Truly Agreed, 2016

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SB 579, 2016    (Amended Section - Proposed Language)

334.108. 1. Prior to prescribing any drug, controlled substance, or other treatment through telemedicine, as defined in section 191.1145, or the internet, a physician shall establish a valid physician-patient relationship as described in section 191.1146. This relationship shall include:
     (1) Obtaining a reliable medical history and performing a physical examination of the patient, adequate to establish the diagnosis for which the drug is being prescribed and to identify underlying conditions or contraindications to the treatment recommended or provided;
     (2) Having sufficient dialogue with the patient regarding treatment options and the risks and benefits of treatment or treatments;
     (3) If appropriate, following up with the patient to assess the therapeutic outcome;
     (4) Maintaining a contemporaneous medical record that is readily available to the patient and, subject to the patient's consent, to the patient's other health care professionals; and
     (5) Maintaining the electronic prescription information as part of the patient's medical record.
     2. The requirements of subsection 1 of this section may be satisfied by the prescribing physician's designee when treatment is provided in:
     (1) A hospital as defined in section 197.020;
     (2) A hospice program as defined in section 197.250;
     (3) Home health services provided by a home health agency as defined in section 197.400;
     (4) Accordance with a collaborative practice agreement as defined in section 334.104;
     (5) Conjunction with a physician assistant licensed pursuant to section 334.738;
     (6) Conjunction with an assistant physician licensed under section 334.036;
     (7) Consultation with another physician who has an ongoing physician-patient relationship with the patient, and who has agreed to supervise the patient's treatment, including use of any prescribed medications; or
     (8) On-call or cross-coverage situations.
     3. No health care provider, as defined in section 376.1350, shall prescribe any drug, controlled substance, or other treatment to a patient based solely on an evaluation over the telephone; except that, a physician, such physician's on-call designee, an advanced practice registered nurse in a collaborative practice arrangement with such physician, a physician assistant in a supervision agreement with such physician, or an assistant physician in a supervision agreement with such physician may prescribe any drug, controlled substance, or other treatment that is within his or her scope of practice to a patient based solely on a telephone evaluation if a previously established and ongoing physician-patient relationship exists between such physician and the patient being treated.
     4. No health care provider shall prescribe any drug, controlled substance, or other treatment to a patient based solely on an internet request or an internet questionnaire.


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