Revision: March 30, 2023, 10:16 a.m.
Sen. Carson, Dist 14
Sen. Bradley, Dist 3
March 29, 2023
2023-1254s
06/10
Floor Amendment to SB 238-FN
Amend the bill by replacing all after the enacting clause with the following:
1 Statement of Purpose. The general court finds and recognizes that parents are responsible for providing and coordinating medical care for their minor children and are presumed to act in the best interest of their children. In order to make informed decisions about a minor child’s healthcare needs, parents must be granted access to their child’s medical records.
2 Physicians and Surgeons; Telemedicine. Amend RSA 329:1-d, III to read as follows:
III. It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV, except substance use disorder (SUD) treatment and/or mental health conditions. Methadone hydrochloride, as defined in RSA 318-B:10, VII(d)(2), shall not be included in the exemption.
III-a. It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV without first obtaining oral or written consent from the patient or a minor patient’s parent or guardian, unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian. For services delivered through telemedicine on an ongoing basis, the practitioner need only obtain consent from the patient or parent or guardian once.
3 Physicians and Surgeons; Telemedicine. Amend RSA 329:1-d, V to read as follows:
V. A physician providing services by means of telemedicine directly to a patient shall:
(a) Use the same standard of care as used in an in-person encounter;
(b) Maintain a medical record that shall be available to the patient, or if the patient is a minor to the patient’s parent or legal guardian, unless: (i) the records are records of treatment that a minor may consent to pursuant to a specific statute under state or federal law without parental consent or the consent of a legal guardian; (ii) a court of competent jurisdiction has determined that the release of the records to a parent or legal guardian is not in the child’s best interest; or (iii) a health care provider has determined by clear and convincing evidence based upon articulable facts that disclosure of the records to a parent or legal guardian of a minor child is likely to result in abuse or neglect. A health care provider who makes this determination shall document in the medical record of the minor child all facts upon which he or she relied in making the determination; and
(c) Subject to the patient's consent, forward the medical record to the patient's primary care or treating provider, if appropriate. In the case of a minor, the consent required by this subparagraph shall be obtained from a parent or legal guardian, unless the records are unavailable to a parent or legal guardian pursuant to subparagraph (b).
4 Nurse Practice Act; Definition of Telemedicine. Amend RSA 326-B:2, XII(c) to read as follows:
(c)(1) It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV except for use in substance use disorder treatment and/or mental health conditions.
(2) It shall be unlawful for any person to prescribe by means of telemedicine a controlled drug classified in schedule II through IV without first obtaining oral or written consent from the patient or a minor patient’s parent or guardian, unless state or federal law allows a minor to consent to treatment without the consent of a parent or guardian. For services delivered through telemedicine on an ongoing basis, the practitioner need only obtain consent from the patient or parent or guardian once.
5 Nurse Practice Act; Definition of Telemedicine. Amend RSA 326-B:2, XII(e) to read as follows:
(e) An APRN providing services by means of telemedicine directly to a patient shall:
(1) Use the same standard of care as used in an in-person encounter;
(2) Maintain a medical record that shall be available to the patient, or if the patient is a minor to the patient’s parent or legal guardian, unless: (i) the records are records of treatment that a minor may consent to pursuant to a specific statute under state or federal law without parental consent or the consent of a legal guardian; (ii) a court of competent jurisdiction has determined that the release of the records to a parent or legal guardian is not in the child’s best interest; or (iii) a health care provider has determined by clear and convincing evidence based upon articulable facts that disclosure of the records to a parent or legal guardian of a minor child is likely to result in abuse or neglect. A health care provider who makes this determination shall document in the medical record of the minor child all facts upon which he or she relied in making the determination.
(3) Subject to the patient's consent, forward the medical record to the patient's primary care or treating provider, if appropriate. In the case of a minor, the consent required by this subparagraph shall be obtained from a parent or legal guardian, unless the records are unavailable to a parent or legal guardian pursuant to subparagraph (2).
6 Effective Date. This act shall take effect upon its passage.