Florida has taken one other step in direction of increasing telemedicine. On April 6, 2022, Governor Ron DeSantis signed into legislation laws to take away Florida’s prior restrictions on telemedicine prescribing of managed substances. Beforehand, Florida had a basic prohibition on prescribing managed substances by way of telemedicine, with solely slender exceptions. The brand new legislation (SB 312) eliminates the ban for all managed substances besides Schedule II. Schedule II medicine might be prescribed by way of telemedicine, however provided that the scientific scenario meets one of many 4 slender exceptions (extra on that beneath).
The legislation is a giant win for Florida sufferers with medical circumstances requiring managed substances as a part of the therapy routine. This consists of, for instance, endocrinology or substance use dysfunction (each of which use Schedule III drugs now permitted below the brand new legislation), permitting these sufferers to acquire higher entry to extra fulsome care. The legislation may even enable Florida clinicians to extra simply prescribe refills in reference to their ongoing care administration as a result of the clinician can periodically conduct affected person exams by way of telemedicine as a substitute of requiring in-person exams even when these exams is perhaps considered as medically pointless.
Some stimulant drugs generally prescribed in psychiatry are Schedule II medicine, which may doubtlessly meet one of many pre-existing exceptions if they’re prescribed for therapy of a psychiatric dysfunction. Most opioids are Schedule II medicine not allowed below this new legislation.
Florida as a Nationwide Chief in Telemedicine Coverage
Properly earlier than the COVID Public Well being Emergency, Florida policymakers had the foresight to favorably place the Sunshine State with a few of the most forward-thinking telemedicine legal guidelines in america. This imaginative and prescient was mirrored within the Board of Medication granting waivers to telemedicine suppliers below pilot applications courting again to 2014 (e.g., telepsychiatry, asynchronous prescribing, weight problems). The Legislature then created a groundbreaking State-sponsored Telehealth Advisory Council in 2016. That very same 12 months, the Board of Medication allowed telemedicine prescribing of managed substances for therapy of psychiatric issues. In 2019, lawmakers enacted a full overhaul of Florida telehealth legal guidelines and created a registration course of to permit out-of-state clinicians to shortly and simply get hold of permission to deal with Florida sufferers by way of telemedicine. And there’s a rulemaking workshop at present rewriting sure laws to higher accommodate telemedicine fashions. (Learn Foley’s feedback on that rule right here.)
The results of this multi-year effort allowed Florida residents to take pleasure in elevated entry to medical care, together with behavioral well being, whereas nonetheless giving the Division of Well being regulatory oversight on high quality. When the COVID Public Well being Emergency occurred, Florida carried out extra waivers permitting much more broad use of telemedicine, finally sunsetting them final 12 months. (Our prior discussions of Florida’s telehealth waivers can be found right here, right here, and right here.)
What’s Florida’s Managed Substance Telemedicine Prescribing Legislation?
The brand new legislation amends Florida’s telehealth statute as follows (new textual content is underlined):
Florida Statutes 456.47 Use of telehealth to supply providers.
(2) PRACTICE STANDARDS.
(c) A telehealth supplier could not use telehealth to prescribe a managed substance listed in Schedule II of s. 893.03 until the managed substance is prescribed for the next:
1. The therapy of a psychiatric dysfunction;
2. Inpatient therapy at a hospital licensed below chapter 20 395;
3. The therapy of a affected person receiving hospice providers as outlined in s. 400.601; or
4. The therapy of a resident of a nursing residence facility as outlined in s. 400.021.
The legislation is efficient beginning July 1, 2022.
What About Federal Legal guidelines?
Clinicians ought to proceed to be aware of prescribing necessities below federal legal guidelines, as telemedicine prescribing of managed substances can be ruled by the Ryan Haight Act. Amongst different issues, the Ryan Haight Act requires a threshold in-person examination between the prescriber and the affected person, though there are seven exceptions for the apply of telemedicine.
Florida legislation should be learn in concord with the Ryan Haight Act necessities, and a prescriber should adjust to each Florida and federal legal guidelines on this regard. Clinicians delivering care by way of telemedicine, notably throughout a number of states, should perceive and navigate many intersecting state and federal legal guidelines on telemedicine, medical apply, fraud and abuse, and managed substances.
Wish to Be taught Extra?
For extra info on telemedicine, telehealth, digital care, distant affected person monitoring, digital well being, and different well being improvements, together with the crew, publications, and consultant expertise, go to Foley’s Telemedicine & Digital Well being Business Group.