TALLAHASSEE -- The doctors at Miami Children's Hospital use advanced communications technology to diagnose sick children in Ecuador, Peru and the Dominican Republic.
Helping young patients in remote parts of Florida or other states, however, is not so easy.
For one, insurance companies in Florida aren't required to reimburse doctors for telemedicine services, meaning physicians aren't guaranteed payment for web-based consultations or diagnostic test interpretations. What's more, many doctors don't have the licenses to practice in other states, or the credentials to practice at other hospitals.
"Because of the regulatory limitations, it is easier for me to care for a child in Colombia than it is for me to care for a child at Broward General," said Dr. Jacques Orces, chief medical information officer at Miami Children's.
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The Florida Legislature wants to change that.
Over the next few weeks, state lawmakers will consider creating statewide standards for telemedicine. They will also debate establishing reimbursement requirements, as well as a system for register
ing out-of-state telemedicine providers in Florida.
"Our goal is to create fertile ground for this kind of technology to be used," said state Rep. Jose Oliva, a Miami Republican who chairs the House Select Committee on Health Care Workforce Innovation.
The discussion is taking place as the Legislature shifts its focus from Medicaid expansion, which observers consider unlikely in an election year, to less controversial health care issues like addressing a shortage of primary care physicians.
Telemedicine is hardly a new concept -- and is already in use in some Florida hospitals.
State law also limits the type of of medications that can be prescribed online.
"It's to the point where it's almost frightening when we get a request for an out-of-state consult," Orces said.
Orces was one of four experts who testified before a House panel last week. He and others said the telemedicine could help rural counties lacking specialists and mental health providers.
The Senate Health Policy Committee heard a proposal by state Sen. Arthenia Joyner, D-Tampa, to require insurance providers to reimburse telemedicine services as if they were face-to-face encounters with doctors.
The bill also sought to establish standards of care and a process that would enable out-of-state telehealth providers to register in Florida.
After taking public comments, Senate Health Policy Committee Chairman Aaron Bean delayed a vote on the proposal, saying the committee needed another week to revise the language.
There will be many questions to answer moving forward.
Among them: Should telehealth services be reimbursed at the same rate as in-person services?
Tamela Perdue of the Associated Industries of Florida cautioned the Legislature against being over-prescriptive.
"We certainly love everything to allow the free market to work at its fullest," she told lawmakers last week. "Letting people negotiate for best rates and letting the market do its work is certainly our suggestion."
The Florida Medical Association will keep close watch on licensing issues, lobbyist Holly Miller said.
"Telemedicine should be performed by a licensed physician," she said.
State Sen. Eleanor Sobel, a Hollywood Democrat, raised similar concerns about quality last week.
"People in other states do not have the same high standards that we do," Sobel said. "I want to ensure that the health care providers from other states are licensed here in Florida."