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House, Senate Grapple With Who Should Practice And How To Regulate Telemedicine

This photo shows how doctors can connect with patients using telemedicine

Jacksonville Doctor Phil Perry is the Chief Medical Officer for Saint Vincent Medical Center, and he’s been using telemedicine at the network’s new Clay County hospital. He says the intensive care staff’s ability to have experts on call at the push of a button has saved lives:

“We have seen one saved life in the care of a sepsis patient. Overall 7 patients’ lives have been saved by the performance of our telehealth facility," Perry told a House health committee.

Perry says the hospital has also seen shorter patient stays and the cost of having an expert on call is a third less than having to pay a doctor to see a patient in-person. The ability to connect doctors to clients who may be far away has lawmakers eyeing the practice as one way to address a looming physician shortage. But the House and Senate are taking routes to bridge the geographic and employment chasms.

The Florida Legislature is poised to pass bills regulating telemedicine -- the practice of physicians digitally connecting to patients. But the House and Senate are taking different approaches, and one powerful lobby is opposed to at least one of the plans.

The House is focused on setting up the regulatory and statutory framework for telemedicine in Florida. Even though doctors and other health providers are already doing it, as Representative Travis Cummings (R-Orange Park) points out, there’s nothing in state law that addresses it.

“Even with the board of medicine’s recent rule that dove into this topic as it has evolved quickly...we’ve felt the great importance to define one of the method of telemedicine, the delivery of telemedicine and telemedicine itself.”

Cummings and Representative Mia Jones (D-Jacksonville) have authored a bill to put telemedicine into state law. When it comes to how telemedicine is practiced, and who should be authorized to do it, the Florida Medical Association—the state’s doctor’s lobby group -- is opposed—at least, to the House proposal.

“An out-of-stater can register... in Ohio, and then move to Washington where there is no regulatory burden...How are you going to know that... Regulation matters, regulation is important," said David Custin, a lobbyist for the FMA.

The FMA says it supports telemedicine, but doesn’t agree with letting out-of-state doctors see Florida patients. But Representative Cary Pigman (R-Avon Park), a medical doctor himself, disagrees with the FMA’s position.

“It’s predicated on ‘Florida’s so good, all other states are rotten’. And what I want to see from the next person who presents that comment is what data are you pulling from where that’s the result?" Pigman said. "Because when you look at data, it’s Florida that’s inferior. It’s perhaps Florida physicians who shouldn’t be allowed to do telehealth in other states.” 

Meanwhile,a plan in the Senate focuses on how telemedicine should be paid for. The proposal calls for Medicaid to reimburse telemedicine services at the same rate as a face-to-face visit. Health plans and doctors would work out their own deals. The bill expands the number of telemedicine services that qualify for reimbursements and, just as in the House plan, out-of-state doctors would be allowed to see Florida patients if the physician registers with the state and pays a fee. But new provisions added into the Senate plan Wednesday would limit which healthcare providers can practice telemedicine, and make it tougher for those out-of-state doctors to work in Florida.

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Lynn Hatter is a Florida A&M University graduate with a bachelor’s degree in journalism. Lynn has served as reporter/producer for WFSU since 2007 with education and health care issues as her key coverage areas.  She is an award-winning member of the Capital Press Corps and has participated in the NPR Kaiser Health News Reporting Partnership and NPR Education Initiative. 

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