"Telehealth" is the use of synchronous or asynchronous telecommunication technology by a practitioner to provide health care to a patient at a different physical location than the practitioner.   A telehealth visit is considered to take place at the patient location, known as the originating site.

The Department of Health (DOH) licenses and certifies health care professionals in a variety of fields.  Licensure or certification may entail the adoption of rules, verification of educational attainment and completion of supervised training, completion of a background check and verification of good character requirements, administration of a knowledge or practical skills examination, and collection of license or certification fees.  The Uniform Disciplinary Act (UDA) provides laws governing the conduct and discipline of license and certification holders, with DOH, or a board or commission within DOH, acting as the disciplining authority.

A health care practitioner may provide telehealth services to a patient located in this state if the services are consistent with the health care practitioner's scope of practice in this state, applicable professional practice standards in this state, and requirements and limitations of federal law and law of this state. A practitioner-patient relationship may be established through telehealth.

An out-of-state health care provider may provide telehealth services to a patient located in Washington if the out-of-state health care practitioner holds a current license or certification required to provide health care in this state, or provides the telehealth services in consultation with a provider who has a provider-patient relationship with the patient or in the form of a specialty assessment, diagnosis, or recommendation for treatment.

A disciplining authority may not adopt or enforce a rule that establishes a different practice standard for telehealth services merely because the services are provided through telehealth or limit the telecommunication technology that may be used for telehealth services.

The telemedicine collaborative is extended until July 1, 2025. The collaborative must review the proposal authored by the Uniform Law Commission for the state to implement a process for out-of-state health care providers to register with the disciplinary authority regulating their profession in this state allowing that provider to provide services through telemedicine or store and forward technology to persons located in this state and provide a report the Legislature by December 1, 2024.

The committee recommended a different version of the bill than what was heard. PRO: The Uniform Law Commission engaged in a two year process to consider this bill language.  This has been used in other states without any issues with bad actors. It gives a pathway to practice and will address the provider shortage issue in the state. This bill is particularly important for mental health care. It is important to be technology neutral and include store and forward technology. The bill expands access to healthcare and greater choice of how that care is delivered.

OTHER:   Peer to peer consults are already allowed under current law. Registration is not licensure and providers should not be allowed to practice in the state without licensure. Compacts are a preferred path. Timeline for licensure is not a barrier to practice.  The telemedicine collaborative should review the registration process. Established relationship needs more consideration. Registered providers are less likely to accept Washington Medicaid patients.  Out of state providers wouldn't know what services are available locally.