HB567: HB567 Professions and businesses; authorize and regulate teledentistry by licensed dentists

25 HB 567/AP House Bill 567 (AS PASSED HOUSE AND SENATE) By: Representatives Dempsey of the 13th, Hatchett of the 155th, Hawkins of the 27th, Buckner of the 137th, and Taylor of the 173rd A BILL TO BE ENTITLED AN ACT To amend Article 2 of Chapter 11 of Title 43 of the Official Co de of Georgia Annotated,1 relating to licenses for the practice of dentistry, so as to authorize and regulate teledentistry2 by licensed dentists in this state; to provide for definitions; to provide for exemptions and3 conditions; to provide for authorized practices; to provide for a referred dentist; to provide4 for ownership of documents; to provide for a limited number of dental hygienists to perform5 teledentistry under certain conditions; to provide for rules and regulations; to amend Article 16 of Chapter 24 of Title 33 of the Official Code of Georgia Annot ated, relating to general7 provisions of insurance, so as to allow for coverage of dental services provided through8 teledentistry; to provide for related matters; to provide an effective date; to repeal conflicting9 laws; and for other purposes.10 BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:11 SECTION 1.12 Article 2 of Chapter 11 of Title 43 of the Official Code of Geo rgia Annotated, relating to13 licenses for the practice of dentistry, is amended by adding a new Code section to read as14 follows:15 H. B. 567 - 1 - 25 HB 567/AP "43-11-54.16 (a) As used in this Code section, the term:17 (1) 'Authorizing dentist' means a dentist licensed by and in good standing with the board18 and practicing in the State of Georgia.19 (2) 'Dental hygienist' means a licensed dental hygienist in good standing with the board20 who meets the requirements to perform the specific dental hygiene functions permitted21 under general supervision under Code Section 43-11-74.22 (3) 'Digital scan' means a computer generated replica of the hard and soft tissues of the23 oral cavity created with digital technology and enhanced digital photography.24 (4) 'Direct supervision' shall have the same meaning as set fo rth in Code Section25 43-l1-74.26 (5) 'General supervision' shall have the same meaning as set f orth in Code Section27 43-11-74.28 (6) 'Referred dentist' means a dentist licensed by and in good standing with the board29 practicing in this state to provide in-person dental treatment to patients receiving dental30 care through a teledentistry interaction under this Code section.31 (7) 'Store and forward technologies' means technologies that a llow for the electronic32 transmission of dental and health information, including images , photographs,33 documents, and health histories, through a secure communication system.34 (8) 'Synchronous, real-time communication' means a live, two-way interaction between35 the authorizing dentist and a dental hygienist or patient permitted under this Code section36 using audiovisual telecommunications technology but shall not c onstitute direct37 supervision for the purposes of Code Section 43-l1-74 and the practice of dentistry in this38 state.39 (9) 'Teledentistry' means the delivery of dental care through the use of synchronous,40 real-time communication in conjunction with and supported by st ore and forward41 technologies under the general supervision of the authorizing dentist when dental care is42 H. B. 567 - 2 - 25 HB 567/AP provided to a patient physically located at a site in this state that is different from the site43 where the authorizing dentist is physically located. A teledentistry interaction shall not44 constitute or be considered the equivalent of an in-person, cli nical examination by a45 licensed dentist.46 (b) No licensed dentist in this state shall provide dental care through teledentistry except47 under the conditions specified in this Code section.48 (c) A licensed dentist who intends to provide dental care through teledentistry pursuant to49 this Code section shall notify the board of such intent and provide written documentation50 evidencing that such dentist has:51 (1) A physical office for the provision of dental services in this state; and52 (2) Established a referral relationship with a referred dentist who practices dentistry and53 treats patients in a physical and operational dental office located in this state.54 Such dentist shall provide other reasonably pertinent informati on as prescribed by the55 board.56 (d) Subject to the conditions specified in subsection (e) of t his Code section, an57 authorizing dentist shall only be allowed to:58 (1) Authorize a dental hygienist to perform the specific denta l hygiene functions59 permitted under general supervision in accordance with the requirements of Code Section60 43-11-74, except as otherwise provided in paragraph (1) of subsection (e) of this Code61 section;62 (2) Prescribe a medication that is not a controlled substance for a patient receiving dental63 care through a teledentistry interaction;64 (3) Authorize the performance of digital scans by a dentist or dental hygienist;65 (4) Authorize the use of store and forward technologies to tra nsmit patient records,66 images, digital scans, X-rays, and other relevant health inform ation between the67 authorizing dentist and a dental hygienist for the purposes of evaluating a patient's oral68 health condition and authorizing the performance of dental care permitted under this69 H. B. 567 - 3 - 25 HB 567/AP Code section. The authorizing dentist shall be the custodian of all patient records for the70 purposes of this Code section unless the patient is treated by a referred dentist. In such71 instance, the referred dentist shall be the custodian of the patient's records associated with72 the dental care the referred dentist provides to the patient, and such referred dentist shall73 furnish copies of these records to the authorizing dentist;74 (5) Provide consultation to another provider regarding the patient's care; and75 (6) Provide the following teledentistry services that are appropriately delivered without76 an in-person clinical examination:77 (A) Emergency evaluation;78 (B) Rendering second opinions; and79 (C) Assessment, diagnosis, consultation, treatment, and monitoring of a patient.80 Teledentistry services described in this paragraph do not include orthodontics, delivering81 of dental appliances, or the supervision of a dental hygienist.82 (e) Authorizing and referring dentists as well as those acting under their supervision shall83 be subject to the following conditions when providing dental care through teledentistry as84 authorized in subsection (d) of this Code section:85 (1) Teledentistry services shall be consistent with how dental treatment is provided in86 person and shall adhere to the standards of appropriate patient care required in other87 dental care settings, including, but not limited to, appropriat e patient examination, the88 taking and review of X-rays, and review of a patient's medical and dental history;89 (2)(A) Initial consultations with new patients may be conducte d via teledentistry,90 provided that the authorizing dentist establishes a bona fide dentist-patient relationship91 by reviewing the patient's medical and dental history and verifying the patient's identity92 and physical location to ensure the patient is physically located in this state when dental93 care is provided and shall obtain the requisite consent from a parent or guardian if the94 patient is a minor.95 H. B. 567 - 4 - 25 HB 567/AP (B) An in-person clinical examination shall be performed immed iately prior to96 providing or authorizing services or treatments to patients that are not reversible or that97 otherwise result in increased risk to the patient. For ongoing dentist-patient98 relationships, dentists shall strongly encourage patients to be seen in person at least99 annually.100 (3) The authorizing dentist shall prepare a written authorization, which shall be given to101 the patient and included in the patient's record, providing the name and license number102 of the authorizing dentist and the name and license number of t he dental hygienist103 treating the patient during the teledentistry interaction, as well as any other information104 the authorizing dentist or board deems appropriate;105 (4) Prior to first performing teledentistry services, and at l east annually thereafter,106 informed consent shall be obtained from the patient, or from the parent or guardian if the107 patient is a minor, explaining the alternatives to and the capa bilities and limitations of108 teledentistry, which shall include a written statement advising that a teledentistry109 interaction is not equivalent to an in-person clinical examination and that the authorizing110 dentist shall not be physically present during the delivery of dental care. Such informed111 consent shall also be documented and included in the patient's record;112 (5) The authorizing dentist shall provide dental services thro ugh teledentistry only if113 such dental services are appropriate for the patient, as determ ined by such authorizing114 dentist;115 (6)(A) The authorizing dentist shall provide the name, license number, office mailing116 address, and office phone number of the referred dentist to the patient after each117 teledentistry interaction.118 (B) The referred dentist shall accept a referral to treat all dental emergencies and119 provide all necessary dental care, as determined by and in cons ultation with the120 authorizing dentist.121 H. B. 567 - 5 - 25 HB 567/AP (7)(A) An authorizing dentist may only authorize up to four de ntal hygienists to122 perform the functions permitted in subsection (d) of this Code section at any one time.123 This requirement shall not apply to the performance of dental h ygiene duties by124 personnel of the Department of Public Health or county boards of health.125 (B) A dental hygienist performing the functions permitted in s ubsection (d) of this126 Code section via teledentistry shall have at least two years of experience in the practice127 of dental hygiene, shall be in compliance with continuing educa tion requirements128 pursuant to Code Section 43-11-73.1 and cardiopulmonary resuscitation certification129 requirements contained in Code Section 43-11-73, and shall be l icensed in good130 standing.131 (C) A dental hygienist practicing under general supervision via teledentistry pursuant132 to this Code section shall maintain professional liability insurance in accordance with133 board rules and regulations; provided, however, that this subparagraph shall not apply134 to an entity covered under sovereign immunity;135 (8) No authorizing dentist or dental hygienist shall attempt t o waive liability for136 teledentistry services in advance of delivering such services, and no authorizing dentist137 or dental hygienist shall attempt to prevent a patient from filing any complaint with any138 governmental agency or authority relating to the provision of d ental care through139 teledentistry; and140 (9) The authorizing dentist shall ensure that the use of teled entistry complies with the141 privacy and security requirements of the federal Health Insuran ce Portability and142 Accountability Act of 1996, in effect on January 1, 2025, as well as those of Chapter 33143 of Title 31.144 (f) Nothing in this Code section shall be construed to:145 (1) Require a licensed dentist in this state to practice teledentistry;146 (2) Require a licensed dentist to authorize a dental hygienist to perform the functions147 permitted in this Code section via teledentistry;148 H. B. 567 - 6 - 25 HB 567/AP (3) Require a school or facility receiving dental hygiene services provided pursuant to149 subsection (h) or (i) of Code Section 43-ll-74 to purchase any equipment to provide150 dental care through teledentistry; or151 (4) Expand the scope of practice for dental hygienists or esta blish independent dental152 hygiene practice.153 (g) The board shall promulgate rules and regulations that are reasonably necessary to154 implement the provisions of this Code section."155 SECTION 2.156 Article 1 of Chapter 24 of Title 33 of the Official Code of Geo rgia Annotated, relating to157 general provisions of insurance, is amended by revising Code Se ction 33-24-59.15 as158 follows: 159 "33-24-59.15.160 (a) As used in this Code section:161 (1) 'Care management organization' shall have the same meaning as set forth in Code162 Section 33-21A-2.163 (1)(2) 'Covered dental services' means dental care services for which a reimbursement164 is available under a covered person's dental benefit plan, or for which a reimbursement165 would be available but for the application of contractual limitations such as deductibles,166 copayments, coinsurance, waiting periods, annual or lifetime ma ximums, frequency167 limitations, alternative benefit payments, or any other limitation.168 (2)(3) 'Covered person' means any subscriber, enrollee, member, bene ficiary, or169 participant, or his or her dependent, for whom benefits are pay able when that covered170 person receives dental care services rendered or authorized by a dentist licensed under171 Chapter 11 of Title 43.172 (3)(4) 'Dental benefit plan' means any individual or group plan, pol icy, contract, or173 subscription agreement which includes or is for dental care ser vices that is issued,174 H. B. 567 - 7 - 25 HB 567/AP delivered, issued for delivery, or renewed in this state whether by a health care healthcare175 insurer, health maintenance organization, preferred provider organization, accident and176 sickness insurer, fraternal benefit society, health care healthcare plan, or any other person,177 firm, corporation, joint venture, or other similar business entity that pays for, purchases,178 or furnishes dental care services to patients, insureds, benefi ciaries, or covered179 dependents in this state.180 (4)(5) 'Dental insurer' means any person, firm, corporation, joint venture, or other similar181 business entity that offers dental benefit plans in consideration of periodic payments.182 (b) No contract between a dental insurer and a dentist shall require a dentist to accept an183 amount set by the dental insurer as payment for dental care services that are not covered184 dental services under the covered person's dental benefit plan.185 (c) A dental insurer or other person or entity providing third-party administrator services186 shall not make available any providers in its dentist network to a plan that sets dental fees187 for any services except covered services.188 (d) A dental insurer shall not draft, publish, disseminate, or circulate explanation of benefit189 forms that include language which directly or indirectly implie s that a dentist may or190 should extend discounts to patients for noncovered dental services. Statements by a dental191 insurer which are prohibited by this Code section include but a re not limited to, 'Our192 members value the services you provide and we encourage you to continue extending the193 discount on noncovered services.194 (e) Any dental benefit plan issued, amended, or renewed on or after January 1, 2026,195 between a dental insurer, contracted vendor thereof, or a care management organization196 and a healthcare provider for the provision of healthcare servi ces to a plan enrollee may197 provide coverage for the cost of dental care provided through t eledentistry as directed198 through regulations promulgated by the Commissioner.199 (f) A dental insurer, contracted vendor thereof, or care management organization shall not:200 H. B. 567 - 8 - 25 HB 567/AP (1) Exclude a service appropriately provided through teledentistry from coverage solely201 because the service is provided through teledentistry and is no t provided through202 in-person consultation or contact between an authorizing dentist and a patient; or203 (2) Require its insureds to receive dental care through telede ntistry in lieu of an204 in-person, clinical examination."205 SECTION 3.206 This Act shall become effective on January 1, 2026.207 SECTION 4.208 All laws and parts of laws in conflict with this Act are repealed.209 H. B. 567 - 9 -