HB 348

Abstract

House Substitute No. 1 for House Bill No. 348 differs from HB 348 in the following ways: 1. In Paragraph 2 of the Preamble, the exact language from Governor Carney’s Second Modification of the March 12, 2020 Declaration of a State of Emergency pertaining to suspension of the Delaware Board of Medical Licensure and Discipline Regulation 19 is incorporated to support Section 4 of the bill which specifies that physicians may prescribe opioids via telemedicine. 2. A new Paragraph 3 has been added to the Preamble to reference a Joint Order of Health and Social Services and the Delaware Emergency Management Agency dated March 24, 2020 specifying categories of out-of-state health care practitioners who will be authorized to practice in Delaware during the state of emergency occasioned by COVID-19. 3. The Substitute adds a requirement that out-of-state practitioners must complete a Medical Request Form and comply with any other regulations established by the Division of Professional Regulation. 4. The Substitute eliminates language limiting the practice of telemedicine by both physicians and APRNs without a practitioner-patient relationship to the existence of COVID-19. 5. The Substitute specifies that prescribing controlled substances including opioids prescribed via telemedicine is subject to the same standards of practice and includes a paragraph under existing law pertaining to authorization for APRNs to prescribe controlled substances and adds the authority to prescribe opioids by electronic means. 6. The Synopsis has been changed to reflect that practitioners covered include respiratory therapists and physician assistants and the other changes in the Substitute bill. This Act continues certain provisions in the Declaration of a State of Emergency for the State of Delaware dated March 12, 2020 due to a Public Health Threat as a result of the COVID-19 pandemic as modified related to telemedicine. The Second Modification of the State of Emergency suspended all Title 24 statutory requirements that patients present in-person before telemedicine services may be provided and the requirement that a patient must be in Delaware at the time the telemedicine services are provided; this Act continues the suspension of those requirements, but specifies that the requirement that a patient present in-person prior to the delivery of telemedicine services is excused under circumstances which make in-person presentation impractical. The Tenth Modification of the State of Emergency suspended any requirement in regulation that required both audio and visual technology; this Act prohibits any regulation pertaining to telemedicine requiring visual communication so as to permit telemedicine services via non-smart phones or land line connections. It continues suspension of the Delaware Board of Medical Licensure and Discipline Regulation 19 limiting the scope of telemedicine, including with respect to prescribing opioids. Professions not covered by this Act include those professionals who require direct supervision by the nature of the work such as licensed associate counselors of mental health. Such professionals may engage in telemedicine and telehealth as provided by existing law. Practitioners covered by the Medical Practices Act, 24 Del. C. Chapter 17 including Respiratory Care Practitioners and Physician Assistants, are covered by the Act. Professions covered by Title 24 which do not currently have statutory telemedicine authorization are not covered. This Act requires that telemedicine services permitted under this Act receive the same insurance coverage as under existing law. The Act expires on July 1, 2021.