LEGISLATIVE, LEGAL AND POLICY ISSUES IN TELEMEDICINE & TELEHEALTH

Licensure Issue Summary

Restrictive Florida Licensure Bill Dies in Committee

by Glenn Wachter, May 31, 2000

Bill background

In early May, a restrictive telemedicine licensure bill (SB 2492) failed to move out of a committee in Florida's Legislature. The bill included language that would have required full licensure for all physicians from another state who practice medicine in Florida.

Introduced by Senator Ginny Brown-Waite, SB 2492 was referred to the Senate Committee on Health, Aging and Long-term Care. This bill had solid support from the state's medical community, but predominately was championed by Florida's radiologist lobby. (Radiology is among medical specialties that can be practiced entirely electronically, permitting digital films to be read virtually anywhere in the world. Therefore, in a given state, less restrictive models of telemedicine licensure laws would make it easier for out-of-state telemedicine, and could result in a less secure patient base.)

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Review of bill

Florida's legislative staff thoroughly examined SB 2492; their findings include:

vague definition of what telehealth services would be regulated;
regulation of Internet health content viewed by Floridians;
requirement of Florida licensed professionals to obtain an additional telehealth license;
assignment of jurisdiction and provision for recovery of damages in Florida for malpractice resulting from interstate telehealth services; and
opportunity for legal challenges of both the Florida and U.S. Constitution.

In essence, the bill was thought to be overly restrictive, promoting professional protectionism, and would potentially limit the choices of Florida consumers who seek health care--even reducing their access to health information on the Internet. Moreover, legislative staff concluded SB 2492's provisions would be nearly impossible to enforce, resulting in substantial costs to taxpayers.

When legislative staff communicated their concerns to Senator Brown-Waite, an advocate for consumer rights and health care access, she requested a major bill modification. Senator Brown-Waite proposed language to support a "reciprocal model" of licensure for out-of-state telemedicine practitioners. As could be expected, the radiologist and medical community lobby opposed less restrictive language, and without their support a revised version never made it onto paper.

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Bill modified & re-introduced

And then the game became a lot more interesting. Another Senator permitted the use of his bill as a "shell" whereas the old language was removed and the radiologist-supported restrictive licensure language written in--a process known as "gut-and-stuff". This new bill was then referred to a supportive committee likely to vote the bill favorably back to the Senate floor. The new bill was headed to the Fiscal Committee, vice-chaired by Senator Brown-Waite. Upon learning that the content of her original bill had been lifted into another bill, she made sure it did not make it out of committee.

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Future of bill

With their legislative end-run foiled, the radiology lobby was out of plays for the session, yet their persistence may eventually pay off since Florida's legislative staff expect another version of the restrictive bill to be introduced in the 2001 session. It is not unusual for major legislation to take several sessions to pass, year by year coordinating and orchestrating coalitions of support.

Is the death of SB 2492 indicative of the climate for telemedicine licensure regulation in other states? Actually, no. In late 1999 TRC examined telemedicine licensure status across the nation, and discovered that 20 states had restrictive laws, only 3 states had laws supporting reciprocal licensure, and 28 states had not passed legislation either way.

Could states with restrictive licensure laws have been motivated from a similar desire to protect their state's patient population from out-of-state practitioners? Without detailed legislative research, it is impossible to determine the motivations one way or the other.

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Page last updated on Tuesday, May 27, 2003