CHAPTER 368ll

MISCELLANEOUS PROVISIONS

Table of Contents

Sec. 19a-900. Use of cartridge injector by staff member of before or after school program, day camp or child care facility.

Sec. 19a-901. Obstetrical ultrasound procedure.

Sec. 19a-902. Dual licensure program for providers of mental health services and substance abuse services. Drug testing at facilities licensed by Department of Public Health. Regulations.

Sec. 19a-903. Prohibited billing practices re hospital-acquired conditions.

Sec. 19a-903a. Circulating nurses in hospitals and outpatient surgical facilities.

Sec. 19a-903b. Hospital designation of health care providers and technologists to perform oxygen-related patient care activities. Training. Competency testing. Exception.

Sec. 19a-903c. Medical spas.

Sec. 19a-904. Emergency service members and exposure to infectious diseases. Definitions. Designated officers. Duties of hospital. Request for notification. Immunity from liability.

Sec. 19a-904a. Notice to patients re coverage by health insurance policy. Understandable language in documents submitted to patients or insureds. Collection from insured of money owed by health carrier.

Sec. 19a-904b. Notice to health carrier when stopping acceptance of patients in insurance plan. Updates to health care provider directories.

Sec. 19a-904c. Electronic health records systems; utilization by hospitals.

Sec. 19a-904d. Health information blocking. Penalty.

Sec. 19a-905. Health care providers who provide direct patient care to wear badges.

Sec. 19a-905a. Recording of developmental screenings by health care providers.

Sec. 19a-906. Telehealth services.


Sec. 19a-900. Use of cartridge injector by staff member of before or after school program, day camp or child care facility. (a) For the purposes of this section:

(1) “Before or after school program” means any educational or recreational program for children administered in any building or on the grounds of any school by a local or regional board of education or other municipal agency, before or after regular school hours, or both, but does not include a program that is licensed by the Department of Public Health;

(2) “Cartridge injector” means an automatic prefilled cartridge injector or similar automatic injectable equipment used to deliver epinephrine in a standard dose for emergency first aid response to allergic reactions;

(3) “Day camp” means any recreational camp program operated by a municipal agency; and

(4) “Child care facility” means any child care center or group child care home, as described in subdivisions (1) and (2) of subsection (a) of section 19a-77, that is excluded from the licensing requirements of sections 19a-77 to 19a-87, inclusive, by subsection (b) of section 19a-77.

(b) Upon the request and with the written authorization of the parent or guardian of a child attending any before or after school program, day camp or child care facility, and pursuant to the written order of (1) a physician licensed to practice medicine, (2) a physician assistant licensed to prescribe in accordance with section 20-12d, or (3) an advanced practice registered nurse licensed to prescribe in accordance with sections 20-94a and 20-94b, the owner or operator of such before or after school program, day camp or child care facility shall approve and provide general supervision to an identified staff member trained to administer medication with a cartridge injector to such child if the child has a medically diagnosed allergic condition that may require prompt treatment in order to protect the child against serious harm or death. Such staff member shall be trained in the use of a cartridge injector by a licensed physician, physician assistant, advanced practice registered nurse or registered nurse or shall complete a course in first aid offered by the American Red Cross, the American Heart Association, the National Ski Patrol, the Department of Public Health or any director of health.

(P.A. 05-144, S. 2; 05-272, S. 35; P.A. 06-196, S. 151; P.A. 15-227, S. 25; P.A. 16-163, S. 36.)

History: P.A. 05-272 amended Subsec. (a)(1) by redefining “Before or after school program” to include programs administered, rather than offered, by a school board or municipality and by removing private providers from the definition, and amended Subsec. (b) by changing “and” to “or” in provision re training and education of staff members; P.A. 06-196 made a technical change in Subsec. (b), effective June 7, 2006; pursuant to P.A. 15-227, “child day care center” and “group day care home” were changed editorially by the Revisors to “child care center” and “group child care home”, respectively, in Subsec. (a)(4), effective July 1, 2015; P.A. 16-163 replaced “day care facility” with “child care facility” and made a technical change, effective June 9, 2016.

See Sec. 52-557b(h) re immunity of staff member from civil liability for rendering emergency assistance by using a cartridge injector.

Sec. 19a-901. Obstetrical ultrasound procedure. No person shall perform an obstetrical ultrasound procedure unless such procedure is (1) ordered by a licensed health care provider, acting within the scope of such provider's authority, and (2) for a medical or diagnostic purpose.

(P.A. 09-125, S. 1.)

History: P.A. 09-125 effective July 1, 2009.

Sec. 19a-902. Dual licensure program for providers of mental health services and substance abuse services. Drug testing at facilities licensed by Department of Public Health. Regulations. On or before January 1, 2011, the Department of Public Health, in consultation with the Department of Mental Health and Addiction Services, shall (1) amend the department's substance abuse treatment regulations; (2) implement a dual licensure program for behavioral health care providers who provide both mental health services and substance abuse services; and (3) permit the use of saliva-based drug screening or urinalysis when conducting initial and subsequent drug screenings of persons who abuse substances other than alcohol at facilities which are licensed by the Department of Public Health.

(P.A. 09-149, S. 3; P.A. 11-242, S. 43.)

History: P.A. 09-149 effective June 29, 2009; P.A. 11-242 designated existing requirements re regulations and program as Subdivs. (1) and (2), added Subdiv. (3) re use of saliva-based drug screening and urinalysis at facilities licensed by Department of Public Health and made a technical change.

Sec. 19a-903. Prohibited billing practices re hospital-acquired conditions. (a) As used in this section:

(1) “Hospital” means an acute care hospital that is subject to the federal inpatient prospective payment system described in 42 CFR 412; and

(2) “Outpatient surgical facility” has the same meaning as provided in section 19a-493b.

(b) No hospital or outpatient surgical facility shall seek payment for any increased costs that are incurred as the direct result of a hospital-acquired condition, identified as nonpayable by Medicare pursuant to Section 5001(c) of the Deficit Reduction Act of 2005. Except as otherwise provided by federal law or section 17b-278e, the provisions of this section shall apply irrespective of the patient's insurance status or source of payment, including self-pay status.

(P.A. 09-206, S. 2.)

History: P.A. 09-206 effective January 1, 2010.

Sec. 19a-903a. Circulating nurses in hospitals and outpatient surgical facilities. (a) As used in this section:

(1) “Circulating nurse” means a registered nurse licensed under chapter 378 who is educated, trained or experienced in perioperative nursing and who is responsible for coordinating the nursing care and safety needs of a patient in an operating room;

(2) “Outpatient surgical facility” has the same meaning as provided in subsection (a) of section 19a-493b; and

(3) “Perioperative nursing” means nursing services that are provided to patients during the preoperative, intraoperative and immediate postoperative periods of a surgical procedure.

(b) Any hospital or outpatient surgical facility shall ensure that a circulating nurse is assigned to, and present for the duration of, each surgical procedure performed in an operating room of such hospital or outpatient surgical facility. While assigned to a surgical procedure, no hospital or outpatient surgical facility shall assign a circulating nurse to another procedure that is scheduled to occur concurrently or that may overlap in time with the originally assigned surgical procedure. A circulating nurse assigned to a surgical procedure shall be present for the duration of the procedure unless it becomes necessary for the nurse to leave the operating room as part of the procedure or the nurse is relieved by another circulating nurse.

(P.A. 10-117, S. 73.)

Sec. 19a-903b. Hospital designation of health care providers and technologists to perform oxygen-related patient care activities. Training. Competency testing. Exception. A hospital, as defined in section 19a-490b, may designate any licensed health care provider and any certified ultrasound or nuclear medicine technologist to perform the following oxygen-related patient care activities in a hospital: (1) Connecting or disconnecting oxygen supply; (2) transporting a portable oxygen source; (3) connecting, disconnecting or adjusting the mask, tubes and other patient oxygen delivery apparatus; and (4) adjusting the rate or flow of oxygen consistent with a medical order. Such provider or technologist may perform such activities only to the extent permitted by hospital policies and procedures, including bylaws, rules and regulations applicable to the medical staff. A hospital shall document that each person designated to perform oxygen-related patient care activities has been properly trained, either through such person's professional education or through training provided by the hospital. In addition, a hospital shall require that such person satisfy annual competency testing. Nothing in this section shall be construed to prohibit a hospital from designating persons who are authorized to transport a patient with a portable oxygen source. The provisions of this section shall not apply to any type of ventilator, continuous positive airway pressure or bi-level positive airway pressure units or any other noninvasive positive pressure ventilation.

(P.A. 10-117, S. 80; P.A. 11-242, S. 2.)

History: P.A. 11-242 substituted “technologist” for “technician” and provided that nothing in section prohibits hospital from designating persons who are authorized to transport a patient with a portable oxygen source, effective July 1, 2011.

Sec. 19a-903c. Medical spas. (a) For purposes of this section:

(1) “Medical spa” means an establishment in which cosmetic medical procedures are performed, but shall not include, hospitals or other licensed health care facilities; and

(2) “Cosmetic medical procedure” means any procedure performed on a person that is directed at improving the person's appearance and that does not meaningfully promote the proper function of the body or prevent or treat illness or disease and may include, but is not limited to, cosmetic surgery, hair transplants, cosmetic injections, cosmetic soft tissue fillers, dermaplaning, dermastamping, dermarolling, dermabrasion that removes cells beyond the stratum corneum, chemical peels using modification solutions that exceed thirty per cent concentration with a pH value of lower than 3.0, laser hair removal, laser skin resurfacing, laser treatment of leg veins, sclerotherapy and other laser procedures, intense pulsed light, injection of cosmetic filling agents and neurotoxins and the use of class II medical devices designed to induce deep skin tissue alteration.

(b) Each medical spa shall employ or contract for the services of: (1) A physician licensed pursuant to chapter 370; (2) a physician assistant licensed pursuant to chapter 370; or (3) an advanced practice registered nurse licensed pursuant to chapter 378. Each such physician, physician assistant or advanced practice registered nurse shall: (A) Be actively practicing in the state; and (B) have received education or training from an institution of higher education or professional organization to perform cosmetic medical procedures and have experience performing such procedures. Any cosmetic medical procedure performed at a medical spa shall be performed in accordance with the provisions of this title and title 20, and shall only be performed by such physician, physician assistant or advanced practice registered nurse, or a registered nurse licensed pursuant to chapter 378.

(c) A physician, physician assistant or advanced practice registered nurse who is employed by, or under contract with, the medical spa shall perform an initial in-person physical assessment of each person undergoing a cosmetic medical procedure at the medical spa prior to such procedure being performed.

(d) Each medical spa shall post information, including the names and any specialty areas of any physician, physician assistant, advanced practice registered nurse or registered nurse performing cosmetic medical procedures, in a conspicuous place that is accessible to customers at the medical spa and on any Internet web site maintained by the medical spa. Such information shall also be: (1) Contained in any advertisement by the medical spa or state that such information may be found on the medical spa's Internet web site and list the address for such Internet web site; and (2) contained in a written notice that is provided to each person before undergoing any cosmetic medical procedure at the medical spa.

(P.A. 14-119, S. 1; P.A. 15-242, S. 19.)

History: P.A. 15-242 amended Subsec. (a)(1) by redefining “medical spa” and amended Subsec. (c) by adding “in-person”.

Sec. 19a-904. Emergency service members and exposure to infectious diseases. Definitions. Designated officers. Duties of hospital. Request for notification. Immunity from liability. (a) As used in this section:

(1) “Infectious disease” means any infectious disease on the list developed by the United States Secretary of Health and Human Services pursuant to 42 USC 300ff-131, as amended from time to time, and any infectious disease designated by the Commissioner of Public Health pursuant to subsection (b) of this section;

(2) “Airborne infectious disease” means any infectious disease specified as an airborne infectious disease on the list of infectious diseases developed by the United States Secretary of Health and Human Services pursuant to 42 USC 300ff-131, as amended from time to time, and any infectious disease so designated by the Commissioner of Public Health pursuant to subsection (b) of this section;

(3) “Exposed” means to be in circumstances in which there is a recognized risk for transmission of an infectious disease from a human source to an emergency services member, or in the case of an infectious disease designated by the United States Secretary of Health and Human Services as a select agent, from a surface or environment contaminated by the agent to an emergency services member;

(4) “Patient” means a person, whether alive or dead, who has been attended, treated, assisted, handled or transported for medical care by an emergency services member as a result of an emergency;

(5) “Emergency services member” means any police officer as defined in section 7-294a, member of a paid or volunteer fire department, emergency medical technician, ambulance driver, or paramedic as defined in section 19a-175, when acting in an official capacity;

(6) “Emergency medical technician” means any class of emergency medical technician certified under regulations adopted pursuant to section 19a-179, including, but not limited to, any advanced emergency medical technician or emergency medical responder;

(7) “Emergency services organization” means the Division of State Police within the Department of Emergency Services and Public Protection, an organized local police department, municipal constabulary, paid or volunteer fire department, ambulance company or any organization whether public, private or voluntary that offers transportation or treatment services to patients under emergency conditions;

(8) “Hospital” has the same meaning as in section 19a-490;

(9) “Designated officer” means the employee or volunteer of an emergency services organization designated in accordance with subdivision (1) of subsection (c) of this section; and

(10) “Hospital contact person” means the employee of a hospital designated by such hospital in accordance with subdivision (2) of subsection (c) of this section.

(b) The Commissioner of Public Health may designate a disease as an infectious disease or an airborne infectious disease, as both terms are defined in subsection (a) of this section. The commissioner shall adopt regulations in accordance with chapter 54 to designate a disease as an infectious disease or airborne infectious disease in accordance with the provisions of this subsection. The commissioner may implement such designations while in the process of adopting such designations in regulation form, provided the commissioner publishes notice of intention to adopt the regulations on the Department of Public Health's Internet web site and the eRegulations System within twenty days of implementing such designations. Designations implemented pursuant to this subsection shall be valid until the time such regulations are effective.

(c) (1) Each emergency services organization shall designate one employee or volunteer to act as the designated officer to receive notification of cases where persons have possibly been exposed to infectious disease, investigate such cases, maintain contact information for hospital contact persons, request further information from hospital contact persons and maintain any records required under this section. The designated officer may designate another employee or volunteer to serve as his or her designee in the event that the designated officer is unavailable.

(2) Each hospital shall designate one employee to act as the hospital contact person to notify designated officers of cases where persons have possibly been exposed to airborne infectious disease and to receive and respond to requests from designated officers for information concerning the results of any test performed on a patient to determine the presence of an infectious disease. The hospital contact person may designate another employee of the hospital to serve as his or her designee in the event that the hospital contact person is unavailable.

(d) (1) Any hospital that diagnoses a patient as having an airborne infectious disease shall, through its hospital contact person, verbally notify the designated officer of the emergency services organization that attended, treated, assisted, handled or transported such patient no later than forty-eight hours after making such a diagnosis, and shall make such notification in writing not later than seventy-two hours after such diagnosis. Such notification shall include, but not be limited to, the diagnosis and the date on which the patient was attended, treated, assisted, handled or transported as a result of an emergency to such hospital, provided the identity of the patient shall not be disclosed in any such notification.

(2) Any hospital that determines that a patient, who died at or before reaching such hospital and who was attended, treated, assisted, handled or transported by an emergency services member, had an airborne infectious disease shall, through its hospital contact person, notify the designated officer of such determination no later than forty-eight hours after making such determination.

(e) (1) Any member of an emergency service organization who believes that he or she may have been exposed to an infectious disease through the member's contact with a patient who was attended, treated, assisted, handled or transported by the member shall report such incident during which the member believes to have been exposed to an infectious disease to the designated officer. The designated officer shall immediately collect the facts surrounding such incident and evaluate such facts to make a determination of whether it would be reasonable to believe that the member may have been exposed to an infectious disease. If the designated officer determines that it is reasonable to believe that the member may have been exposed to an infectious disease, the designated officer shall submit a written request to the hospital contact person at the hospital that received the patient requesting to be notified of the results of any test performed on the patient to determine the presence of an infectious disease. The request shall include:

(A) The name, address and telephone number of the designated officer submitting the request;

(B) The name of the designated officer's employer or, in the case of a volunteer emergency services member, the entity for which the designated officer volunteers, and the name and contact information of the emergency services member who may have been exposed to the infectious disease; and

(C) The date, time, location and manner of the incident during which the member may have been exposed.

(2) Such request shall be valid for ten days after it is made. If at the end of such ten-day period no test has been performed to determine the presence of an infectious disease, no diagnosis has been made or the result of the test is negative, the hospital shall, through its hospital contact person, so notify the designated officer who made the request. The notification shall not include the name of the patient.

(3) Any hospital that receives a written request for notification shall, through its hospital contact person, give an oral notification of the presence of an infectious disease or of a confirmed positive test result, if known, to the designated officer no later than forty-eight hours after receiving such request, and shall send a written notification no later than three days after receiving such request. If an infectious disease is present or the test results are confirmed positive, both the oral and written notification shall include the name of the infectious disease and the date on which the patient was attended, treated, assisted, handled or transported by the emergency services organization. Such notification shall not disclose the name of the patient.

(4) If a designated officer makes a request pursuant to this subsection and the patient has died at, or before reaching, the hospital receiving such request, the hospital shall, through its hospital contact person, provide a copy of the request to the medical facility ascertaining the cause of death if such facility is not the hospital that received the original request.

(f) (1) Not later than January 1, 2016, each emergency services organization shall notify the Commissioner of Public Health, or the commissioner's designee, of its designated officer and the designated officer's contact information.

(2) Not later than January 1, 2016, each hospital shall notify said commissioner, or said commissioner's designee, of its hospital contact person and the hospital contact person's contact information.

(3) Each emergency services organization and hospital shall promptly notify said commissioner of any change of the designated officer or hospital contact person or such person's contact information.

(g) The Commissioner of Public Health, or the commissioner's designee, shall assist designated officers and hospital contact persons in answering questions with respect to responsibilities of a designated officer or hospital contact person under the provisions of this section. Said commissioner shall, on and after January 1, 2016, maintain and update, as necessary, a list of designated officers and hospital contact persons along with such designated officers' and hospital contact persons' contact information and make such list available to the public on the Department of Public Health's Internet web site.

(h) No cause of action for damages shall arise, or any civil penalty be imposed, against any hospital, hospital contact person or designated officer for failure to comply with the duties established by this section. Notwithstanding the provisions of this subsection, the Commissioner of Public Health may take any action specified in subdivisions (1) to (5), inclusive, of subsection (a) of section 19a-17 and section 19a-494 for a violation of the provisions of this section as the commissioner deems appropriate.

(P.A. 09-76, S. 1; 09-232, S. 43; P.A. 10-18, S. 18; 10-117, S. 22; P.A. 11-51, S. 134; P.A. 15-242, S. 51.)

History: P.A. 09-232 redefined “infectious disease” in Subsec. (a)(1); P.A. 10-18 amended Subsec. (a)(5) by replacing “emergency medical technician-intermediate” with “advanced emergency medical technician” and by replacing “medical response technician” with “emergency medical responder”; P.A. 10-117 made technical changes in Subsec. (a)(5), effective June 8, 2010; pursuant to P.A. 11-51, “Department of Public Safety” was changed editorially by the Revisors to “Department of Emergency Services and Public Protection” in Subsec. (a)(6), effective July 1, 2011; P.A. 15-242 amended Subsec. (a) by redefining “infectious disease” in Subdiv. (1), deleting former Subdiv. (2) defining “exposure”, adding new Subdiv. (2) defining “airborne infectious disease”, adding new Subdiv. (3) defining “exposed”, redesignating existing Subdivs. (3) to (8) as Subdivs. (4) to (9) and adding Subdiv. (10) defining “hospital contact person”, added new Subsec. (b) re designation of a disease by commissioner, redesignated existing Subsec. (b) as Subsec. (c)(1) and amended same by making technical changes, added Subsec. (c)(2) re designation of contact person, redesignated existing Subsec. (c) as Subsec. (d) and amended same by changing “infectious pulmonary tuberculosis” to “an airborne infectious disease” and adding references to hospital contact person, redesignated existing Subsec. (d) as Subsec. (e) and amended same by making technical changes in Subdiv. (1) and adding references to hospital contact person, added Subsec. (f) re notifying commissioner, added Subsec. (g) re assisting designated officers and contact persons in answering questions, redesignated existing Subsec. (e) as Subsec. (h) and amended same by adding reference to hospital contact person and provisions re commissioner taking action for violations, and made a conforming change.

Sec. 19a-904a. Notice to patients re coverage by health insurance policy. Understandable language in documents submitted to patients or insureds. Collection from insured of money owed by health carrier. (a) On and after January 1, 2016, each health care provider shall, prior to any scheduled admission, procedure or service, for nonemergency care, determine whether the patient is covered under a health insurance policy. If the patient is determined not to have health insurance coverage or the patient's health care provider is out-of-network, such health care provider shall notify the patient, in writing, electronically or by mail, (1) of the charges for the admission, procedure or service, (2) that such patient may be charged, and is responsible for payment for unforeseen services that may arise out of the proposed admission, procedure or service, and (3) if the health care provider is out-of-network under the patient's health insurance policy, that the admission, service or procedure will likely be deemed out-of-network and that any out-of-network applicable rates under such policy may apply. Nothing in this subsection shall prevent a health care provider from charging a patient for such unforeseen services.

(b) Each health care provider and health carrier shall ensure that any notice, billing statement or explanation of benefits submitted to a patient or insured is written in language that is understandable to an average reader.

(c) No health care provider shall collect or attempt to collect from an insured patient any money owed to such health care provider by such patient's health carrier.

(P.A. 15-146, S. 3; P.A. 16-205, S. 4.)

History: P.A. 16-205 added Subsec. (c) re prohibition on collection from insured patient of money owed by health carrier, effective January 1, 2017.

See Sec. 38a-1084a re applicable definitions and disclosures required to be provided by hospital to patient.

Sec. 19a-904b. Notice to health carrier when stopping acceptance of patients in insurance plan. Updates to health care provider directories. (a) Not later than thirty days after the date that a health care provider stops accepting patients who are enrolled in an insurance plan, such health care provider shall notify, in writing, the applicable health carrier.

(b) Each health carrier shall update, not less than monthly, its health care provider directory or directories.

(P.A. 15-146, S. 6.)

See Sec. 38a-472f re removal or departure of participating provider from health carrier network.

See Sec. 38a-1084a for applicable definitions.

Sec. 19a-904c. Electronic health records systems; utilization by hospitals. (a) For purposes of this section:

(1) “Electronic health record” means any computerized, digital or other electronic record of individual health-related information that is created, held, managed or consulted by a health care provider and may include, but need not be limited to, continuity of care documents, discharge summaries and other information or data relating to patient demographics, medical history, medication, allergies, immunizations, laboratory test results, radiology or other diagnostic images, vital signs and statistics;

(2) “Electronic health record system” means a computer-based information system that is used to create, collect, store, manipulate, share, exchange or make available electronic health records for the purpose of the delivery of patient care;

(3) “Health care provider” means any individual, corporation, facility or institution licensed by the state to provide health care services; and

(4) “Secure exchange” means the exchange of patient electronic health records between a hospital and a health care provider in a manner that complies with all state and federal privacy requirements, including, but not limited to, the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191) (HIPAA), as amended from time to time.

(b) Each hospital licensed under chapter 368v shall, to the fullest extent practicable, use its electronic health records system to enable bidirectional connectivity and the secure exchange of patient electronic health records between the hospital and any other health care provider who (1) maintains an electronic health records system capable of exchanging such records, and (2) provides health care services to a patient whose records are the subject of the exchange. The requirements of this section apply to at least the following: (A) Laboratory and diagnostic tests; (B) radiological and other diagnostic imaging; (C) continuity of care documents; and (D) discharge notifications and documents.

(c) Each hospital shall implement the use of any hardware, software, bandwidth or program functions or settings already purchased or available to it to support the secure exchange of electronic health records and information as described in subsection (b) of this section.

(d) Nothing in this section shall be construed as requiring a hospital to pay for any new or additional information technology, equipment, hardware or software, including interfaces, where such additional items are necessary to enable such exchange.

(e) The failure of a hospital to take all reasonable steps to comply with this section shall constitute evidence of health information blocking pursuant to section 19a-904d.

(f) A hospital that connects to, and actively participates in, the State-wide Health Information Exchange, established pursuant to section 17b-59d shall be deemed to have satisfied the requirements of this section.

(P.A. 15-146, S. 24.)

Sec. 19a-904d. Health information blocking. Penalty. (a) For purposes of this section:

(1) “Affiliated provider” means a health care provider that is: (A) Employed by a hospital or health system, (B) under a professional services agreement with a hospital or health system that permits such hospital or health system to bill on behalf of such health care provider, or (C) a clinical faculty member of a medical school, as defined in section 33-182aa, that is affiliated with a hospital or health system in a manner that permits such hospital or health system to bill on behalf of such clinical faculty member;

(2) “Certified electronic health record system” means a health record system that is certified by the federal Office of the National Coordinator for Health Information Technology;

(3) “Electronic health record” means any computerized, digital or other electronic record of individual health-related information that is created, held, managed or consulted by a health care provider and may include, but need not be limited to, continuity of care documents, discharge summaries and other information or data relating to patient demographics, medical history, medication, allergies, immunizations, laboratory test results, radiology or other diagnostic images, vital signs and statistics;

(4) “Electronic health record system” means a computer-based information system that is used to create, collect, store, manipulate, share, exchange or make available electronic health records for the purposes of the delivery of patient care;

(5) “Health care provider” means any individual, corporation, facility or institution licensed by the state to provide health care services;

(6) “Health information blocking” means (A) knowingly interfering with or knowingly engaging in business practices or other conduct that is reasonably likely to interfere with the ability of patients, health care providers or other authorized persons to access, exchange or use electronic health records, or (B) knowingly using an electronic health record system to both (i) steer patient referrals to affiliated providers, and (ii) prevent or unreasonably interfere with patient referrals to health care providers who are not affiliated providers but shall not include legitimate referrals between providers participating in an accountable care organizations or similar value-based collaborative care models;

(7) “Hospital” has the same meaning as provided in section 19a-490;

(8) “Health system” has the same meaning as provided in section 19a-508c;

(9) “Seller” means any person or entity that directly, or indirectly through an employee, agent, independent contractor, vendor or other person, sells, leases or offers to sell or lease an electronic health record system or a license or right to use an electronic health record system.

(b) Electronic health records shall, to the fullest extent practicable, (1) follow the patient, (2) be made accessible to the patient, and (3) be shared and exchanged with the health care provider of the patient's choice in a timely manner.

(c) Health information blocking shall be an unfair trade practice pursuant to section 42-110b.

(d) Health information blocking by a hospital, health system or seller shall be subject to the penalties contained in subsection (b) of section 42-110o.

(e) It shall be an unfair trade practice pursuant to section 42-110b for any seller to make a false, misleading or deceptive representation that an electronic health record system is a certified electronic health record system.

(f) The provisions of this section shall be enforced by the Attorney General.

(g) Nothing contained in this section shall be construed as a limitation upon the power or authority of the state, the Attorney General or the Commissioner of Consumer Protection to seek administrative, legal or equitable relief as provided by any state statute or common law.

(P.A. 15-146, S. 20.)

Sec. 19a-905. Health care providers who provide direct patient care to wear badges. (a) As used in this section:

(1) “Health care provider” means any person employed by or acting on behalf of a health care facility or institution; and

(2) “Health care facility or institution” means a hospital, nursing home, rest home, home health care agency, homemaker-home health aide agency, emergency medical services organization, assisted living services agency, outpatient surgical facility and an infirmary operated by an educational institution for the care of students enrolled in, and faculty and employees of, such institution.

(b) Any health care provider who provides direct patient care shall wear in plain view during such provider's working hours a photographic identification badge issued by the health care facility or institution that includes the name of the health care facility or institution, the name of the health care provider, and the type of license, certificate or employment title that the health care provider holds with the health care facility or institution. Health care facilities or institutions, in consultation with the Department of Public Health, shall develop policies and procedures concerning (1) the size, content and format of the photographic identification badge required pursuant to this subsection, and (2) any exemptions to the requirements of this subsection necessary to ensure the safety of patients and health care providers.

(P.A. 11-32, S. 1.)

Sec. 19a-905a. Recording of developmental screenings by health care providers. Each health care provider, who is authorized under state law to perform a physical examination of a child five years of age or under for purposes of completing, on behalf of such child, the state Department of Education's early childhood health assessment record form or the health assessment form described in section 10-206 shall indicate on such record or form whether or not the health care provider performed a developmental screening during such physical examination. For purposes of this section, “developmental screening” means a screening using a method recommended by the American Academy of Pediatrics to identify concerns regarding a child's physical and mental development, including, but not limited to, the child's sensory, behavioral, motor, language, social, perceptual or emotional skills.

(P.A. 15-157, S. 1.)

History: P.A. 15-157 effective July 1, 2015.

Sec. 19a-906. Telehealth services. (a) As used in this section:

(1) “Asynchronous” means any transmission to another site for review at a later time that uses a camera or other technology to capture images or data to be recorded.

(2) “Health record” means the record of individual, health-related information that may include, but need not be limited to, continuity of care documents, discharge summaries and other information or data relating to a patient's demographics, medical history, medication, allergies, immunizations, laboratory test results, radiology or other diagnostic images, vital signs and statistics.

(3) “Facility fee” has the same meaning as in section 19a-508c.

(4) “Medical history” means information, including, but not limited to, a patient's past illnesses, medications, hospitalizations, family history of illness if known, the name and address of the patient's primary care provider if known and other matters relating to the health condition of the patient at the time of a telehealth interaction.

(5) “Originating site” means a site at which a patient is located at the time health care services are provided to the patient by means of telehealth.

(6) “Peripheral devices” means the instruments a telehealth provider uses to perform a patient exam, including, but not limited to, stethoscope, otoscope, ophthalmoscope, sphygmomanometer, thermometer, tongue depressor and reflex hammer.

(7) “Remote patient monitoring” means the personal health and medical data collection from a patient in one location via electronic communication technologies that is then transmitted to a telehealth provider located at a distant site for the purpose of health care monitoring to assist the effective management of the patient's treatment, care and related support.

(8) “Store and forward transfer” means the asynchronous transmission of a patient's medical information from an originating site to the telehealth provider at a distant site.

(9) “Synchronous” means real-time interactive technology.

(10) “Telehealth” means the mode of delivering health care or other health services via information and communication technologies to facilitate the diagnosis, consultation and treatment, education, care management and self-management of a patient's physical and mental health, and includes (A) interaction between the patient at the originating site and the telehealth provider at a distant site, and (B) synchronous interactions, asynchronous store and forward transfers or remote patient monitoring. Telehealth does not include the use of facsimile, audio-only telephone, texting or electronic mail.

(11) “Telehealth provider” means any physician licensed under chapter 370, physical therapist licensed under chapter 376, chiropractor licensed under chapter 372, naturopath licensed under chapter 373, podiatrist licensed under chapter 375, occupational therapist licensed under chapter 376a, optometrist licensed under chapter 380, advanced practice registered nurse licensed under chapter 378, physician assistant licensed under chapter 370, psychologist licensed under chapter 383, marital and family therapist licensed under chapter 383a, clinical social worker or master social worker licensed under chapter 383b, alcohol and drug counselor licensed under chapter 376b, professional counselor licensed under chapter 383c, dietitian-nutritionist certified under chapter 384b, speech and language pathologist licensed under chapter 399, respiratory care practitioner licensed under chapter 381a or audiologist licensed under chapter 397a, who is providing health care or other health services through the use of telehealth within such person's scope of practice and in accordance with the standard of care applicable to the profession.

(b) (1) A telehealth provider shall only provide telehealth services to a patient when the telehealth provider: (A) Is communicating through real-time, interactive, two-way communication technology or store and forward technologies; (B) has access to, or knowledge of, the patient's medical history, as provided by the patient, and the patient's health record, including the name and address of the patient's primary care provider, if any; (C) conforms to the standard of care applicable to the telehealth provider's profession and expected for in-person care as appropriate to the patient's age and presenting condition, except when the standard of care requires the use of diagnostic testing and performance of a physical examination, such testing or examination may be carried out through the use of peripheral devices appropriate to the patient's condition; and (D) provides the patient with the telehealth's provider license number and contact information.

(2) At the time of the telehealth provider's first telehealth interaction with a patient, the telehealth provider shall inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform and, after providing the patient with such information, obtain the patient's consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient's health record.

(c) Notwithstanding the provisions of this section or title 20, no telehealth provider shall prescribe schedule I, II or III controlled substances through the use of telehealth.

(d) Each telehealth provider shall, at the time of each telehealth interaction, ask the patient whether the patient consents to the telehealth's provider disclosure of records concerning the telehealth interaction to the patient's primary care provider. If the patient consents to such disclosure, the telehealth provider shall provide such records to the patient's primary care provider, in a timely manner, in accordance with the provisions of sections 20-7b to 20-7e, inclusive.

(e) The provision of telehealth services and health records maintained and disclosed as part of a telehealth interaction shall comply with the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time.

(f) Nothing in this section shall prohibit: (1) A health care provider from providing on-call coverage pursuant to an agreement with another health care provider or such health care provider's professional entity or employer; (2) a health care provider from consulting with another health care provider concerning a patient's care; or (3) orders of health care providers for hospital outpatients or inpatients. For purposes of this subsection, “health care provider” means a person or entity licensed or certified pursuant to chapter 370, 372, 373, 375, 376 to 376b, inclusive, 378, 379, 380, 381a, 383 to 383c, inclusive, 384b, 397a or 399 or licensed or certified pursuant to chapter 368d or 384d.

(g) No telehealth provider shall charge a facility fee for telehealth services.

(P.A. 15-88, S. 1; P.A. 16-25, S. 1, 2.)

History: P.A. 16-25 amended Subsec. (a)(11) by adding references to speech and language pathologist, respiratory care practitioner and audiologist, and amended Subsec. (f) by adding references to chapters 376 to 376b, 380, 381a, 383 to 383c, 384b, 397a and 399.