HB 348 — AN ACT TO AMEND TITLES 18 AND 24 OF THE DELAWARE CODE RELATING TO TELEMEDICINE SERVICES.

“(2)The “DistantDivision site”of meansProfessional aRegulation siteshall atrequire whichany aout-of-state health care provider legallypracticing allowedin tothe practiceState inof theDelaware stateto iscomplete locateda whileMedical providingRequest healthForm careas serviceswell byas meanscomply ofwith telemedicineany orother telehealth.”registration FURTHERrequirements AMENDthe HouseDivision Substituteof No.Professional Regulation may establish.

1(2) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to Househim Billor No.her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

348provided, byhowever, strikingHD line: 278 to line 283 and inserting in lieu thereof the following:

“(8)KK “Distant: site” means a site at which a health care provider legally allowed to practice in the state is located while providing health care services by means of telemedicine or telehealth.” FURTHER AMEND House Substitute No.

1MAW toPage House2 Billof No.24 Released:

34806/23/2020 by01:06 strikingPM linenotwithstanding 315any toother lineprovision 320of law, insurers and insertingproviders inmay lieuagree thereofto alternative siting arrangements deemed appropriate by the following:parties.

“(8)(4) “Distant“Telehealth” site” means athe siteuse atof information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which asupport clinical health carecare, provider legallyconsultation, allowedpatient toand practiceprofessional inhealth-related theeducation, statepublic ishealth, locatedhealth whileadministration, providingand healthother care services byas meansdescribed ofin telemedicineregulation, orwhich telehealth.”may FURTHERnot AMENDrequire Housethe Substituteuse No.of technology permitting visual communication.

1(5) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to Houseprovide Billor No.support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in the state, or other jurisdiction when treating a Delaware resident, while such patient is at an originating site and the health care provider is at a distant site.

348Section by3. striking line 353 to line 358 and inserting in lieu thereof the following:

Amend Chapter 35 of Title 18 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 35.

Group and Blanket Health Insurance.

§ 3571R.

Telemedicine.

(a) As used in this section:

(1) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(2) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

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06/24/202006/23/2020 04:5301:06 PM “(i)78 “Distant(4) site”“Telehealth” means athe siteuse atof whichinformation aand healthcommunications caretechnologies providerconsisting legallyof allowedtelephones, toremote practicepatient inmonitoring thedevices stateor isother locatedelectronic whilemeans providingwhich support clinical health carecare, servicesprovider byconsultation, meanspatient ofand telemedicineprofessional orhealth-related telehealth.”education, FURTHERpublic AMENDhealth, Househealth Substituteadministration, No.and other services as described in regulation.

1which tomay Housenot Billrequire No.the use of technology permitting visual communication.

348(5) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by strikingmeans lineof 388real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to lineprovide 393or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and insertingself- management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in lieuthe thereofstate, or other jurisdiction when treating a Delaware resident while such patient is at an originating site and the following:health care provider is at a distant site.

“(i)(b) “DistantEach site”insurer meansproposing ato siteissue atindividual whichor agroup healthaccident careand providersickness legallyinsurance allowedpolicies to practice in the state is located while providing healthhospital, caremedical servicesand bysurgical, means of telemedicine or telehealth.”major FURTHERmedical AMENDcoverage Houseon Substitutean No.expense-incurred basis;

1each tocorporation Houseproviding Billindividual No.or group accident and sickness subscription contracts;

348and byeach strikinghealth linemaintenance 437organization toproviding linea 442health andcare insertingplan infor lieuhealth thereofcare services shall provide coverage for the following:cost of such health care services provided through telemedicine.

“(3)(c) “DistantEach site”insurer meansproposing ato siteissue atindividual whichor agroup healthaccident careand providersickness legallyinsurance allowedpolicies to practice in the state is located while providing healthhospital, caremedical servicesand bysurgical, means of telemedicine or telehealth.”major FURTHERmedical AMENDcoverage Houseon Substitutean No.expense-incurred basis;

1each tocorporation Houseproviding Billindividual No.or group accident and sickness subscription contracts;

348and byeach deletinghealth linesmaintenance 479organization andproviding linea 483health incare theirplan entiretyfor andhealth insertingcare inservices lieushall thereofprovide coverage for the following:cost of such health care services provided through telehealth as directed through regulations promulgated by the Department.

“site at which amay healthnot carerequire provider legally allowed to practice in the stateuse is located while providing health care services by means of telemedicinetechnology orpermitting telehealth.visual communication.

“OriginatingSection site””.4.

FURTHERAmend AMENDChapter House17, SubstituteTitle No.24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

1Chapter to17. House Bill No.

348Medical byPractice strikingAct lineSubchapter 497I. to line 502 and inserting in lieu thereof the following:

“(6)General “DistantProvisions. site” means a site at which a health care provider legally allowed to practice in the state is located while providing health care services by means of telemedicine or telehealth.” FURTHER AMEND House Substitute No.

1§1702 toDefinitions House[Effective Billuntil No.Jan.

3481, by2021]. striking line 623 to line 628 and inserting in lieu thereof the following:

“(5)The “Distantfollowing site”definitions meansapply a site at which a health care provider legally allowed to practicethis inchapter theunless stateotherwise isexpressly locatedstated while providing health care services by means of telemedicine or telehealth.”implied SYNOPSIS Since Governor Carney issued the Declaration of a State of Emergency as modified since March 12, 2020, the fear that Delaware’s health care system would be overwhelmed by the pandemiccontext: has eased to the point where the need to rely on out-of-state health care practitioners has diminished.

Accordingly,(4) this“Distant Amendmentsite” eliminatesmeans authorizationa forsite out-of-at statewhich practitionersa health care provider legally allowed to practice telemedicinein andthe telehealthstate or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware withif thelicensed exceptionunder ofthis mentaltitle is located while providing health care providers.services by means of telemedicine.

ItThe retainsDivision the suspension of anyHD Delaware: Board of Medical Licensure and Discipline Regulations which limit the practice of telemedicine.

TheKK authorization: to use audio-only communication devices and to dispense with a pre-existing patient provider relationship if it is impractical to have an in-person encounter prior to the delivery of telehealth services is maintained.

TheMAW suspensionPage of4 the Delaware Board of Medical24 LicensureReleased: and Discipline Regulation regarding prescribing opioids is also maintained.

06/23/2020 01:06 PM Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(10) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(16) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

regulation, which may not require the use of technology permitting visual communication.

(17) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, legally allowed to practice in the state, or other jurisdiction when treating a Delaware resident, while such patient is at an originating site and the health care provider is at a distant site.

§1702 Definitions [Effective Jan.

1, 2021].

The following definitions apply to this chapter unless otherwise expressly stated or implied by the context:

(4) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(11) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any HD :

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06/23/2020 01:06 PM other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(17) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

regulation, which may not require the use of technology permitting visual communication.

(18) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, legally allowed to practice in the state, or other jurisdiction when treating a Delaware resident, while such patient is at an originating site and the health care provider is at a distant site.

§ 1769D.

Telemedicine and Telehealth.

(c) Treatment and consultation recommendations made in an online setting or through audio only communication, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings.

(g) Prescriptions, including for opioids, made through telemedicine and under a physician-patient relationship may include controlled substances, subject to limitations as set by the Board substances.

Prescribing controlled substances utilizing telemedicine is subject to the same standard of care and requisite practice as prescribing for in-person visits.

(k) Telemedicine may be practiced without a physician-patient relationship during:

(1) Informal consultation performed by a physician outside the context of a contractual relationship and on an irregular or infrequent basis without the expectation or exchange of direct or indirect compensation;

(2) Furnishing of medical assistance by a physician in case of an emergency or disaster if no charge is made for the medical assistance;

or (3) Episodic consultation by a medical specialist located in another jurisdiction who provides such consultation services on request to a licensed health care professional.

(4) Circumstances which make it impractical for a patient to consult with a physician in-person prior to the delivery of telemedicine services.

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06/24/202006/23/2020 04:5301:06 PM 2141500320Section 5.

Amend Chapter 5, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 5.

Podiatry Subchapter I.

Board of Podiatry.

§ 502 Definitions [Effective until Jan.

1, 2021] The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(3) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(10) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(11) "Practice of podiatry" shall mean the diagnosis and the medical, surgical, mechanical, manipulative and electrical treatment of all ailments of the foot and ankle.

As appropriate in regulation, these services may be performed with the use of Telemedicine.

Podiatry may also include participation in Telehealth, as further defined in regulation.

Telemedicine or Telehealth regulations may not require the use of technology permitting visual communication.

Amputation of the foot shall be restricted to state licensed podiatrists who have completed an American Podiatric Medical Association accredited surgical residency program acceptable to the Board and have current amputation privileges, or have fulfilled the credentialing criteria of the surgical committee of the Joint Committee on Accreditation of Hospitals accredited hospital where the amputation is to be performed.

(17) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

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06/23/2020 01:06 PM (18) “Telemedicine” means the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

§ 502 Definitions [Effective Jan.

1, 2021] The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(3) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(11) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(13) "Practice of podiatry" shall mean the diagnosis and the medical, surgical, mechanical, manipulative and electrical treatment of all ailments of the foot and ankle.

As appropriate in regulation, these services may be performed with the use of Telemedicine.

Podiatry may also include participation in Telehealth, as further defined in regulation.

Telemedicine or Telehealth regulations may not require the use of technology permitting visual communication.

Amputation of the foot shall be restricted to state licensed podiatrists who have completed an American Podiatric Medical Association accredited surgical residency program acceptable to the Board and have current amputation privileges, or have fulfilled the credentialing criteria of the surgical committee of the Joint Committee on Accreditation of Hospitals accredited hospital where the amputation is to be performed.

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06/23/2020 01:06 PM (18) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(19) “Telemedicine” means the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

regulation, which may not require the use of technology permitting visual communication.

Section 6.

Amend Chapter 7, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 7.

Board of Chiropractic.

§ 701 Chiropractic defined;

limitation of chiropractic license.

(a)(1) "Chiropractic" means a drugless system of health care based on the principle that interference with the transmission of nerve impulses may cause disease.

(2) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(3) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(5) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, HD :

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06/23/2020 01:06 PM patient and professional health-related education, public health, health administration, and other services as described in regulation.

regulation, which may not require the use of technology permitting visual communication.

(6) “Telemedicine” means a form of telehealth which the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology requiring visual communication.

(b) The practice of chiropractic includes, but is not limited to, the diagnosing and locating of misaligned or displaced vertebrae (subluxation complex), using x-rays and other diagnostic test procedures.

The practice includes the use of telemedicine and may also include the practice of and participation in Telehealth, as further defined in regulation.

which may not require the use of technology requiring visual communication.

Practice of chiropractic includes the treatment through manipulation/adjustment of the spine and other skeletal structures and the use of adjunctive procedures not otherwise prohibited by this chapter.

Section 7.

Amend Chapter 11, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 11.

Dentistry and Dental Hygiene Subchapter I.

State Board of Dentistry and Dental Hygiene § 1101 Definitions [Effective until Jan.

1, 2021].

The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(8) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(11) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or HD :

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06/23/2020 01:06 PM telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(13) "Practice of dentistry" is defined as the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of the dentist's education, training and experience, in accordance with the ethics of the profession and applicable law.

The practice includes the use of Telemedicine and may also include participation in Telehealth as further defined in regulation.

which may not require the use of technology permitting visual communication.

A person shall be construed to practice dentistry who by verbal claim, sign, advertisement, opening of an office, or in any other way, including use of the words "dentist," "dental surgeon," the letters "D.D.S.," "D.M.D.," or other letters or titles, represents the person to be a dentist or who holds himself or herself out as able to perform, or who does perform, dental services or work.

A person shall be regarded as practicing dentistry who is a manager, proprietor, operator or conductor of a place for performing dental operations or who for a fee, salary or other reward paid, or to be paid either to himself or herself or to another person, performs or advertises to perform dental operations of any kind.

(18) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(19) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

§1101 Definitions [Effective Jan.

1, 2021].

The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

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06/23/2020 01:06 PM (8) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(12) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(15) "Practice of dentistry" is defined as the evaluation, diagnosis, prevention and/or treatment (nonsurgical, surgical or related procedures) of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent and associated structures and their impact on the human body provided by a dentist within the scope of the dentist's education, training and experience, in accordance with the ethics of the profession and applicable law.

The practice includes the use of Telemedicine and may also include participation in Telehealth as further defined in regulation.

which may not require the use of technology permitting visual communication.

A person shall be construed to practice dentistry who by verbal claim, sign, advertisement, opening of an office, or in any other way, including use of the words "dentist," "dental surgeon," the letters "D.D.S.," "D.M.D.," or other letters or titles, represents the person to be a dentist or who holds himself or herself out as able to perform, or who does perform, dental services or work.

A person shall be regarded as practicing dentistry who is a manager, proprietor, operator or conductor of a place for performing dental operations or who for a fee, salary or other reward paid, or to be paid either to himself or herself or to another person, performs or advertises to perform dental operations of any kind.

(19) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(20) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare HD :

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06/23/2020 01:06 PM delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

Section 8.

Chapter 19, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 19.

Nursing § 1902 Definitions [Effective until January 1, 2021].

(i) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider is licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(s) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(w) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(x) “Telemedicine” means the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

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06/23/2020 01:06 PM (y) "The practice of practical nursing" as a licensed practical nurse means the performance for compensation of nursing services by a person who holds a valid license pursuant to the terms of this chapter and who bears accountability for nursing practices which require basic knowledge of physical, social and nursing sciences.

These services, at the direction of a registered nurse or a person licensed to practice medicine, surgery or dentistry, include:

(8) The use of Telemedicine, as defined in this Chapter, and practice of and participation in Telehealth as further defined in regulation.

which may not require the use of technology permitting visual communication.

(z) "The practice of professional nursing" as a registered nurse means the performance of professional nursing services by a person who holds a valid license pursuant to the terms of this chapter, and who bears primary responsibility and accountability for nursing practices based on specialized knowledge, judgment and skill derived from the principles of biological, physical and behavioral sciences.

The registered nurse practices in the profession of nursing by the performance of activities, among which are:

(8) The use of telemedicine, as defined in this Chapter, and participation in Telehealth, as further defined in regulation.

which may not require the use of technology permitting vicommunication.

§ 1902 Definitions [Effective January 1, 2021].

(i) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider is licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(t) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(x) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

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06/23/2020 01:06 PM (y) “Telemedicine” means the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

(z) "The practice of practical nursing" as a licensed practical nurse means the performance for compensation of nursing services by a person who holds a valid license pursuant to the terms of this chapter and who bears accountability for nursing practices which require basic knowledge of physical, social and nursing sciences.

These services, at the direction of a registered nurse or a person licensed to practice medicine, surgery or dentistry, include:

(8) The use of Telemedicine, as defined in this Chapter, and practice of and participation in Telehealth as further defined in regulation.

which may not require the use of technology permitting visual communication.

(aa) "The practice of professional nursing" as a registered nurse means the performance of professional nursing services by a person who holds a valid license pursuant to the terms of this chapter, and who bears primary responsibility and accountability for nursing practices based on specialized knowledge, judgment and skill derived from the principles of biological, physical and behavioral sciences.

The registered nurse practices in the profession of nursing by the performance of activities, among which are:

(8) The use of telemedicine, as defined in this Chapter, and participation in Telehealth, as further defined in regulation.

which may not require the use of technology permitting visual communication.

§1933.

Telemedicine (a) Telemedicine shall not be utilized by an APRN with respect to any patient in the absence of an APRN-patient relationship.

except under circumstances which make it impractical for a patient to consult with the APRN in-person prior to the delivery of telemedicine services.

(c) Treatment and consultation recommendations made in an online setting, or through audio only communication, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional (encounter in person) settings.

(g) Prescriptions made through telemedicine, including for opioids, and under an APRN-patient relationship may include controlled substances, subject to limitations as set by the Board.

Section 9.

Amend Chapter 20, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

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06/23/2020 01:06 PM Chapter 20.

Occupational Therapy.

Subchapter I.

Board of Occupational Therapy Practice.

§ 2002 Definitions.

As used in this chapter:

(3) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(9)a.

“Occupational therapy services includes any of the following:

c.

“Occupational therapy services” or “practice of occupational therapy” may be provided through the use of Telemedicine in a manner deemed appropriate by regulation and may include participation in Telehealth as further defined in regulation.

Telemedicine or Telehealth regulations may not require the use of technology permitting visual communications.

(10) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(16) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(17) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced HD :

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06/23/2020 01:06 PM in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

Section 10.

Amend Chapter 21, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 21.

Optometry.

§2101 Definition of practice of optometry.

(e) The practice of optometry also includes services provided by Telemedicine and participation in Telehealth.

For the purposes of this section, “Telehealth” is defined as the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

“Telemedicine” means a form of Telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

“Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

“Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

“Store and forward transfer” means the transmission of a patient’s medical information either to or from an originating site or to or from the provider at the distant site, but does not require the patient being present nor must it be in real time.

Section 11.

Amend Chapter 25, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

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Pharmacy Subchapter I.

Objectives;

Definitions;

Board of Pharmacy § 2502 Definitions.

The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(6) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(17) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(23) "Practice of pharmacy" means the interpreting, evaluating, and dispensing of a practitioner's or prescriber's order.

The practice of pharmacy includes, but is not limited to, the proper compounding, labeling, packaging, and dispensing of a drug to a patient or the patient's agent, and administering a drug to a patient.

The practice of pharmacy includes the application of the pharmacist's knowledge of pharmaceutics, pharmacology, pharmacokinetics, drug and food interactions, drug product selection, and patient counseling.

It also includes:

g.

The use of Telemedicine and participation in Telehealth in a manner deemed appropriate by regulation, which may not require the use of technology permitting visual communication;

and (33) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(34) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare HD :

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which may not require the use of technology permitting visual communication.

Section 12.

Amend Chapter 30, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 30.

Mental Health and Chemical Dependency Professionals.

Subchapter I.

Board of Mental Health and Chemical Dependency Professionals.

§ 3002 Definitions.

The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(3) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(6) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(10) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(11) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- HD :

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which may not require the use of technology permitting visual communication.

Subchapter III.

Chemical Dependency Professionals §3041 Definitions.

As used in this subchapter:

(1) "Chemical dependency professional" is a person who uses addiction counseling methods to assist an individual or group to develop an understanding of alcohol and drug dependency problems, define goals, and plan action reflecting the individual's or group's interest, abilities and needs as affected by addiction problems.

Such services may be provided through the use of Telemedicine in a manner deemed appropriate by regulation.

Services also may include participation in Telehealth as further defined in regulation.

Telemedicine and Telehealth regulations may not require the use of technology permitting visual communication.

Section 13.

Amend Chapter 35, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 35.

Psychology Subchapter I.

Board of Examiners of Psychologists § 3502 Definitions.

The following words, terms and phrases, when used in this chapter shall have the meanings ascribed to them under this section, except where the context clearly indicates a different meaning:

(3) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(5) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

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06/23/2020 01:06 PM (7) "Practice of psychology" shall mean the observation, description, evaluation, interpretation and/or modification of human behavior by the application of psychological principles, methods, and/or procedures, for the purpose of preventing or eliminating symptomatic, maladaptive or undesired behavior, and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health and mental health.

The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes and neuropsychological function;

counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy;

diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as the psychological aspects of physical illness, accident, injury or disability;

and psychoeducational evaluation, therapy, remediation, and consultation.

Psychological services may be rendered to individuals, families, groups, organizations, institutions and the public.

The practice of psychology shall be construed within the meaning of this definition without regard to whether or not payment is received for services rendered.

The practice of psychology may be provided through the use of Telemedicine in a manner deemed appropriate by Regulation.

Services also may include participation in Telehealth as further defined in regulation.

Telemedicine and Telehealth regulations may not require the use of technology permitting visual communication.

(14) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(15) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

Section 14.

Amend Chapter 38, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 38.

Dietitian/Nutritionist Licensure Act § 3802 Definitions.

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06/23/2020 01:06 PM The following words, terms and phrases, when used in this chapter, shall have the meanings ascribed to them in this chapter, except where the context clearly indicates a different meaning:

(2) "Dietetic and nutrition therapy" shall mean the scope of services utilized in the delivery of preventive nutrition services and/or nutrition therapy.

It involves an assessment of the individual's specific nutritional needs and the development and implementation of an intervention plan.

The intervention plan can include nutrition education, counseling, administration and monitoring of specialized nutrition support and/or referrals for additional services.

This application and practice of "dietetic and nutrition therapy" shall include the following Scope of Practice:

Scope of Practice:

(i) The use of Telemedicine in a manner deemed appropriate by regulation.

This also may include participation in Telehealth as further defined in regulation.

Telemedicine and Telehealth regulations may not require the use of technology permitting visual communication.

(5) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(9) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(12) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(13) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- HD :

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which may not require the use of technology permitting visual communication.

Section 15.

Amend Chapter 39, Title 24 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:

Chapter 39.

Board of Social Work Examiners § 3902 Definitions.

As used in this chapter:

(13) “Distant site” means a site at which a health care provider legally allowed to practice in the state or at which a health care provider licensed in another jurisdiction who would be permitted to provide services in Delaware if licensed under this title is located while providing health care services by means of telemedicine or telehealth.

The Division of Professional Regulation shall require any out-of-state health care provider practicing in the State of Delaware to complete a Medical Request Form as well as comply with any other registration requirements the Division of Professional Regulation may establish.

(23) “Originating site” means a site in Delaware or outside of Delaware if the patient is a Delaware resident at which a patient is located at the time health care services are provided to him or her by means of telemedicine or telehealth, unless the term is otherwise defined with respect to the provision in which it is used;

provided, however, notwithstanding any other provision of law, insurers and providers may agree to alternative siting arrangements deemed appropriate by the parties.

(30) “Telehealth” means the use of information and communications technologies consisting of telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health-related education, public health, health administration, and other services as described in regulation.

which may not require the use of technology permitting visual communication.

(31) “Telemedicine” means a form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self- management of a patient’s health care by a licensee practicing within his or her scope of practice as would be practiced in-person with a patient and with other restrictions as defined in regulation.

which may not require the use of technology permitting visual communication.

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06/23/2020 01:06 PM § 3920 Telehealth and Telemedicine.

(a) Licensed clinical social work may be provided through the use of telemedicine as permitted by regulation, and may include participation in telehealth as further defined by this chapter and by regulation.

No telemedicine or telehealth regulations may require the use of technology permitting visual communication.

Section 16.

This act expires on July 1, 2021.

SYNOPSIS House Substitute No.

1 for House Bill No.

348 differs from HB 348 in the following ways:

1.

In Paragraph 2 of the Preamble, the exact language from Governor Carney’s Second Modification of the March 12, 2020 Declaration of a State of Emergency pertaining to suspension of the Delaware Board of Medical Licensure and Discipline Regulation 19 is incorporated to support Section 4 of the bill which specifies that physicians may prescribe opioids via telemedicine.

2.

A new Paragraph 3 has been added to the Preamble to reference a Joint Order of Health and Social Services and the Delaware Emergency Management Agency dated March 24, 2020 specifying categories of out-of-state health care practitioners who will be authorized to practice in Delaware during the state of emergency occasioned by COVID-19.

3.

The Substitute adds a requirement that out-of-state practitioners must complete a Medical Request Form and comply with any other regulations established by the Division of Professional Regulation.

4.

The Substitute eliminates language limiting the practice of telemedicine by both physicians and APRNs without a practitioner-patient relationship to the existence of COVID-19.

5.

The Substitute specifies that prescribing controlled substances including opioids prescribed via telemedicine is subject to the same standards of practice and includes a paragraph under existing law pertaining to authorization for APRNs to prescribe controlled substances and adds the authority to prescribe opioids by electronic means.

6.

The Synopsis has been changed to reflect that practitioners covered include respiratory therapists and physician assistants and the other changes in the Substitute bill.

This Act continues certain provisions in the Declaration of a State of Emergency for the State of Delaware dated March 12, 2020 due to a Public Health Threat as a result of the COVID-19 pandemic as modified related to telemedicine.

The Second Modification of the State of Emergency suspended all Title 24 statutory requirements that patients present in- person before telemedicine services may be provided and the requirement that a patient must be in Delaware at the time the telemedicine services are provided;

this Act continues the suspension of those requirements, but specifies that the requirement that a patient present in-person prior to the delivery of telemedicine services is excused under circumstances which make in-person presentation impractical.

The Tenth Modification of the State of Emergency suspended any requirement in regulation that required both audio and visual technology;

this Act prohibits any regulation pertaining to telemedicine requiring visual communication so as to permit telemedicine services via non-smart phones or land line connections.

It continues suspension of the Delaware Board of Medical Licensure and Discipline Regulation 19 limiting the scope of telemedicine, including with respect to prescribing opioids.

Professions not covered by this Act include those professionals who require direct supervision by the nature of the work such as licensed associate counselors of mental health.

Such professionals may engage in telemedicine and telehealth as provided by existing law.

Practitioners covered by the Medical Practices Act, 24 Del.

C.

Chapter 17 including Respiratory Care Practitioners and Physician Assistants, are covered by the Act.

Professions covered by Title 24 which do not currently have statutory telemedicine authorization are not covered.

This Act requires that telemedicine services permitted under this Act receive the same insurance coverage as under existing law.

The Act expires on July 1, 2021.

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