PRINTER'S NO. 647
No. 585 Session of 2003
INTRODUCED BY LEMMOND, WENGER, MUSTO, MADIGAN, SCHWARTZ, BOSCOLA, RAFFERTY, MELLOW, ERICKSON, PILEGGI, ROBBINS, CORMAN, TOMLINSON, C. WILLIAMS, WOZNIAK AND WONDERLING, APRIL 11, 2003
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE, APRIL 11, 2003
AN ACT 1 Regulating certain services provided by a nonresident physician. 2 The General Assembly of the Commonwealth of Pennsylvania 3 hereby enacts as follows: 4 Section 1. Short title. 5 This act shall be known and may be cited as the Telemedicine 6 Act. 7 Section 2. Legislative findings and intent. 8 The General Assembly finds and declares as follows: 9 (1) That due to technological advances and changing 10 practice patterns, the practice of medicine is occurring with 11 increasing frequency across State lines, and that certain 12 technological advances in the practice of medicine are in the 13 public interest. 14 (2) That recent technological advances in electronic 15 data transmission have made it possible for nonresident 16 physicians, not licensed in this Commonwealth, to render
1 written or otherwise documented opinions for patients 2 residing in this Commonwealth and that these opinions may 3 directly affect patient care. 4 (3) That the practice of medicine is a privilege and 5 that the licensure of practitioners outside this Commonwealth 6 engaging in such medical practice within this Commonwealth 7 and the ability to discipline such practitioners is both 8 necessary and desirable for the protection of the citizens of 9 this Commonwealth and for the public interest, health, 10 welfare and safety. 11 Section 3. Definitions. 12 The following words and phrases when used in this act shall 13 have the meanings given to them in this section unless the 14 context clearly indicates otherwise: 15 "Board." The State Board of Medicine or the State Board of 16 Osteopathic Medicine. 17 "Healing arts." The science and skill of diagnosis and 18 treatment in any manner whatsoever of disease or any ailment of 19 the human body. 20 "Health care practitioner." An individual, other than a 21 physician assistant, who is authorized to practice some 22 component of the healing arts by a license, permit, certificate 23 or registration issued by a licensing agency or board of the 24 Commonwealth or any other jurisdiction. 25 "License." A license to practice medicine granted under this 26 act. 27 "Licensed practitioner." Any physician licensed to practice 28 medicine in this Commonwealth. 29 "Medicine and surgery." The art and science of which the 30 objectives are the cure of diseases and the preservation of the 20030S0585B0647 - 2 -
1 health of man, including the practice of the healing arts with 2 or without drugs, except healing by spiritual means or prayer. 3 "Physician." An individual who has acquired one of the 4 following licenses or their equivalents in jurisdictions other 5 than this Commonwealth to practice medicine and surgery: 6 (1) License without restriction. 7 (2) Interim limited license. 8 (3) Graduate license. 9 (4) Institutional license. 10 (5) Temporary license. 11 (6) Extraterritorial license. 12 "Practice of medicine across State lines." A physician 13 located or licensed, or both, outside of this Commonwealth 14 rendering a written or otherwise documented medical opinion 15 concerning diagnosis or treatment of a patient within this 16 Commonwealth or for the purpose of such physician rendering 17 treatment to a patient within this Commonwealth, as a result of 18 transmission of individual patient data, by electronic or other 19 means, from within this Commonwealth to a location outside this 20 Commonwealth to such physician or his or her agent. The term 21 does not include telephone consultations between Commonwealth 22 physicians and nonresident physicians for which compensation is 23 neither given nor expected. 24 "Telemedicine." The electronic transmission of medical data, 25 other than through telephone calls from one physician to 26 another, from one location to another for the purposes of 27 interpretation or consultation. 28 "Teleradiology." The electronic transmission of radiological 29 images such as X-rays, CAT scans, etc., so that interpretation 30 of these images can be made at a remote site. The term does not 20030S0585B0647 - 3 -
1 include consultations between Commonwealth physicians and 2 nonresident physicians for which compensation is neither given 3 nor expected. 4 Section 4. License requirement. 5 (a) Licensure.--Any physician who is physically located in 6 and/or licensed by another jurisdiction but who through the use 7 of telemedicine or teleradiology performs an act that is part of 8 a patient-care service initiated in this Commonwealth and that 9 would directly affect the diagnosis or treatment of the patient 10 is engaged in the practice of medicine in this Commonwealth. 11 (b) Regulation.--The nonresident physicians who perform 12 these services through electronic media, since they are engaged 13 in the practice of medicine in this Commonwealth, shall obtain a 14 license without restriction to practice medicine in this 15 Commonwealth and shall be subject to the same requirements, 16 including requirements to purchase malpractice insurance and 17 participate in the Medical Professional Catastrophe Loss Fund, 18 as other physicians with full and unrestricted licenses 19 practicing in this Commonwealth. 20 Section 5. Exceptions. 21 This act shall not apply to: 22 (1) The acts of a medical specialist located or 23 licensed, or both, outside of this Commonwealth who provides 24 only episodic consultation on request and for which 25 compensation is neither given nor expected to a person 26 licensed in this Commonwealth. 27 (2) The acts of another physician located or licensed, 28 or both, outside of this Commonwealth who is providing 29 consultation to a medical school or residency training 30 program. 20030S0585B0647 - 4 -
1 (3) Dentists who are duly qualified and registered under 2 the laws of this Commonwealth and who confine their practice 3 strictly to dentistry. 4 (4) Duly licensed optometrists who confine their 5 practice strictly to optometry as defined by law. 6 (5) Duly licensed chiropractors who confine their 7 practice strictly to chiropractic as defined by law. 8 (6) Duly licensed podiatrists who confine their practice 9 strictly to podiatry as defined by law. 10 (7) Duly licensed or certified psychologists who confine 11 their practice strictly to psychology as defined by law. 12 (8) Duly licensed physical therapists who confine their 13 activities or practice strictly to physical therapy and who 14 are not in violation of any law relating to physical therapy 15 practice. 16 (9) Registered or professional nurses and licensed 17 vocational nurses registered or licensed under the laws of 18 this Commonwealth who confine their practice strictly within 19 the provisions of such applicable licensing acts and laws of 20 this Commonwealth. 21 (10) Commissioned or contract physicians of the 22 uniformed services of the United States or in the Public 23 Health Service in the performance of their duties and not 24 engaged in private practice. 25 (11) A student in training in a medical school while 26 performing the duties assigned in the course of training, 27 provided the duties are performed under the supervision of a 28 licensed practitioner, except that medical residents, interns 29 and fellows shall be required to register and be subject to 30 the other applicable provisions of this act. 20030S0585B0647 - 5 -
1 (12) A legally certified physician who is a resident of 2 another state, territory or nation who is in this 3 Commonwealth solely for consultation with licensed 4 practitioners but who does not: 5 (i) have an office in this Commonwealth; or 6 (ii) appoint a place in this Commonwealth for 7 seeing, examining or treating patients. 8 (13) Any other activities that the board may designate 9 as exempt from the application of this act. 10 Section 6. Sanctions. 11 Any person who violates the provisions of this act is subject 12 to criminal prosecution for the unlicensed practice of medicine 13 and/or to injunctive or other action authorized in this 14 Commonwealth to prohibit continued practice without a license. 15 Section 7. Effective date. 16 This act shall take effect immediately. C20L63JS/20030S0585B0647 - 6 -