A bill in the North Dakota Senate would require patients to do a video or in-person examination for their initial visit with a telemedicine provider.
In 2017, the North Dakota Board of Medicine drafted a rule that would require a video exam or face-to-face visit for the patient's first telemedicine appointment. But the rule was shot down by the state Legislature's Administrative Rules Committee in March. Committee members stated that the rule was "arbitrary and capricious," according to meeting minutes.
The rule also received strong pushback from some health care organizations, including Teladoc, whose representatives told lawmakers that the requirement would disenfranchise people without access to broadband or technology.
Bonnie Storbakken, executive secretary for the state Board of Medicine, said the mandate is intended to protect patients and provide a framework for telemedicine providers in the state.
"Really, (the board was) trying to open it up and say yes, you can do telemedicine here ... but when you're first getting started with a new patient, there are parameters we want you to use," she said.
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Some states have laws that require face-to-face visits, including Arkansas, as well as Alabama, Georgia and Texas, according to the National Conference of State Legislatures. Several states also have passed laws to make it clear whether face-to-face means in-person or via video.
After the state Board of Medicine's telemedicine rule didn't pass, the Administrative Rules Committee told the board to bring the rule to the full Legislative Assembly for consideration, according to Storbakken.
The board then agreed to submit a bill — Senate Bill 2094 — with a section that requires an initial video exam or a visit with an "intervening health care provider," who consults with a telemedicine provider. She conceded that the bill may receive similar opposition, as its language has not changed.
"The board looked at all the comments that came in through the rules process and talked about each of them and, at the end of the day, felt that patient safety outweighed some of those comments," she said.
SB2094 has been assigned to the Senate Human Services Committee.