好消息，加州法律允許ND視訊看診
所以，未來我的加州和華州診所的看診和義診將擴大到全球各地，不限美國。
以下是加州自然醫學會的問答集：
法律原文如下（冗長，沒時間不必看）
BILL NUMBER: AB 415 CHAPTERED
BILL TEXT
CHAPTER 547
FILED WITH SECRETARY OF STATE OCTOBER 7, 2011
APPROVED BY GOVERNOR OCTOBER 7, 2011
PASSED THE SENATE SEPTEMBER 7, 2011
PASSED THE ASSEMBLY SEPTEMBER 8, 2011
AMENDED IN SENATE SEPTEMBER 2, 2011
AMENDED IN SENATE AUGUST 15, 2011
AMENDED IN SENATE JULY 7, 2011
AMENDED IN ASSEMBLY MAY 27, 2011
AMENDED IN ASSEMBLY MAY 10, 2011
AMENDED IN ASSEMBLY APRIL 25, 2011
AMENDED IN ASSEMBLY MARCH 31, 2011
INTRODUCED BY Assembly Member Logue
(Principal coauthors: Assembly Members Chesbro, Galgiani, Pan, and
- Manuel P廨ez)
FEBRUARY 14, 2011
An act to repeal and add Section 2290.5 of the Business and
Professions Code, to repeal and add Section 1374.13 of the Health and
Safety Code, to repeal and add Section 10123.85 of the Insurance
Code, and to amend Sections 14132.72 and 14132.725 of the Welfare and
Institutions Code, relating to telehealth.
LEGISLATIVE COUNSEL'S DIGEST
AB 415, Logue. Healing arts: telehealth.
(1) Existing law provides for the licensure and regulation of
various healing arts professions by various boards within the
Department of Consumer Affairs. A violation of specified provisions
is a crime. Existing law defines telemedicine, for the purpose of its
regulation, to mean the practice of health care delivery, diagnosis,
consultation, treatment, transfer of medical data, and education
using interactive audio, video, or data communications. Existing law
requires a health care practitioner, as defined, to obtain verbal and
written informed consent from the patient or the patient's legal
representative before telemedicine is delivered. Existing law also
imposes various requirements with regard to the provision of
telemedicine by health care service plans, health insurers, or under
the Medi-Cal program, including a prohibition on requiring
face-to-face contact between a health care provider and a patient for
services appropriately provided through telemedicine, subject to
certain contracts or policies. Existing federal regulations, for the
purposes of participation in the Medicare and Medicaid programs,
authorize the governing body of a hospital whose patients are
receiving telemedicine services to grant privileges based on its
medical staff recommendations that rely on information provided by
the distant-site hospital. Existing state regulations require medical
staff, appointed by the governing body of a hospital, to adopt
procedures for the evaluation of staff applications for credentials
and privileges. Existing law provides that health care service plans
and health insurers shall not be required to pay for consultations
provided by telephone or facsimile machines. Existing law provides
that a willful violation of the provisions governing health care
service plans is a crime.
This bill would delete the provisions of state law regarding
telemedicine as described above, and would instead set forth
provisions relating to telehealth, as defined. This bill would
require a health care provider, as defined, prior to the delivery of
health care via telehealth, to verbally inform the patient that
telehealth may be used and obtain verbal consent from the patient.
This bill would provide that failure to comply with this provision
constitutes unprofessional conduct. This bill would, subject to
contract terms and conditions, also preclude health care service
plans and health insurers from imposing prior to payment, certain
requirements regarding the manner of service delivery. This bill
would establish procedures for granting privileges to, and verifying
and approving credentials for, providers of telehealth services. By
changing the definition of a crime applicable to health care service
plans, the bill would impose a state-mandated local program.
(2) Existing law prohibits a requirement of face-to-face contact
between a health care provider and a patient under the Medi-Cal
program for services appropriately provided through telemedicine,
subject to reimbursement policies developed by the Medi-Cal program
to compensate licensed health care providers who provide health care
services, that are otherwise covered by the Medi-Cal program, through
telemedicine.
This bill would, instead, prohibit a requirement of in-person
contact between a health care provider and patient under the Medi-Cal
program for any service otherwise covered by the Medi-Cal program
when the service is appropriately provided by telehealth, as defined,
and would make related changes.
(3) Existing law, until January 1, 2013, and to the extent that
federal financial participation is available, authorizes, under the
Medi-Cal program, teleophthalmology and teledermatology by store and
forward, as defined.
This bill would delete the repeal of the above-described
authorization.
(4) The California Constitution requires the state to reimburse
local agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. This act shall be known, and may be cited, as the
Telehealth Advancement Act of 2011.
SEC. 2. The Legislature finds and declares all of the following:
(a) Lack of primary care providers, specialty providers, and
transportation continue to be significant barriers to access to
health services in medically underserved rural and urban areas.
(b) Parts of California have difficulty attracting and retaining
health professionals, as well as supporting local health facilities
to provide a continuum of health care.
(c) Many health care providers in medically underserved areas are
isolated from mentors, colleagues, and the information resources
necessary to support them personally and professionally.
(d) It is the intent of the Legislature to create a parity of
telehealth with other health care delivery modes, to actively promote
telehealth as a tool to advance stakeholders' goals regarding health
status and health system improvement, and to create opportunities
and flexibility for telehealth to be used in new models of care and
system improvements.
(e) Telehealth is a mode of delivering health care services and
public health utilizing information and communication technologies to
enable the diagnosis, consultation, treatment, education, care
management, and self-management of patients at a distance from health
care providers.
(f) Telehealth is part of a multifaceted approach to address the
problem of inadequate provider distribution and the development of
health systems in medically underserved areas by improving
communication capabilities and providing convenient access to
up-to-date information, consultations, and other forms of support.
(g) The use of information and telecommunication technologies to
deliver health services has the potential to reduce costs, improve
quality, change the conditions of practice, and improve access to
health care, particularly in rural and other medically underserved
areas.
(h) Telehealth will assist in maintaining or improving the
physical and economic health of medically underserved communities by
keeping the source of medical care in the local area, strengthening
the health infrastructure, and preserving health care-related jobs.
(i) Consumers of health care will benefit from telehealth in many
ways, including expanded access to providers, faster and more
convenient treatment, better continuity of care, reduction of lost
work time and travel costs, and the ability to remain with support
networks.
(j) It is the intent of the Legislature that the fundamental
health care provider-patient relationship cannot only be preserved,
but can also be augmented and enhanced, through the use of telehealth
as a tool to be integrated into practices.
(k) Without the assurance of payment and the resolution of legal
and policy barriers, the full potential of telehealth will not be
realized.
SEC. 3. Section 2290.5 of the Business and Professions Code is
repealed.
SEC. 4. Section 2290.5 is added to the Business and Professions
Code, to read:
2290.5. (a) For purposes of this division, the following
definitions shall apply:
(1) "Asynchronous store and forward" means the transmission of a
patient's medical information from an originating site to the health
care provider at a distant site without the presence of the patient.
(2) "Distant site" means a site where a health care provider who
provides health care services is located while providing these
services via a telecommunications system.
(3) "Health care provider" means a person who is licensed under
this division.
(4) "Originating site" means a site where a patient is located at
the time health care services are provided via a telecommunications
system or where the asynchronous store and forward service
originates.
(5) "Synchronous interaction" means a real-time interaction
between a patient and a health care provider located at a distant
site.
(6) "Telehealth" means the mode of delivering health care services
and public health via information and communication technologies to
facilitate the diagnosis, consultation, treatment, education, care
management, and self-management of a patient's health care while the
patient is at the originating site and the health care provider is at
a distant site. Telehealth facilitates patient self-management and
caregiver support for patients and includes synchronous interactions
and asynchronous store and forward transfers.
(b) Prior to the delivery of health care via telehealth, the
health care provider at the originating site shall verbally inform
the patient that telehealth may be used and obtain verbal consent
from the patient for this use. The verbal consent shall be documented
in the patient's medical record.
(c) The failure of a health care provider to comply with this
section shall constitute unprofessional conduct. Section 2314 shall
not apply to this section.
(d) This section shall not be construed to alter the scope of
practice of any health care provider or authorize the delivery of
health care services in a setting, or in a manner, not otherwise
authorized by law.
(e) All laws regarding the confidentiality of health care
information and a patient's rights to his or her medical information
shall apply to telehealth interactions.
(f) This section shall not apply to a patient under the
jurisdiction of the Department of Corrections and Rehabilitation or
any other correctional facility.
(g) (1) Notwithstanding any other provision of law and for
purposes of this section, the governing body of the hospital whose
patients are receiving the telehealth services may grant privileges
to, and verify and approve credentials for, providers of telehealth
services based on its medical staff recommendations that rely on
information provided by the distant-site hospital or telehealth
entity, as described in Sections 482.12, 482.22, and 485.616 of Title
42 of the Code of Federal Regulations.
(2) By enacting this subdivision, it is the intent of the
Legislature to authorize a hospital to grant privileges to, and
verify and approve credentials for, providers of telehealth services
as described in paragraph (1).
(3) For the purposes of this subdivision, "telehealth" shall
include "telemedicine" as the term is referenced in Sections 482.12,
482.22, and 485.616 of Title 42 of the Code of Federal Regulations.
SEC. 5. Section 1374.13 of the Health and Safety Code is repealed.
SEC. 6. Section 1374.13 is added to the Health and Safety Code, to
read:
1374.13. (a) For the purposes of this section, the definitions in
subdivision (a) of Section 2290.5 of the Business and Professions
Code shall apply.
(b) It is the intent of the Legislature to recognize the practice
of telehealth as a legitimate means by which an individual may
receive health care services from a health care provider without
in-person contact with the health care provider.
(c) No health care service plan shall require that in-person
contact occur between a health care provider and a patient before
payment is made for the covered services appropriately provided
through telehealth, subject to the terms and conditions of the
contract entered into between the enrollee or subscriber and the
health care service plan, and between the health care service plan
and its participating providers or provider groups.
(d) No health care service plan shall limit the type of setting
where services are provided for the patient or by the health care
provider before payment is made for the covered services
appropriately provided through telehealth, subject to the terms and
conditions of the contract entered into between the enrollee or
subscriber and the health care service plan, and between the health
care service plan and its participating providers or provider groups.
(e) The requirements of this subdivision shall also be operative
for health care service plan contracts with the department pursuant
to Article 2.7 (commencing with Section 14087.3), Article 2.8
(commencing with Section 14087.5), Article 2.81 (commencing with
Section 14087.96), or Article 2.91 (commencing with Section 14089) of
Chapter 7, or Chapter 8 (commencing with Section 14200) of, Part 3
of Division 9 of the Welfare and Institutions Code.
(f) Notwithstanding any other provision, this section shall not be
interpreted to authorize a health care service plan to require the
use of telehealth when the health care provider has determined that
it is not appropriate.
SEC. 7. Section 10123.85 of the Insurance Code is repealed.
SEC. 8. Section 10123.85 is added to the Insurance Code, to read:
10123.85. (a) For purposes of this section, the definitions in
subdivision (a) of Section 2290.5 of the Business and Professions
Code shall apply.
(b) It is the intent of the Legislature to recognize the practice
of telehealth as a legitimate means by which an individual may
receive health care services from a health care provider without
in-person contact with the health care provider.
(c) No health insurer shall require that in-person contact occur
between a health care provider and a patient before payment is made
for the services appropriately provided through telehealth, subject
to the terms and conditions of the contract entered into between the
policyholder or contractholder and the insurer, and between the
insurer and its participating providers or provider groups.
(d) No health insurer shall limit the type of setting where
services are provided for the patient or by the health care provider
before payment is made for the covered services appropriately
provided by telehealth, subject to the terms and conditions of the
contract between the policyholder or contract holder and the insurer,
and between the insurer and its participating providers or provider
groups.
(e) Notwithstanding any other provision, this section shall not be
interpreted to authorize a health insurer to require the use of
telehealth when the health care provider has determined that it is
not appropriate.
SEC. 9. Section 14132.72 of the Welfare and Institutions Code is
amended to read:
14132.72. (a) For purposes of this section, the definitions in
subdivision (a) of Section 2290.5 of the Business and Professions
Code shall apply.
(b) It is the intent of the Legislature to recognize the practice
of telehealth as a legitimate means by which an individual may
receive health care services from a health care provider without
in-person contact with the provider.
(c) In-person contact between a health care provider and a patient
shall not be required under the Medi-Cal program for services
appropriately provided through telehealth, subject to reimbursement
policies adopted by the department to compensate a licensed health
care provider who provides health care services through telehealth
that are otherwise reimbursed pursuant to the Medi-Cal program.
Nothing in this section or the Telehealth Advancement Act of 2011
shall be construed to conflict with or supersede the provisions of
Section 14091.3 of this code or any other existing state laws or
regulations related to reimbursement for services provided by a
noncontracted provider.
(d) The department shall not require a health care provider to
document a barrier to an in-person visit for Medi-Cal coverage of
services provided via telehealth.
(e) For the purposes of payment for covered treatment or services
provided through telehealth, the department shall not limit the type
of setting where services are provided for the patient or by the
health care provider.
(f) Nothing in this section shall be interpreted to authorize the
department to require the use of telehealth when the health care
provider has determined that it is not appropriate.
(g) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, and make specific this section
by means of all-county letters, provider bulletins, and similar
instructions.
SEC. 10. Section 14132.725 of the Welfare and Institutions Code is
amended to read:
14132.725. (a) Commencing July 1, 2006, to the extent that
federal financial participation is available, face-to-face contact
between a health care provider and a patient shall not be required
under the Medi-Cal program for teleophthalmology and teledermatology
by store and forward. Services appropriately provided through the
store and forward process are subject to billing and reimbursement
policies developed by the department.
(b) For purposes of this section, "teleophthalmology and
teledermatology by store and forward" means an asynchronous
transmission of medical information to be reviewed at a later time by
a physician at a distant site who is trained in ophthalmology or
dermatology or, for teleophthalmology, by an optometrist who is
licensed pursuant to Chapter 7 (commencing with Section 3000) of
Division 2 of the Business and Professions Code, where the physician
or optometrist at the distant site reviews the medical information
without the patient being present in real time. A patient receiving
teleophthalmology or teledermatology by store and forward shall be
notified of the right to receive interactive communication with the
distant specialist physician or optometrist, and shall receive an
interactive communication with the distant specialist physician or
optometrist, upon request. If requested, communication with the
distant specialist physician or optometrist may occur either at the
time of the consultation, or within 30 days of the patient's
notification of the results of the consultation. If the reviewing
optometrist identifies a disease or condition requiring consultation
or referral pursuant to Section 3041 of the Business and Professions
Code, that consultation or referral shall be with an ophthalmologist
or other appropriate physician and surgeon, as required.
(c) Notwithstanding Chapter 3.5 (commencing with Section 11340) of
Part 1 of Division 3 of Title 2 of the Government Code, the
department may implement, interpret, and make specific this section
by means of all-county letters, provider bulletins, and similar
instructions.
(d) On or before January 1, 2008, the department shall report to
the Legislature the number and type of services provided, and the
payments made related to the application of store and forward
telemedicine as provided, under this section as a Medi-Cal benefit.
SEC. 11. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.
轉載自：【陳俊旭 美國自然醫學博士】Facebook
