PRINTER'S NO. 1265
No. 1039 Session of 1999
INTRODUCED BY LEMMOND, SALVATORE, MADIGAN, O'PAKE, MUSTO,
SCHWARTZ, THOMPSON, RHOADES, STOUT AND BOSCOLA, JUNE 18, 1999
REFERRED TO COMMUNICATIONS AND HIGH TECHNOLOGY, JUNE 18, 1999
AN ACT
1 Regulating certain services provided by a nonresident physician
2 or osteopathic physician.
3 The General Assembly of the Commonwealth of Pennsylvania
4 hereby enacts as follows:
5 Section 1. Short title.
6 This act shall be known and may be cited as the Telemedicine
7 Act.
8 Section 2. Legislative findings and intent.
9 The General Assembly finds and declares as follows:
10 (1) That due to technological advances and changing
11 practice patterns, the practice of medicine is occurring with
12 increasing frequency across state lines, and that certain
13 technological advances in the practice of medicine are in the
14 public interest.
15 (2) That recent technological advances in electronic
16 data transmission have made it possible for nonresident
17 physicians and osteopathic physicians, not licensed in this
18 Commonwealth, to render written or otherwise documented
1 opinions for patients residing in this Commonwealth and that
2 these opinions may directly affect patient care.
3 (3) That the practice of medicine is a privilege and
4 that the licensure of practitioners outside this Commonwealth
5 engaging in such medical practice within this Commonwealth
6 and the ability to discipline such practitioners is both
7 necessary and desirable for the protection of the citizens of
8 this Commonwealth and for the public interest, health,
9 welfare and safety.
10 Section 3. Definitions.
11 The following words and phrases when used in this act shall
12 have the meanings given to them in this section unless the
13 context clearly indicates otherwise:
14 "Board." The State Board of Medicine or the State Board of
15 Osteopathic Medicine.
16 "Healing arts." The science and skill of diagnosis and
17 treatment in any manner whatsoever of disease or any ailment of
18 the human body.
19 "Health care practitioner." An individual, other than a
20 physician assistant, who is authorized to practice some
21 component of the healing arts by a license, permit, certificate
22 or registration issued by a licensing agency or board of the
23 Commonwealth or any other jurisdiction.
24 "License." A license to practice medicine granted under this
25 act.
26 "Licensed practitioner." Any physician or osteopath licensed
27 to practice medicine in this Commonwealth.
28 "Medicine and surgery." The art and science of which the
29 objectives are the cure of diseases and the preservation of the
30 health of man, including the practice of the healing arts with
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1 or without drugs, except healing by spiritual means or prayer.
2 "Physician." An individual who has acquired one of the
3 following licenses or their equivalents in jurisdictions other
4 than this Commonwealth to practice medicine and surgery:
5 (1) License without restriction.
6 (2) Interim limited license.
7 (3) Graduate license.
8 (4) Institutional license.
9 (5) Temporary license.
10 (6) Extraterritorial license.
11 "Practice of medicine across state lines." A physician or
12 osteopathic physician located or licensed, or both, outside of
13 this Commonwealth rendering a written or otherwise documented
14 medical opinion concerning diagnosis or treatment of a patient
15 within this Commonwealth or for the purpose of such physician or
16 osteopathic physician rendering treatment to a patient within
17 this Commonwealth, as a result of transmission of individual
18 patient data, by electronic or other means, from within this
19 Commonwealth to a location outside this Commonwealth to such
20 physician or his or her agent. The term does not include
21 telephone consultations between Commonwealth physicians and
22 nonresident physicians or osteopathic physicians for which
23 compensation is 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
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1 include consultations between Commonwealth physicians and
2 nonresident physicians or osteopathic physicians for which
3 compensation is neither given nor expected.
4 Section 4. License requirement.
5 (a) Licensure.--Any physician or osteopathic physician who
6 is physically located in and/or licensed by another jurisdiction
7 but who through the use of telemedicine or teleradiology
8 performs an act that is part of a patient-care service initiated
9 in this Commonwealth and that would directly affect the
10 diagnosis or treatment of the patient is engaged in the practice
11 of medicine in this Commonwealth.
12 (b) Regulation.--The nonresident physicians or osteopathic
13 physicians who perform these services through electronic media,
14 since they are engaged in the practice of medicine or
15 osteopathic medicine in this Commonwealth, shall obtain a
16 license without restriction to practice medicine or osteopathic
17 medicine in this Commonwealth and shall be subject to the same
18 requirements, including requirements to purchase malpractice
19 insurance and participate in the Medical Professional
20 Catastrophe Loss Fund, as other physicians with full and
21 unrestricted licenses practicing in this Commonwealth.
22 Section 5. Exceptions.
23 This act shall not apply to:
24 (1) The acts of a medical specialist located or
25 licensed, or both, outside of this Commonwealth who provides
26 only episodic consultation on request and for which
27 compensation is neither given nor expected to a person
28 licensed in this Commonwealth.
29 (2) The acts of another physician or osteopathic
30 physician located or licensed, or both, outside of this
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1 Commonwealth who is providing consultation to a medical
2 school or residency training program.
3 (3) Dentists who are duly qualified and registered under
4 the laws of this Commonwealth and who confine their practice
5 strictly to dentistry.
6 (4) Duly licensed optometrists who confine their
7 practice strictly to optometry as defined by law.
8 (5) Duly licensed chiropractors who confine their
9 practice strictly to chiropractic as defined by law.
10 (6) Duly licensed podiatrists who confine their practice
11 strictly to podiatry as defined by law.
12 (7) Duly licensed or certified psychologists who confine
13 their practice strictly to psychology as defined by law.
14 (8) Duly licensed physical therapists who confine their
15 activities or practice strictly to physical therapy and who
16 are not in violation of any law relating to physical therapy
17 practice.
18 (9) Registered or professional nurses and licensed
19 vocational nurses registered or licensed under the laws of
20 this Commonwealth who confine their practice strictly within
21 the provisions of such applicable licensing acts and laws of
22 this Commonwealth.
23 (10) Commissioned or contract physicians and osteopathic
24 physicians of the uniformed services of the United States or
25 in the Public Health Service in the performance of their
26 duties and not engaged in private practice.
27 (11) A student in training in a medical school while
28 performing the duties assigned in the course of training,
29 provided the duties are performed under the supervision of a
30 licensed practitioner, except that medical residents, interns
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1 and fellows shall be required to register and be subject to
2 the other applicable provisions of this act.
3 (12) A legally certified physician or osteopathic
4 physician who is a resident of another state, territory or
5 nation who is in this Commonwealth solely for consultation
6 with licensed practitioners but who does not:
7 (i) have an office in this Commonwealth; or
8 (ii) appoint a place in this Commonwealth for
9 seeing, examining or treating patients.
10 (13) Any other activities that the board may designate
11 as exempt from the application of this act.
12 Section 6. Sanctions.
13 Any person who violates the provisions of this act is subject
14 to criminal prosecution for the unlicensed practice of medicine
15 and/or to injunctive or other action authorized in this
16 Commonwealth to prohibit continued practice without a license.
17 Section 7. Effective date.
18 This act shall take effect immediately.
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