My CMS News and Ideas on Telemedicine in Florida

April 9, 2014

Who Gets to Be a Telemedicine Provider in Florida?

Filed under: Uncategorized — cbondsullivan @ 7:09 pm

Senate Bill 1646 was heard before the Senate Appropriations Subcommittee on Health and Human Services on April 9, 2014. Senator Bean provided an amended bill that altered a number of differences to bring it more in line with the House Bill 751. The new language was an attempt to resolve an interesting discussion that is shaping up in the Legislature over who gets to use telemedicine services and who doesn’t.

The initial Senate bill included all health care professionals as providers of telemedicine services. After several hearings this language was restricted to MDs and DOs only, much to the dismay of the Advanced Registered Nurse Practitioners (ARNPs) and Physician Assistants (PAs). The House had a different idea and allowed medical and osteopathic doctors, chiropractors, podiatrists, optometrists, nurses and dentists health care professionals to provide clinical services over a telemedicine link. Senator Bean’s amendment was an attempt to take the two competing bills and integrate them into an acceptable bill that the entire Legislature could vote on. During today’s committee hearing there was clear push back from radiology and other professional medical groups against letting anyone but a doctor provide telemedicine services.

A major sticking point with the “who gets to be a telemedicine provider” debate was the issue of out-of-state doctors. This debate has swirled around liability insurance, lawsuits, having to be licensed in Florida or being affiliated with a Florida hospital. There was a clear sentiment that neither the Florida Legislature nor the Florida Board of Medicine would have control over out-of-state doctors. Senator Bean’s amendment softened the requirements that had been included in the original bill, not requiring the out-of-state doctors to carry liability insurance or pay a fee to practice over telemedicine in Florida. An interesting argument by one of the committee members was that medical practice in Florida should be done by Florida doctors, overlooking the obvious benefit of telemedicine that would allow consultation services to medical experts anywhere in the country.

Opening up telemedicine services to doctors only did not seem to bother the committee. Reducing the controls over out-of-state doctors did create problems. Senator Bean’s amendment received an unfavorable vote, and the language as passed by earlier committees was passed – along with an amendment to limit the ability of out-of-state doctors to practice telemedicine with Florida patients.

This is just one of a number of interesting debates surrounding this bill. Next in line for discussion will be: “who gets to pay for telemedicine services.”

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