SB 579 Modifies provisions relating to infection reporting of health care facilities and telehealth services
Sponsor: Schaaf Co-Sponsor(s)
LR Number: 4862S.02T Fiscal Notes
Committee: Veterans' Affairs and Health
Last Action: 6/8/2016 - Signed by Governor Journal Page: S2303
Title: Calendar Position:
Effective Date: August 28, 2016
House Handler: Frederick

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Current Bill Summary


SB 579 - This act requires the Department of Health and Senior Services to include carbapenem-resistant enterobacteriaceae (CRE) in its list of communicable or infectious diseases which must be reported to the Department.

Under current law, the Department is required to disseminate reports to the public based on data compiled showing infection incidence rates for certain infections for hospitals and ambulatory surgical centers. This act adds other infections to be reported, including: hospital and ambulatory surgical center procedure infections that meet certain requirements, central line-related bloodstream infections, health care-associated infections specified by the Centers for Medicare and Medicaid Services (CMS), and other categories of infections established by the Department through rule. The Department shall make such reports available to the public for at least 2 years.

This act requires the Infection Control Advisory Panel to make recommendations to the Department regarding CMS' reporting requirements by January 1, 2017. The panel recommendations shall address which hospitals shall be required, as a condition of licensure, to use specified national networks for data collection, risk analysis and adjustment, or public reporting of infection data. After considering the panel's recommendations, the Department shall implement guidelines from the Centers for Disease Control and Prevention's National Healthcare Safety Network, or its successor. As a condition of licensure, those hospitals that meet the minimum public reporting requirements shall participate in the National Healthcare Safety Network program. Those hospitals shall permit the program to disclose facility-specific data. Those facilities not participating in the program shall submit facility-specific data to the Department as a condition of licensure.

This act also provides that no later than August 28, 2017, each hospital and ambulatory surgical center, excluding mental health facilities, shall establish an antibiotic stewardship program for evaluating the judicious use of antibiotics, especially antibiotics that are the last line of defense against resistant infections. The stewardship program procedures shall be made available to the Department upon inspection. Hospitals shall meet specified national standards for reporting antimicrobial usage or resistance and shall authorize the National HealthCare Safety Network, or its successor, to disclose to the Department facility-specific reported data. Such data shall not be disclosed to the public except under specific circumstances. Beginning January 1, 2018, and every year thereafter, the Department shall report the General Assembly on the incidence, type, and distribution of antimicrobial-resistant infections in the state.

These provisions are substantially similar to SCS/HCS/HB 1066 (2015) and similar to SCS/SB 10 (2015) and SB 910 (2014).

This act also defines "telehealth" or "telemedicine" as the delivery of health care services by means of information and communication technologies which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while such patient is at the originating site and the health care provider is at the distant site. Telehealth shall also include the use of asynchronous store-and-forward technology. Any licensed health care provider shall be authorized to provide telehealth services if such services are within the scope of practice for which the health care provider is licensed and if such services are provided under the same standard of care as services provided in person. Additionally, no originating site shall be required to maintain immediate availability of on-site clinical staff during the telehealth service, unless such is necessary to meet the standard of care for the treatment of the patient's medical condition when the treating health care provider has not previously seen the patient in person in a clinical setting, is not located at the originating site, and is not providing coverage for a health care provider with an established relationship with the patient.

Additionally, physicians practicing telemedicine shall ensure that a properly established physician-patient relationship, as described in this act, exists with the person receiving telemedicine services. No health care provider shall prescribe any drug, controlled substance, or other treatment to a patient based solely on a telephone evaluation. However, physicians, or their delegates, on-call physicians, advanced practice registered nurses, physician assistants, or assistant physicians in a supervision agreement may prescribe any drug, controlled substance, or other treatment, within his or her scope of practice, to a patient based solely on an evaluation over the telephone if a previously-established and ongoing valid physician-patient relationship exists. No health care provider shall prescribe any drug, controlled substance, or other treatment based solely on an Internet request or an Internet questionnaire.

This act specifies the licensed individuals who shall be considered eligible health care providers for the provision of telehealth services for MO HealthNet participants. Additionally, this act specifies the originating sites where a MO HealthNet participant may receive telehealth services.

This act addresses the use of asynchronous store-and-forward technology in the provision of telehealth services for MO HealthNet participants. "Asynchronous store-and-forward" is defined in the act as the transfer of a patient's clinically important digital samples, such as still images, videos, audio, and text files, and relevant data from an originating site through the use of a camera or similar recording device that stores digital samples that are forwarded via telecommunication to a distant site for consultation by a consulting provider without requiring the simultaneous presence of the patient and the patient's treating provider. The Department of Social Services, in consultation with the Departments of Mental Health and Health and Senior Services, shall promulgate rules governing the use of asynchronous store-and-forward technology in the practice of telehealth in MO HealthNet. The act also specifies reimbursement for asynchronous store-and-forward services for the treating provider and the consulting provider.

This act establishes the "Telehealth Services Advisory Committee" to advise the Department of Social Services and to propose rules relating to telehealth services through asynchronous store-and-forward technology. The act specifies the committee members, appointments, and other terms.

This act establishes a statewide home telemonitoring program for the MO HealthNet program. Home telemonitoring services are health care services that require scheduled remote monitoring of data related to a patient's health. The act specifies the individuals for whom home telemonitoring services may be made available. If the Department of Social Services determines that home telemonitoring is not cost effective, the Department may discontinue the program and stop providing reimbursement through MO HealthNet for such services.

These provisions are substantially similar to provisions in HCS/SS/SCS/SB 621 (2016), HB 1923 (2016) and HCS/SCS/SB 230 (2015).

SARAH HASKINS