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Louisiana Joins its Peers in Removing In-State Barriers to Telemedicine

Last week, Louisiana legislators approved the removal of certain restrictions on the delivery of telemedicine services to residents of Louisiana to encourage the provision of telemedicine services in the state.  H.B. No. 570 was signed by the President of the Senate on June 5, 2016 and sent to Governor John Bel Edwards on June 6, 2016.

Notably, the Bill modifies the telemedicine requirements under La. Stat. Ann. § 37:1271, and R.S. 40:1223.3(5) and 1223.4(A) as follows:

  • A physician practicing telemedicine in the state who does not maintain a physical practice location within the state of Louisiana (but who is licensed in the state and has access to the patient’s medical records) is no longer required to first conduct an in-person patient history or physical examination of the patient before engaging in a telemedicine encounter.
  • In sum, La. Stat. Ann. § 37:1271 now requires that telemedicine providers hold an unrestricted license to practice medicine in Louisiana; obtain access to the patient’s medical records upon consent of the patient; create a medical record on each patient and make it available to the Louisiana State Board of Medical Examiners upon request; and, if necessary, provide a referral to a physician or arrange follow-up care in the state, as indicated.
  • The definition of “synchronous interaction” found in S. 40:1223.3(5) is now broadened to allow providers to use audio (without video) for telemedicine encounters if the same standard of care as in-person encounters is maintained.
  • This means that patients will be able to use a phone for telemedicine purposes, which is especially useful for patients who may not have: access to video-based technology, the know-how to connect with a provider using video-based technology, or an appropriate data plan/wireless connection for the simultaneous transmission of video.
  • Each state agency and each professional or occupational licensing board or commission authorized to adopt rules and regulations specific to the practice of telemedicine pursuant to S. 1223.4(A) is now prohibited from adopting any rules or regulations that are more restrictive than the provisions of the present law.

Like Alaska’s recent modifications to its telemedicine requirements, the Louisiana Bill broadens the base of available health care providers through the removal of the in-state restriction, which helps to increase the supply of physicians and competition from lower-cost providers, reduces transportation costs and improves access to quality care.  In addition, this Bill expands the types of technologies that may be used to deliver telemedicine services, which will better accommodate the significant portion of health care consumers who prefer phone consultations to access care.




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Mobile Health Tools, Developers Need Better Data Protection Guidance, Attorney Jennifer Geetter Says

After three government agencies collectively created an online tool to help developers navigate federal regulations impacting mobile health apps, McDermott partner Jennifer Geetter was interviewed by FierceMobileHealthcare on the need for mobile health development tools.

Read the full article from FierceMobileHealthCare.




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FTC Weighs-in on Telehealth: Providing Comments Regarding Alaska’s Proposed Licensure and Standard of Care Requirements

In March 2016, the US Federal Trade Commission (“FTC”) staff submitted public comments regarding the telehealth provisions of a proposed state bill in Alaska demonstrating the FTC’s continued focus on health care competition and general discouragement of anti competitive conduct in health care markets, with a renewed interest and focus on telehealth.

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Developing and Implementing an Effective Telemedicine Informed Consent Form

The search by consumers, payers and providers for more efficient, effective and convenient care delivery models has led to an explosion of technological innovation in the health care sector. This explosion has supported the increased use of telemedicine by providers to reach patients who were previously out of reach, and to provide more timely and cost-effective care.

With the use of telemedicine technologies comes a responsibility on the part of providers to educate and inform patients on the benefits, and more importantly, on the risks associated with receiving care via telemedicine. Like any other care setting, compliance with this responsibility serves the dual purpose of providing consumers with the information needed to make an informed decision about their care, but also mitigates the provider’s potential liability exposure from medical malpractice claims. (more…)




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Government Issues New Tool to Help Mobile App Developers Identify Applicable Federal Laws

This week, the Federal Trade Commission (FTC or Commission) released an interactive tool (entitled the “Mobile Health Apps Interactive Tool”) that is intended to help developers identify the federal law(s) that apply to apps that collect, create and share consumer information, including health information. The interactive series of questions and answers augments and cross-references existing guidance from the US Department of Health and Human Service (HHS) that helps individuals and entities—including app developers—understand when the Health Insurance Portability and Accountability Act (HIPAA) and its rules may apply.  The tool is also intended to help developers determine whether their app is subject to regulation as a medical device by the FDA, or subject to certain requirements under the Federal Trade Commission Act (FTC Act) or the FTC’s Health Breach Notification Rule. The Commission developed the tool in conjunction with HHS, FDA and the Office of the National Coordinator for Health Information Technology (ONC).

Based on the user’s response to ten questions, the tool helps developers determine if HIPAA, the Federal Food, Drug, and Cosmetic Act (FDCA), FTC Act and/or the FTC’s Health Breach Notification Rule apply to their app(s). Where appropriate based on the developer’s response to a particular question, the tool provides a short synopsis of the potentially applicable law and links to additional information from the appropriate federal government regulator.

The first four questions cover a developer’s potential obligations under HIPAA. The first question explores whether an app creates, receives, maintains or transmits individually identifiable health information, such as an IP address. Developers may use the tool’s second, third and fourth questions to assess whether they are a covered entity or a business associate under HIPAA. The tool’s fifth, sixth and seventh questions help developers establish whether their app may be a medical device that the FDA has chosen to regulate.  The final three questions are intended to help users assess the extent to which the developer is subject to regulation by the FTC.

Although the tool provides helpful, straightforward guidance, users will likely need a working knowledge of relevant regulatory principles to successfully use the tool.  For example, the tool asks the user to identify whether the app is “intended for use” for diagnosis, cure, mitigation, treatment or disease prevention, but does not provide any information regarding the types of evidence that the FDA would consider to identify a product’s intended use or the intended use of a mobile app (e.g., statements made by the developer in advertising or oral or written statements). In addition, how specifically an app will be offered to individuals to be used in coordination with their physicians can be dispositive of the HIPAA analysis in ways that are not necessarily intuitive.

The tool provides a starting point for developers to raise their awareness of potential compliance obligations. It also highlights the need to further explore the three federal laws, implementing rules and their exceptions. Developers must be aware of the tool’s limitations—it does not address state laws and is not intended to provide [...]

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Farewell ‘Safe Harbor,’ Hello ‘Privacy Shield’: Europe and U.S. Agree on New Rules for Transatlantic Data Transfer

After intense negotiations, and after the official deadline had passed on Sunday, 31 January 2016, the United States and the European Union have finally agreed on a new set of rules—the “EU-U.S. Privacy Shield”—for data transfers across the Atlantic. The Privacy Shield replaces the old Safe Harbor agreement, which was struck down by the European Court of Justice (ECJ) in October 2015. Critics already comment that the Privacy Shield will share Safe Harbor’s fate and will be declared invalid by the ECJ; nevertheless, until such a decision exists, the Privacy Shield should give companies legal security when transferring data to the United States.

While a text of the new agreement is not yet published, European Commissioner Věra Jourvá stated that the Privacy Shield should be in place in the next few weeks. According to a press release from the European Commission, the new arrangement

…will provide stronger obligations on companies in the U.S. to protect the personal data of Europeans and stronger monitoring and enforcement by the U.S. Department of Commerce and Federal Trade Commission (FTC), including through increased cooperation with European Data Protection Authorities. The new arrangement includes commitments by the U.S. that possibilities under U.S. law for public authorities to access personal data transferred under the new arrangement will be subject to clear conditions, limitations and oversight, preventing generalized access. Europeans will have the possibility to raise any enquiry or complaint in this context with a dedicated new Ombudsperson.

One of the most known critics of the U.S. data processing practices and initiator of the ECJ Safe Harbor decision, Austrian Max Schrems, already reacted to the news. Schrems stated on social media that the ECJ Safe Harbor decision explicitly says that “generalized access to content of communications” by intelligence agencies violates the fundamental right to respect for privacy. Commissioner Jourová, referring to the Privacy Shield, stated that “generalized access … may happen in very rare cases”—which could be viewed as contradictory to the ECJ decision. Critics also argue that an informal commitment by the United States during negotiations with the European Union is not something on which European citizens could base lawsuits in the United States if their data is transferred or used illegally.

The European Commission will now prepare a draft text for the Privacy Shield, which still must be ratified by the Member States. The EU Parliament will also review the draft text. In the meantime, the United States will make the necessary preparations to put in place the new framework, monitoring mechanisms and new ombudsperson.

 




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FDA Releases Draft Guidance on Postmarket Management of Cybersecurity in Medical Devices

On January 15, 2016,  the U.S. Food and Drug Administration (FDA) published a draft guidance entitled Postmarket Management of Cybersecurity in Medical Devices (Draft Guidance), which outlines FDA’s recommendations for managing postmarket cybersecurity vulnerabilities in medical devices that contain software or programmable logic and software that is a medical device, including networked medical devices. The Draft Guidance represents FDA’s latest attempt to outline principles intended to enhance medical device cybersecurity throughout the product lifecycle.

Read the full article.




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FTC Report Alerts Organizations about the Risks and Rewards of Big Data Analytics

On January 6, the Federal Trade Commission (FTC) released a report that it hopes will educate organizations on the important laws and research that are relevant to big data analytics. The report, Big Data: A Tool for Inclusion or Exclusion? Understanding the Issues, looks specifically at how big data is used after it is collected and analyzed and provides suggestions aimed at maximizing the benefits and minimizing the risks of using big data.

Risk and Rewards

The report argues that big data analytics can provide numerous opportunities for improvements in society. In addition to more effectively matching products and services to consumers, big data can create opportunities for low income and underserved communities. The report highlights a number of innovative uses of big data that provide benefits to underserved populations, such as increased educational attainment, access to credit through nontraditional methods, specialized health care for underserved communities, and better access to employment.

At the same time, the report shows that potential inaccuracies and biases might lead to detrimental effects for low-income and underserved populations. For example, organizations  could use big data to inadvertently exclude low-income and underserved communities from credit and employment opportunities, which may reinforce existing disparities or weaken the effectiveness of consumer choice.

Considerations for Using Big Data

The report outlines some of the consumer protection laws (in particular, the Fair Credit Reporting Act and FTC Act)  and equal opportunity laws that apply to the use of big data, especially with regard to possible issues of discrimination or exclusion. It also recommends that an organization consider the following questions to help ensure that its use of big data analytics does not lead to unlawful exclusion or discrimination:

How representative is your data set? 

If the data set is missing information from particular populations, take appropriate steps to address this problem.

Does your data model account for biases? 

Review data sets and algorithms to ensure that hidden biases do not have an unintended impact on certain populations.

How accurate are your predictions based on big data? 

Balance the risks of using correlative results, especially where the business’ policies could negatively affect certain populations.

Does your reliance on big data cause ethical or fairness concerns?

Consider whether fairness and ethical considerations advise against using big data in certain circumstances and whether the business can use big data in ways that advance opportunities for previously underrepresented populations.

Monitoring and Enforcement Ahead

The FTC stated that its collective challenge is to make sure that big data analytics continue to provide benefits and opportunities to consumers while adhering to core consumer protection values and principles. It has committed to continue monitoring areas where big data practices could violate existing laws and to bring enforcement actions where appropriate.  With that in mind, organizations that already use big data and those that are have been persuaded by reported benefits of big data should heed [...]

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China Released the Latest Classification Catalogue of Telecommunications Services (2015 Revision)

On December 28, 2015, the Ministry of Industry and Information Technology of China released the newly revised Classification Catalogue of Telecommunications Services, which is due to take effect as of March 1st, 2016. This round of revision has long been awaited since its last amendment in 2003, and is expected to reflect the advancement and emergence of new technologies and business models in the telecommunication field as well as to help keep new telecommunication business models under the regulatory radar.

 

Read the full China Law Alert.




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