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Telemedicine bill sails through House, awaits Senate vote

Legislation that would establish ground rules for the practice of telemedicine roared through the Mississippi House of Representatives and a version of it is in a Senate committee.

House Bill 1178 was approved by the lower chamber 103-17 and was sent to the Senate Public Health and Welfare.

The legislation is a result of telemedicine companies and businesses that were concerned about the Mississippi Medical Licensure Board’s proposals that they saw as restricting the practice, said Rep. Sam Mims, R-McComb, lead author of the measure.

One of the major telemedicine practitioners in the state, Teladoc Inc., opposed the rules, which were filed with the Secretary of State’s office in March 2015. The company demanded an economic impact statement.

The board said in August that it would provide one, possibly the next month. As of Tuesday, no such statement has been finalized, said Dr. H. Vann Craig, executive director of the board. Craig said that he has tendered his resignation, effective March 25. “Let’s just say I’m needed at home,” said Craig, who added that he does not have a medical practice.

A draft of the impact statement has been done, Craig said. The board has shelved its proposed rules for the time being, he said in an earlier interview.

The absence of the board action, the legislation would replace an outdated law passed in 1997. The one-page state law, 73-25-34, says only that physicians from outside the state have to be licensed in Mississippi.

The 18-page House bill goes into much detail to “modernize our idea of telemedicine and help telemedicine services expand throughout the state, particularly in rural areas,” Mims said.

The licensing board is composed of members of the Mississippi Medical Association, which represents about 70 percent of the state’s physicians.

Association President Dr. Dan Edney said in an interview Tuesday that HB 1178 is “terrible” legislation that would “blindfold” telemedicine physicians by not requiring video communication with patients.

Edney that audio and video are the national standard for telemedicine. If the Legislature approves the measure, the association will ask Gov. Phil Bryant to veto it, Edney said.

The legislation states that a telemedicine practitioner “must have the ability to offer multiple forms of telemedicine services and cannot be solely telephone services.”

Charlie Ross, a Jackson attorney and former member of the state Senate who is representing Teladoc, said that a physician has final say as to whether video is necessary, depending on his or her interpretation of the standard of care.

Teladoc physicians are all licensed in Mississippi, though they do not have to live in the state.

Ninety-five percent Teladoc patients request audio only and 5 percent request video in addition, Ross said, adding that in 7 percent of the cases, a Teladoc patient is referred to a physician for an office visit or to an emergency room, Ross said.

Jay Moon, executive director of the Mississippi Manufacturing Association, said that its member companies use Teladoc and also MDLIVE.

“We think that it is a great service that employers can offer to employees,” Moon said.

Many manufacturing employees live in a rural area and work in an urban area and so they have long commutes, which makes telemedicine work for them, he said.

The cost is attractive, too, Moon said. Teladoc visits are about $45 each while MDLIVE charges $49, according to its website. The website states that the average wait for one of its customers is 12 minutes versus hours for office or hospital visits.

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