and patient. A patient-provider relationship may be established via synchronous

telemedicine technologies as defined in subsection (16) of this section, without any requirement of

a prior in-person meeting, so long as the standard of care is met, the treatment delivered to the

patient is within the scope of practice for which the healthcare professional is a Rhode Island

licensed medical professional, and is delivered pursuant to the same standard of care that would

apply to the delivery of the treatment in an in-person setting, including obtaining the patient's

informed consent to be treated using telemedicine, furnishing the patient with the healthcare

provider's location, contact information and licensure credentials, and providing the patient with

information sufficient to locate appropriate follow up care. Notwithstanding the foregoing,

asynchronous telemedicine technologies may be used to establish a patient-provider relationship

solely for orthodontic services.

     (13) “Policy of accident and sickness insurance” means a policy of accident and sickness

insurance as defined in chapter 18 of this title.

     (13)(14) “Rhode Island Medicaid program” means a state-administered, medical assistance

program that is funded by the state and federal governments under Title XIX and Title XXI of the

U.S. Social Security Act and any general or public laws and administered by the executive office

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of health and human services.

     (14)(15) “Store-and-forward technology” means the technology used to enable the

transmission of a patient’s medical information from an originating site to the healthcare provider

at the distant site without the patient being present.

     (15)(16) “Telemedicine” means the delivery of clinical healthcare services by use of real

time, two-way synchronous audio, video, telephone-audio-only communications or electronic

media or other telecommunications technology including, but not limited to: online adaptive

interviews, remote patient monitoring devices, audiovisual communications, including the

application of secure video conferencing or store-and-forward technology to provide or support

healthcare delivery, which facilitate the assessment, diagnosis, counseling and prescribing

treatment, and care management of a patient’s health care while such patient is at an originating

site and the healthcare provider is at a distant site, consistent with applicable federal laws and

regulations. “Telemedicine” does not include an email message or facsimile transmission between

the provider and patient, or an automated computer program used to diagnose and/or treat ocular

or refractive conditions.

     SECTION 2. This act shall take effect upon passage.

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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

agrees to undertake diagnosis and treatment of the patient and the patient agrees to be treated. This

act further allows for a relationship to be established without any requirement of a prior in-person

meeting so long as the standard of care is met.

     This act would take effect upon passage.

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