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House Amendment 1
S 1035 - Session 121 (2015-2016)
SC Telemedicine Act
View Vote History
Reference is to Printer's Date 3/2/16--S.
Amend the bill, as and if amended, by striking SECTION 2 in its entirety and inserting:
/ SECTION 2. Article 1, Chapter 47, Title 40 of the 1976 Code is amended by adding:
"Section 40-47-37.
(A) A licensee who establishes a
physician-patient relationship solely via telemedicine as
defined in Section 40-47-20(52) shall adhere to the same
standard of care as a licensee employing more traditional
in-person medical care and be evaluated according to the
standard of care applicable to the licensee's area of specialty.
A licensee shall not establish a physician-patient relationship
by telemedicine pursuant to Section 40-47-113(B) for the purpose
of prescribing medication when an in-person physical examination
is necessary for diagnosis. The failure to conform to the
appropriate standard of care is considered unprofessional
conduct under Section 40-47-110(B)(9).
(B) A licensee who
establishes a physician-patient relationship solely via
telemedicine as defined in Section 40-47-20(52) shall generate
and maintain medical records for each patient using such
telemedicine services in compliance with any applicable state
and federal laws, rules, and regulations, including this
chapter, the Health Insurance Portability and Accountability Act
(HIPAA), and the Health Information Technology for Economic and
Clinical Health Act (HITECH). Such records shall be accessible
to other practitioners and to the patient in a timely fashion
when lawfully requested to do so by the patient or by a lawfully
designated representative of the patient.
(C) In addition to
those requirements set forth in subsections (A) and (B), a
licensee who establishes a physician-patient relationship solely
via telemedicine as defined in Section 40-47-20(52) shall:
(1)
adhere to current standards for practice improvement and
monitoring of outcomes and provide reports containing such
information upon request of the board;
(2)
provide an appropriate evaluation prior to diagnosing
and/or treating the patient, which need not be done in-person if
the licensee employs technology sufficient to accurately
diagnose and treat the patient in conformity with the applicable
standard of care; provided, that evaluations in which a licensee
is at a distance from the patient, but a practitioner is able to
provide various physical findings the licensee needs to complete
an adequate assessment, is permitted; further, provided, that a
simple questionnaire without an appropriate evaluation is
prohibited;
(3)
verify the identity and location of the patient and be
prepared to inform the patient of the licensee's name, location,
and professional credentials;
(4)
establish a diagnosis through the use of accepted medical
practices, which may include patient history, mental status
evaluation, physical examination, and appropriate diagnostic and
laboratory testing in conformity with the applicable standard of
care;
(5)
ensure the availability of appropriate follow-up care and
maintain a complete medical record that is available to the
patient and other treating health care practitioners, to be
distributed to other treating health care practitioners only
with patient consent and in accordance with applicable law and
regulation;
(6)
prescribe within a practice setting fully in compliance
with this section and during an encounter in which threshold
information necessary to make an accurate diagnosis has been
obtained in a medical history interview conducted by the
prescribing licensee; provided, however, that Schedule II and
Schedule III prescriptions are not permitted except for those
Schedule II and Schedule III medications specifically authorized
by the board, which may include, but not be limited to, Schedule
II-nonnarcotic and Schedule III-nonnarcotic medications;
further, provided, that licensees prescribing controlled
substances by means of telemedicine must comply with all
relevant federal and state laws including, but not limited to,
participation in the South Carolina Prescription Monitoring
Program set forth in Article 15, Chapter 53, Title 44 of the
1976 Code; further, provided, that prescribing of lifestyle
medications including, but not limited to, hormone replacement
therapies, birth control, or erectile dysfunction drugs are not
permitted unless approved by the board; further, provided, that
prescribing abortion-inducing drugs is not permitted unless
approved by the board; as used in this article
'abortion-inducing drug' means a medicine, drug, or any other
substance prescribed or dispensed with the intent of terminating
the clinically diagnosable pregnancy of a woman, with knowledge
that the termination will with reasonable likelihood cause the
death of the unborn child. This includes off-label use of drugs
known to have abortion-inducing properties, which are prescribed
specifically with the intent of causing an abortion, such as
misoprostol (Cytotec), and methotrexate. This definition does
not apply to drugs that may be known to cause an abortion, but
which are prescribed for other medical indications, including,
but not limited to, chemotherapeutic agents or diagnostic drugs.
Use of such drugs to induce abortion is also known as 'medical',
'drug-induced', and/or 'chemical abortion';
(7)
maintain a complete record of the patient's care according
to prevailing medical record standards that reflects an
appropriate evaluation of the patient's presenting symptoms;
provided that relevant components of the telemedicine
interaction be documented as with any other encounter;
(8)
maintain the patient's records' confidentiality and
disclose the records to the patient consistent with state and
federal law; provided, that licensees practicing telemedicine
shall be held to the same standards of professionalism
concerning medical records transfer and communication with the
primary care provider and medical home as licensees practicing
via traditional means; further, provided, that if a patient has
a primary care provider and a telemedicine provider for the same
ailment, then the primary care provider's medical record and the
telemedicine provider's record constitute one complete medical
record;
(9)
be licensed to practice medicine in South Carolina;
provided, however, a licensee need not reside in South Carolina
so long as he or she has a valid, current South Carolina medical
license; further, provided, that a licensee residing in South
Carolina who intends to practice medicine via telemedicine to
treat or diagnose patients outside of South Carolina shall
comply with other state licensing boards; and
(10)
discuss with the patient the value of having a primary
care medical home and, if the patient requests, provide
assistance in identifying available options for a primary care
medical home.
(D) A licensee,
practitioner, or any other person involved in a telemedicine
encounter must be trained in the use of the telemedicine
equipment and competent in its operation.
(E) Notwithstanding any
of the provisions of this section, the board shall retain all
authority with respect to telemedicine practice as granted in
Section 40-47-10(I) of this chapter." /
Renumber sections to conform.
Amend title to conform.