Utah Admin. Code 156-1-602

Current through Bulletin No. 2024-21, November 1, 2024

Section R156-1-602 - Telehealth

(1) Terms used in this rule are defined in Section 26B-4-704. In addition:

(a) "Patient Encounter" means any encounter where medical treatment and evaluation and management services are provided. The entire course of an inpatient stay in a healthcare facility or treatment in an emergency department is a single patient encounter.

(b) "Provider" means the same as defined in Subsection 26-60-102(6)(b), an individual licensed under Title 58, Occupations and Professions to provide health care services, and:

(i) shall include an individual exempt from licensure as defined in Section 58-1-307 who provides health care services within the individual's scope of practice under Title 58, Occupations and Professions; and

(ii) may include multiple providers obtaining informed consent and providing care as a team, consistent with the standards of practice applicable to a broader practice model found in traditional health care settings.

(2) Under Subsection 26B-4-704(2)(b), a provider offering telehealth services shall, before each patient encounter:

(i) verify the patient's identity and originating site;

(ii) allow the patient an opportunity to select their provider rather than being assigned a provider at random, to the extent possible; and

(iii) ensure that the online site does not restrict the patient's choice to select a specific pharmacy for pharmacy services; and

(b) before each initial patient encounter, obtain informed consent to the use of telehealth services by clear disclosure of:

(i) additional fees for telehealth services, if any, and how payment is to be made for those additional fees if they are charged separately;

(ii) to whom patient health information may be disclosed and for what purpose, including clear reference to any patient consent governing release of patient-identifiable information to a third-party;

(iii) the rights of the patient with respect to patient health information;

(iv) appropriate uses and limitations of the site, including emergency health situations;

(v) information affirming that the telehealth services meet industry security and privacy standards in Subsection 26B-4-704(1)(i)(ii), and warning of potential risks to privacy regardless of the security measures;

(vi) a warning that information may be lost due to technical failures, and clearly referencing any patient consent to hold the provider harmless for such loss; and

(vii) information disclosing the website owner-operator, location, and contact information.

(3) Under Subsection 26B-4-704(2)(d), a provider offering telehealth services shall be available to the patient for subsequent care related to the initial telemedicine services as follows:

(a) providing the patient with a clear mechanism to:

(i) access, supplement, and amend patient-provided personal health information;

(ii) contact the provider for subsequent care;

(iii) obtain upon request the patient's medical record or other report containing an explanation of the treatment provided to the patient and the provider's evaluation, analysis, or diagnosis of the patient's condition, including the informed consent provided; and

(iv) request a transfer to another provider of the patient's medical record documenting the telemedicine services; and

(b) if the provider recommends that the patient be seen in person, such as if diagnosis requires a physical examination, lab work, or imaging studies:

(i) arranging to see the patient in person, or referring the patient to the patient's designated health care provider, or if none, to an appropriate health care provider; and

(ii) documenting the referral in the patient's medical record; and

(c) if the patient does not have a designated health care provider, consult with the patient and send a medical record or other report to the referred health care provider in the manner provided under Subsection 26B-4-704(2)(g), except the medical record or report shall be provided within a reasonable time frame allowing for timely care of the patient by that provider.

(4) Nothing in this section shall prohibit electronic communications consistent with standards of practice applicable in traditional health care settings, including the following:

(a) between a provider and a patient with a preexisting provider-patient relationship;

(b) between a provider and another provider concerning a patient with whom the other provider has a provider-patient relationship;

(c) in on-call or cross coverage situations when the provider has access to patient records;

(d) in broader practice models when multiple providers provide care as a team, including, for example:

(i) within an existing organization; or

(ii) within an emergency department; or

(e) in an emergency, which as used in this section means a situation when there is an occurrence posing an imminent threat of a life-threatening condition or severe bodily harm.

Utah Admin. Code R156-1-602

Adopted by Utah State Bulletin Number 2018-23, effective 11/8/2018

Amended by Utah State Bulletin Number 2020-03, effective 1/9/2020

Amended by Utah State Bulletin Number 2021-07, effective 3/25/2021

Amended by Utah State Bulletin Number 2024-09, effective 4/23/2024