H O U S E THIS AMENDMENT 

A M E N D M E N T  ADOPTED 

CREATEDATE \@ "MMMM d, yyyy" \* MERGEFORMAT May 9, 2023

31089603048000

    CLERK OF THE HOUSE  

014605000

Rep. HERBKERSMAN proposes the following Amendment No. to H.4300 as Passed By The House

(Doc Name h:\legwork\house\amend\h-wm\001\h2-prescribing by telemedicine.docx):

EXPLANATION: Allows prescribing via telemedicine.

Amend the bill, as and if amended, Part IB, Section 117, GENERAL PROVISIONS, page 533, after line 9, by adding an appropriately numbered proviso to read:

/(GP: Prescribing by Telemedicine) From the funds authorized to the Department of Labor, Licensing and Regulation and the Board of Medical Examiners for Fiscal Year 2023-24, the department and board shall make certain that a licensee who establishes and/or maintains a physician-patient relationship, provides care, renders a diagnosis, or otherwise engages in the practice of medicine as defined in Section 40-47-20(36) solely via telemedicine as defined in Section 40-47-20(53) shall:

 (1)adhere to current standards for practice improvement and monitoring of outcomes and provide reports containing such information upon request of the board; 

 (2)provide an appropriate evaluation prior to diagnosing and/or treating the patient, which need not be done in person if the licensee considers that he is able to accurately diagnose and treat the patient in conformity with the applicable standard of care via telehealth; provided that evaluations in which a licensee is at a distant site, but a practitioner who is acting within his scope is able to provide various physical findings the licensee needs to complete an adequate assessment, is permitted; 

 (3)ensure the availability of appropriate follow-up care; 

 (4)verify the identity and location of the patient and inform the patient of the licensee's name, location, and professional credentials; 

 (5)maintain the confidentiality of a patient's records and disclose the records to the patient consistent with state and federal law; provided, that licensees practicing telemedicine must be held to the same standards of professionalism concerning medical records transfer and communication with the primary care provider and medical home as licensees practicing via traditional means; 

 (6)if applicable, discuss with the patient the value of having a primary care medical home and, if the patient requests, provide assistance in identifying available options for a primary care medical home; 

 (7)prescribe in compliance with all relevant federal and state laws including, but not limited to, participation in the South Carolina Prescription Monitoring Program in Article 15, Chapter 53, Title  44 and the Ryan Haight Act, within a practice setting fully compliant with this provision, and subject to the following limitations:

  (a)at each encounter, threshold information necessary to make an accurate diagnosis must be obtained in a medical history interview conducted by the prescribing licensee; 

  (b)Schedule II-narcotic and Schedule III-narcotic prescriptions are not permitted except in the following instances: 

   (i)when the practice of telemedicine is being conducted while the patient is physically located in a hospital and being treated by a practitioner acting in the usual course of professional practice; 

   (ii)those Schedule II and Schedule III medications used specifically for patients actively enrolled in a Medication-Assisted Treatment (MAT) program with a provider who has an established physician-patient relationship when buprenorphine is being prescribed as a medication for opioid use disorder; 

   (iii)patients enrolled in palliative care or hospice; or 

   (iv)any other programs specifically authorized by the board; and 

  (c)prescribing abortion-inducing drugs is not permitted. "Abortion-inducing drug" means a medicine, drug, or any other substance prescribed or dispensed with the intent of terminating the clinically diagnosable pregnancy of a woman, with knowledge that the termination will, with reasonable likelihood, cause the death of the unborn child. This includes off-label use of drugs known to have abortion-inducing properties that are prescribed specifically with the intent of causing an abortion, such as misoprostol (Cytotec) and methotrexate. This definition does not apply to drugs that may be known to cause an abortion, but which are prescribed for other medical indications including, but not limited to, chemotherapeutic agents or diagnostic drugs. Use of such drugs to induce abortion is also known as "medical", "drug-induced", or "chemical abortion"; and 

 (8)be prohibited from establishing a physician-patient relationship pursuant to Section 40-47-113(B) for the purpose of prescribing medication when an in-person physical examination is necessary for diagnosis.  /

Amend totals and titles to conform.