Truly Agreed, 2016

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SB 579, 2016    (New Section - Proposed Language)

208.671. 1. As used in this section and section 208.673, the following terms shall mean:
     (1) "Asynchronous store-and-forward", the transfer of a participant's clinically important digital samples, such as still images, videos, audio, text files, and relevant data from an originating site through the use of a camera or similar recording device that stores digital samples that are forwarded via telecommunication to a distant site for consultation by a consulting provider without requiring the simultaneous presence of the participant and the participant's treating provider;
     (2) "Asynchronous store-and-forward technology", cameras or other recording devices that store images which may be forwarded via telecommunication devices at a later time;
     (3) "Consultation", a type of evaluation and management service as defined by the most recent edition of the Current Procedural Terminology published annually by the American Medical Association;
     (4) "Consulting provider", a provider who, upon referral by the treating provider, evaluates a participant and appropriate medical data or images delivered through asynchronous store-and-forward technology. If a consulting provider is unable to render an opinion due to insufficient information, the consulting provider may request additional information to facilitate the rendering of an opinion or decline to render an opinion;
     (5) "Distant site", the site where a consulting provider is located at the time the consultation service is provided;
     (6) "Originating site", the site where a MO HealthNet participant receiving services and such participant's treating provider are both physically located;
     (7) "Provider", any provider of medical, mental health, optometric, or dental health services, including all other medical disciplines, licensed and providing MO HealthNet services who has the authority to refer participants for medical, mental health, optometric, dental, or other health care services within the scope of practice and licensure of the provider;
     (8) "Telehealth", as that term is defined in section 191.1145;
     (9) "Treating provider", a provider who:
     (a) Evaluates a participant;
     (b) Determines the need for a consultation;
     (c) Arranges the services of a consulting provider for the purpose of diagnosis and treatment; and
     (d) Provides or supplements the participant's history and provides pertinent physical examination findings and medical information to the consulting provider.
     2. The department of social services, in consultation with the departments of mental health and health and senior services, shall promulgate rules governing the use of asynchronous store-and-forward technology in the practice of telehealth in the MO HealthNet program. Such rules shall include, but not be limited to:
     (1) Appropriate standards for the use of asynchronous store-and-forward technology in the practice of telehealth;
     (2) Certification of agencies offering asynchronous store-and-forward technology in the practice of telehealth;
     (3) Timelines for completion and communication of a consulting provider's consultation or opinion, or if the consulting provider is unable to render an opinion, timelines for communicating a request for additional information or that the consulting provider declines to render an opinion;
     (4) Length of time digital files of such asynchronous store-and-forward services are to be maintained;
     (5) Security and privacy of such digital files;
     (6) Participant consent for asynchronous store-and-forward services; and
     (7) Payment for services by providers; except that, consulting providers who decline to render an opinion shall not receive payment under this section unless and until an opinion is rendered.
Telehealth providers using asynchronous store-and-forward technology shall be required to obtain participant consent before asynchronous store-and-forward services are initiated and to ensure confidentiality of medical information.
     3. Asynchronous store-and-forward technology in the practice of telehealth may be utilized to service individuals who are qualified as MO HealthNet participants under Missouri law. The total payment for both the treating provider and the consulting provider shall not exceed the payment for a face-to-face consultation of the same level.
     4. The standard of care for the use of asynchronous store-and-forward technology in the practice of telehealth shall be the same as the standard of care for services provided in person.


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