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The telemedicine company Teladoc is opposed to a bill in North Dakota that its representatives say would be restrictive and have a "chilling effect" on patients and providers.

The North Dakota Board of Medicine brought forth a bill that would require a telemedicine provider to do an initial video examination or have the patient exam done with another licensed provider.

Bonnie Storbakken, executive secretary of the state Board of Medicine, previously said the requirement would protect patients in allowing them to verify for themselves that they are being treated by a licensed doctor, as well as set up a "framework" for telemedicine providers in the state.

Under the bill, once a physician-patient relationship is established after the initial visit, then it's the discretion of the physician in deciding how to visit with and diagnose patients.

Proponents of the bill say it would protect patients, while critics say it could decrease access.

Last year, in North Dakota, Teladoc completed 1,500 virtual visits in North Dakota and saved companies and employees in the state more than $700,000 in health care costs, according to Claudia Tucker, Teladoc’s vice president of government affairs.

"There can be unintended consequences when states pass legislation. Albeit well-intended, some language can actually rob access and diminish savings. And part of what you have here today ... would have a chilling effect," Tucker said at the hearing.

Dr. Donna Campbell, a member of the Texas State Senate and an emergency care physician who works with Teladoc, said that telemedicine is particularly important for patients in rural areas, some who may not have access to broadband and use a landline.

John Ward, a Bismarck attorney and lobbyist representing Teladoc, also told lawmakers that the bill is arbitrary and "potentially the most restrictive stature that would be implemented across the nation."

In 2017, the state Board of Medicine proposed a rule that would require the video or in-patient visit to the Legislature's Administrative Rules Committee. The committee ultimately denied the proposed rule and instead asked the board to present a bill to the full Legislature.

"One of the important aspects is the Legislature will have oversight over this so it's not just an administrative agency,” Ward said, of the bill being introduced this session.

Ward said, though legislative oversight takes place in the Administrative Rules Committee, "this gets the full process." He also said it is his experience that the interim committee has a tendency to defer to agencies recommendations.

"In that respect, it’s preferable,” he said, to have the legislation face the full body.

The Senate Human Services Committee did not take action on the bill on Monday.

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(Reach Blair Emerson at 701-250-8251 or Blair.Emerson@bismarcktribune.com)

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