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7 LONG TITLE
8 General Description:
9 This bill amends the Telehealth Act and the Online Prescribing, Dispensing, and
10 Facilitation Licensing Act.
11 Highlighted Provisions:
12 This bill:
13 ▸ amends definitions;
14 ▸ amends provisions related to a telehealth provider establishing a provider-patient
15 relationship;
16 ▸ amends provisions related to a telehealth provider providing a patient's medical
17 record to another health care provider;
18 ▸ addresses prescribing by a provider who uses only asynchronous interaction to
19 establish a provider-patient relationship with a patient;
20 ▸ repeals an obsolete reporting requirement; and
21 ▸ makes technical changes.
22 Money Appropriated in this Bill:
23 None
24 Other Special Clauses:
25 None
26 Utah Code Sections Affected:
27 AMENDS:
28 26-60-102, as last amended by Laws of Utah 2020, Chapter 119
29 26-60-103, as last amended by Laws of Utah 2021, Chapter 64
30 58-83-102, as enacted by Laws of Utah 2010, Chapter 180
31 58-83-301, as enacted by Laws of Utah 2010, Chapter 180
32 REPEALS:
33 26-60-105, as last amended by Laws of Utah 2019, Chapter 249
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35 Be it enacted by the Legislature of the state of Utah:
36 Section 1. Section 26-60-102 is amended to read:
37 26-60-102. Definitions.
38 As used in this chapter:
39 (1) "Asynchronous [
40 exchange of a patient's health care information from an originating site to a provider at a distant
41 site that does not occur in real time.
42 (2) "Controlled substance" means the same as that term is defined in Section 58-37-2.
43 [
44 telemedicine services.
45 [
46 telemedicine services.
47 [
48 [
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53 (6) "Prescription drug" means the same as that term is defined in Section 58-17b-102.
54 [
55 (a) licensed under [
56 Act;
57 (b) licensed under Title 58, Occupations and Professions, to provide health care; or
58 (c) licensed under Title 62A, Chapter 2, Licensure of Programs and Facilities.
59 [
60 technology that enables a provider at a distant site and a patient at an originating site to interact
61 simultaneously through two-way audio and video transmission.
62 [
63 information through the use of electronic communication or information technology.
64 [
65 (a) including:
66 (i) clinical care;
67 (ii) health education;
68 (iii) health administration;
69 (iv) home health;
70 (v) facilitation of self-managed care and caregiver support; or
71 (vi) remote patient monitoring occurring incidentally to general supervision; and
72 (b) provided by a provider to a patient through a method of communication that uses:
73 [
74 (i) (A) asynchronous interaction; or
75 (B) [
76 (ii) meets industry security and privacy standards, including, when applicable,
77 compliance with:
78 (A) the federal Health Insurance Portability and Accountability Act of 1996, Pub. L.
79 No. 104-191, 110 Stat. 1936, as amended; and
80 (B) the federal Health Information Technology for Economic and Clinical Health Act,
81 Pub. L. No. 111-5, 123 Stat. 226, 467, as amended.
82 Section 2. Section 26-60-103 is amended to read:
83 26-60-103. Scope of telehealth practice.
84 (1) A provider offering telehealth services shall:
85 (a) at all times:
86 (i) act within the scope of the provider's license under Title 58, Occupations and
87 Professions, in accordance with the provisions of this chapter and all other applicable laws and
88 rules; and
89 (ii) be held to the same standards of practice as those applicable in traditional health
90 care settings;
91 (b) if the provider does not already have a provider-patient relationship with the
92 patient, establish a provider-patient relationship during the patient encounter:
93 (i) in a manner consistent with:
94 (A) the same standards of practice[
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97 provider's licensure and credentials to the patient; and
98 (B) rules made by the division consistent with the standards of practice described in
99 Subsection (1)(a)(ii); and
100 (ii) using synchronous or asynchronous interaction;
101 (c) before providing treatment or prescribing a prescription drug, establish a diagnosis
102 and identify underlying conditions and contraindications to a recommended treatment after:
103 (i) obtaining from the patient or another provider the patient's relevant clinical history;
104 and
105 (ii) documenting the patient's relevant clinical history and current symptoms;
106 (d) be available to a patient who receives telehealth services from the provider for
107 subsequent care related to the initial telemedicine services, in accordance with community
108 standards of practice;
109 (e) be familiar with available medical resources, including emergency resources near
110 the originating site, in order to make appropriate patient referrals when medically indicated;
111 (f) in accordance with any applicable state and federal laws, rules, and regulations,
112 generate, maintain, and make available to each patient receiving telehealth services the patient's
113 medical records; and
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127 (g) if requested by the patient, provide the patient's medical record to another health
128 care provider designated by the patient, to the extent allowed under HIPAA, as defined in
129 Section 26-18-17.
130 (2) Subsection (1)(g) does not apply to prescriptions for eyeglasses or contacts.
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139 (3) (a) Except as provided in Subsection (3)(b), a provider may not prescribe a
140 prescription drug to a patient if the provider:
141 (i) offers telehealth services to the patient; and
142 (ii) uses only asynchronous interaction to establish a provider-patient relationship with
143 the patient.
144 (b) A provider described in Subsection (3)(a) may prescribe a prescription drug to a
145 patient if the prescription drug:
146 (i) is not subject to Title 58, Chapter 83, Online Prescribing, Dispensing, and
147 Facilitation Licensing Act;
148 (ii) is approved by the division by rule under Subsection (4); and
149 (iii) is prescribed to the patient to treat:
150 (A) dermatological conditions;
151 (B) gastrointestinal disorders;
152 (C) infertility;
153 (D) mental health;
154 (E) metabolic disorders;
155 (F) sexual health;
156 (G) sleep disorders; and
157 (H) smoking cessation.
158 (c) A provider described in Subsection (3)(a) may order laboratory-based diagnostic
159 testing for a patient.
160 (4) (a) The division shall make rules in accordance with Title 63G, Chapter 3, Utah
161 Administrative Rulemaking Act, to specify:
162 (i) the prescription drugs that may be prescribed under Subsection (3); and
163 (ii) the conditions for which the prescription drugs described in Subsection (4)(a)(i)
164 may be prescribed.
165 (b) The division shall make rules under this Subsection (4) in collaboration with:
166 (i) the Physicians Licensing Board created in Section 58-67-201; and
167 (ii) the Osteopathic Physician and Surgeon's Licensing Board created in Section
168 58-68-201.
169 (c) The division may not authorize a provider to prescribe a controlled substance under
170 this section.
171 [
172 (a) the provider is not in compliance with applicable laws, rules, and regulations
173 regarding the provider's licensed practice; or
174 (b) the provider's license under Title 58, Occupations and Professions, is not active and
175 in good standing.
176 Section 3. Section 58-83-102 is amended to read:
177 58-83-102. Definitions.
178 In addition to the definitions in Section 58-1-102, as used in this chapter:
179 (1) "Board" means the Online Prescribing, Dispensing, and Facilitation Licensing
180 Board created in Section 58-83-201.
181 (2) "Branching questionnaire" means an adaptive and progressive assessment tool
182 approved by the board.
183 (3) "Delivery of online pharmaceutical services" means the process in which a
184 prescribing practitioner diagnoses a patient and prescribes one or more of the drugs authorized
185 by Section 58-83-306, using:
186 (a) a branching questionnaire or other assessment tool approved by the division for the
187 purpose of diagnosing and assessing a patient's health status;
188 (b) an Internet contract pharmacy to:
189 (i) dispense the prescribed drug; or
190 (ii) transfer the prescription to another pharmacy; and
191 (c) an Internet facilitator to facilitate the practices described in Subsections (3)(a) and
192 (b).
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195 electronic communication between and among an online prescriber, the online prescriber's
196 patient, and the online contract pharmacy.
197 [
198 under Chapter 17b, Pharmacy Practice Act, as either a Class A Retail Pharmacy or a Class B
199 Closed Door Pharmacy and licensed under this chapter to fulfill prescriptions issued by an
200 online prescriber through a specific Internet facilitator.
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202 (a) licensed under another chapter of this title;
203 (b) whose license under another chapter of this title includes assessing, diagnosing, and
204 prescribing authority for humans; and
205 (c) who has obtained a license under this chapter to engage in online prescribing.
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207 conduct that is defined as unlawful conduct under Section 58-1-501 or 58-83-501.
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210 58-1-501, 58-83-502, or by the division by rule made in accordance with Title 63G, Chapter 3,
211 Utah Administrative Rulemaking Act.
212 Section 4. Section 58-83-301 is amended to read:
213 58-83-301. Licensure required -- Issuance of licenses.
214 (1) Beginning July 1, 2010, and except as provided in Section 58-1-307 and Subsection
215 26-60-102(6):
216 (a) a physician licensed under Chapter 67, Utah Medical Practice Act, or Chapter 68,
217 Utah Osteopathic Medical Practice Act, shall be licensed under this chapter to engage in the
218 delivery of online pharmaceutical services;
219 (b) an online contract pharmacy shall be licensed under this chapter to engage in the
220 delivery of online pharmaceutical services; and
221 (c) an Internet facilitator shall be licensed under this chapter to engage in the delivery
222 of online pharmaceutical services.
223 (2) The division shall issue[
224 under this chapter[
225 (a) to prescribe online;
226 (b) to operate as an online contract pharmacy; or
227 (c) to operate as an Internet facilitator.
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231 (3) Nothing in this chapter shall prohibit a physician licensed under Chapter 67, Utah
232 Medical Practice Act, or Chapter 68, Utah Osteopathic Medical Practice Act, from [
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234 (a) Chapter 67, Utah Medical Practice Act[
235 (b) Chapter 68, Utah Osteopathic Medical Practice Act[
236 (c) Title 26, Chapter 60, Telehealth Act; or
237 (d) other law.
238 Section 5. Repealer.
239 This bill repeals:
240 Section 26-60-105, Study by Public Utilities, Energy, and Technology Interim
241 Committee and Health Reform Task Force.