View Amendment Current Amendment: 1 to Bill 345 Rep. G.M. SMITH proposes the following Amendment No. to S. 345 (COUNCIL\WAB\345C002.AGM.WAB18):

Reference is to Printer's Date 4/25/18-H.

Amend the bill, as and if amended, Section 40-33-34, as contained in SECTION 2, by adding an appropriately lettered subsection to read:

/      ( )(1)      For purposes of this subsection:
           (a)      'Telemedicine' has the same meaning as provided in Section 40-47-20(52).
           (b)      'Unprofessional conduct' has the same meaning as provided in Section 40-33-20(64).
           (2)      An APRN may perform medical acts via telemedicine pursuant to a practice agreement as defined in Section 40-33-20(45).
           (3)      An APRN who establishes a nurse-patient relationship solely by means of telemedicine shall adhere to the same standard of care as a licensee employing more traditional in-person medical care. Failure to conform to the appropriate standard of care is considered unprofessional conduct and may be subject to enforcement by the board.
           (4)      An APRN may not establish a nurse-patient relationship by means of telemedicine for the purpose of prescribing medication when an in-person physical examination is necessary for diagnosis.
           (5)      An APRN who establishes a nurse-patient relationship solely by means of telemedicine only may prescribe within a practice setting fully in compliance with this chapter and during an encounter in which threshold information necessary to make an accurate diagnosis is obtained in a medical history interview conducted by the prescribing licensee; provided, however, that Schedule II-V prescriptions are only permitted pursuant to a practice agreement as defined in Section 40-33-20(45) and nothing in this item may be construed to authorize the prescribing of medications via telemedicine that otherwise are restricted by the limitations in Section 40-47-37(C)(6).
           (6)      An APRN who establishes a nurse-patient relationship solely by means of telemedicine shall generate and maintain medical records for each patient using those telemedicine services in compliance with any applicable state and federal laws, rules, and regulations, including the provisions of this chapter, the Health Insurance Portability and Accountability Act (HIPAA), and the Health Information Technology for Economic and Clinical Health Act (HITECH). These records must be accessible to other practitioners and to the patient in a timely fashion when lawfully requested by the patient or his lawfully designated representative.
           (7)      The provisions of this subsection may not be construed to allow an APRN to perform services beyond the scope of what is authorized by Title 40, Chapter 33 and Title 40, Chapter 47." /

Amend the bill further, by adding appropriately numbered SECTIONS at the end to read:

/ SECTION      ___.      Section 40-47-935 of the 1976 Code is amended to read:

     "Section 40-47-935.      (A)      Physician assistants may perform:
           (1)      medical acts, tasks, or functions with written scope of practice guidelines under physician supervision;
           (2)      those duties and responsibilities, including the prescribing and dispensing of drugs and medical devices, that are lawfully delegated by their supervising physicians.; provided, however, only physician assistants holding a permanent license may prescribe drug therapy as provided in this article; and
           (3)      telemedicine in accordance with the requirements of Section 40-47-37 including, but not limited to, Section 40-47-37(C)(6) requiring board authorization prior to prescribing Schedule II and Schedule III prescriptions, Section 40-47-113, approved written scope of practice guidelines, and pursuant to all physician supervisory requirements imposed by this chapter.
     (B)      A physician assistant is an agent of his or her supervising physician in the performance of all practice related activities including, but not limited to, the ordering of diagnostic, therapeutic, and other medical services."

SECTION      ___.      Section 40-47-955(B) of the 1976 Code, as last amended by Act 28 of 2013, is further amended to read:

     "(B)      Pursuant to scope of practice guidelines, a physician assistant may:
           (1)      practice in a public place, a private place, or a facility where the supervising physician regularly sees patients,; and
           (2)      may make house calls, perform hospital duties, perform telemedicine, and perform any functions performed by the supervising physician if the physician assistant is also qualified to perform those functions." /

Renumber sections to conform.
Amend title to conform.