Amended in Assembly March 19, 2013

California Legislature—2013–14 Regular Session

Assembly Bill No. 318

Introduced by Assembly Member Logue

February 12, 2013

An act begin insert to add Section 14132.726 to the Welfare and Institutions Code, end insert relating to begin delete dental care end delete begin insert Medi- end insert begin insert Cal end insert .

LEGISLATIVE COUNSEL’S DIGEST

AB 318, as amended, Logue. begin delete Dental care: telehealth. end delete begin insert Medi-Cal: teledentistry. end insert

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Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services, including certain dental services, as specified. Existing law provides that, to the extent that federal financial participation is available, face-to-face contact between a health care provider and a patient is not required under the Medi-Cal program for “teleophthalmology and teledermatology by store and forward,” as defined to mean the asynchronous transmission of medical information to be reviewed at a later time by a licensed physician or optometrist, as specified, at a distant site.

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This bill would enact similar provisions relating to the use of teledentistry, as defined, under the Medi-Cal program. The bill would provide that, to the extent that federal financial participation is available, face-to-face contact between a health care provider and a patient shall not be required under the Medi-Cal program for “teledentistry by store and forward.” The bill would define that term to mean an asynchronous transmission of dental information to be reviewed at a later time by a licensed dentist at a distant site, where the dentist at the distant site reviews the dental information without the patient being present in real time, as defined and as specified. The bill would also provide that dentist participation in services provided at an intermittent clinic, as defined, through the use of telehealth, as defined, shall be considered a billable encounter under Medi-Cal. The bill would also require, on or before January 1, 2017, the department to report to the Legislature the number and type of services provided, and the payments made related to the application of teledentistry, as specified.

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Existing law, the Dental Practice Act, provides for the licensure and regulation by the Dental Board of California of those engaged in the practice of dentistry. Existing law provides that a person practices dentistry if the person, among other things, manages or conducts as manager, proprietor, conductor, lessor, or otherwise, in any place where dental operations are performed.

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This bill would declare the intent of the Legislature to enact legislation that would promote the advancement of telehealth in dental care.

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Vote: majority. Appropriation: no. Fiscal committee:  begin delete no end delete begin insert yes end insert . State-mandated local program: no.

The people of the State of California do enact as follows:

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begin insert SECTION 1. end insert   

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begin insert Section 14132.726 is added to the end insert begin insert Welfare and
Institutions Code end insert begin insert , to read: end insert

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begin insert 14132.726. end insert   

(a) To the extent that federal financial participation
is available, face-to-face contact between a health care provider
and a patient shall not be required under the Medi-Cal program
for teledentistry by store and forward. Services appropriately
provided through the store and forward process are subject to
billing and reimbursement policies developed by the department.

(b) A patient receiving teledentistry by store and forward shall
be notified of the right to receive interactive communication with
the distant dentist, and shall receive an interactive communication
with the distant dentist, upon request. If requested, communication
with the distant dentist may occur either at the time of the
consultation, or within 30 days of the patient’s notification of the
results of the consultation.

(c) Dentist participation in services provided at an intermittent
clinic, as defined in Section 1206 of the Health and Safety Code,
through the use of telehealth, as defined in Section 2290.5 of the
Business and Professions Code, shall be considered a billable
encounter under Medi-Cal.

(d) Notwithstanding Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code,
the department may implement, interpret, and make specific this
section by means of all-county letters, provider bulletins, and
similar instructions.

(e) On or before January 1, 2017, the department shall report
to the Legislature the number and type of services provided, and
the payments made related to the application of store and forward
teledentistry as provided, under this section as a Medi-Cal benefit.

(f) For purposes of this section, the following definitions apply:

(1) “Asynchronous store and forward” means the transmission
of a patient’s dental information from an originating site to the
health care provider at a distant site without the presence of the
patient.

(2) “Distant site” means a site where a health care provider
who provides health care services is located while providing these
services via a telecommunications system.

(3) “Health care provider” means a person who is licensed
under Chapter 4 (commencing with Section 1600) of Division 2
of the Business and Professions Code.

(4) “Originating site” means a site where a patient is located
at the time health care services are provided via a
telecommunications system or where the asynchronous store and
forward service originates.

(5) “Synchronous interaction” means a real-time interaction
between a patient and a health care provider located at a distant
site.

(6) “Teledentistry” means the mode of delivering dental health
care services and public dental health via information and
communication technologies to facilitate the diagnosis,
consultation, treatment, education, care management, and
self-management of a patient’s dental health care while the patient
is at the originating site and the dental health care provider is at
a distant site. Teledentistry includes synchronous interactions and
asynchronous store and forward transfers.

(7) “Teledentistry by store and forward” means an
asynchronous transmission of dental information to be reviewed
at a later time by a licensed dentist at a distant site, where the
dentist at the distant site reviews the dental information without
the patient being present in real time.

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SECTION 1.  

It is the intent of the Legislature to enact
legislation to promote the advancement of telehealth in dental care.

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