INDIANAPOLIS, IN –Characterized as a “new chapter in healthcare delivery” by medical professionals, Indiana’s new telemedicine statutes go into effect on July 1 (House Act No. 1263) These new statutes create standardized telemedicine practice standards and remote prescribing rules. Core tenants of the new law include: formal definition of telemedicine and the accepted mode of communication; the expectations of a proper physician-patient relationship; the required patient records; remote prescribing; out-of-state certification; and commercial coverage.
“This new law continues to further Indiana’s strong national leadership position in telemedicine practice and applications, particularly in our rural areas, where the ability to offer physician and specialist’s expertise to geographically remote areas is paramount,” said Don Kelso, executive director of the Indiana Rural Health Association (IRHA). “This new law allows advances for practical application of telemedicine services in a numbers of ways, including providing access to specialists, decreased transit for at-risk patients, immediate access to life-saving consultations, as well as an innovative means to address the patient backlog that many rural doctor offices face.”
Kelso added that the new law “addresses the required standard of patient care, concerns of potential opioid abuse, the issue of thorough and transparent communication, and commercial billing.”
The new law replaces the Indiana Telehealth Pilot Program and received strong bi-partisan support, passing near unanimously in both the Indiana House and Senate. Gov. Mike Pence signed the act into law on March 21
Definition of Telemedicine and Accepted Modalities
Telemedicine is defined as health care service delivered using electronic information and communications technology between a provider and a patient in separate locations. Accepted communication modalities include: 1) secure videoconferencing; 2) interactive audio-using store and forward technology; or 3) remote patient monitoring technology.
Accepted communication modalities do not include: 1) audio-only communication; 2) a telephone call; 3) electronic mail; 4) an instant messaging conversation; 5) facsimile; 6) internet questionnaire; 7) telephone consultation; or 8) internet consultation.
Proper Physician-Patient Relationship
Through telemedicine, an in-person visit and examination is no longer required in order to establish a proper physician-patient relationship. According to the law, the examination must meet eight elements including 1.) contact information, 2.) the professional designation of the telehealth provider, 3.) informed consent, 4.) patient’s medical history, 5.) the diagnosis, evidence for diagnosis, and treatment options (including risks and benefits), 6.) written medical records, including clearly communicated prescription information, 7.) follow-up care information, and 8.) telemedicine summary shared with the patient.
Each telemedicine visit or consultation requires a patient record to be created, recorded, and forward to the primary care provider. State and federal laws continue to apply concerning the confidentiality and maintenance of the records. Primary care providers should be informed of any prescriptions written.
A key function is this law allows providers with prescriptive authority to write prescriptions for non-controlled substances, after establishing a provider-patient relationship through a telemedicine consultation.
Certain exceptions apply to prescription authority, including the inability to prescribe:
- a controlled substance (defined in IC 35-48-1-9).
- an abortion inducing drug (defined in IC 16-18-2-1.6).
- an ophthalmic device, including: 1) glasses; 2) contact lenses; or 3) low vision devices.
Telemedicine providers require certification through a professional licensing agency and is subject to Indiana jurisdiction of the courts of law as well as substantive and procedural laws.
Commercial Insurance Coverage
A telehealth commercial insurance coverage law, enacted in 2015, requires Indiana health plans to cover telehealth services, equal to the service covered via in-person consultations. Indiana is one of only 29 states plus Washington DC which enacted a commercial insurance coverage for telehealth services.
Several Indiana hospitals and primary care providers, including IHRA members, already offer telemedicine services. The new bill offers specific guidance and expectations when operating within the telehealth landscape, creating safety, transparency, and effectiveness.
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About the Indiana Rural Health Association
The Indiana Rural Health Association was organized in 1997 and is a nonprofit organization working to enhance the health and well-being of rural populations in Indiana through leadership, education, advocacy, collaboration, and resource development. The strength of the organization is through the present diverse membership and the founding organizers who are committed to impacting the health of citizens through the identification of rural health issues and through advocacy roles in both the public and private sectors. IRHA membership is made up of 3,300 diverse individuals and organizations, making it the largest state rural health association in the nation, and a nationally recognized leader in rural health care. For more information, visit www.indianaruralhealth.org
Contact: Becky Sanders 812-478-3919, ext. 232 firstname.lastname@example.org
Don Kelso (812) 478-3919 e-mail: email@example.com
Michael Snyder (317) 805-4870 e-mail: firstname.lastname@example.org
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