Panel narrows telehealth language after debate over "supervision" and out-of-state physicians

The House Committee on Consumer Protection & Commerce moved March 3 to narrow HB 2558 HD1, which would allow qualifying out-of-state physicians to establish physician-patient relationships via telehealth under certain conditions.

Witnesses offered mixed testimony. Shipta (supporting the bill) warned the draft'ed supervision requirement could be an implementation barrier. "We think the supervision clause ... is going to be turned out to be a barrier in actual implementation," a Shipta representative said, urging clearer, practicable language.

HMSA testified with concerns about patient safety, licensure and accountability if out-of-state clinicians could order services performed in Hawaii without clear local oversight. The committee responded by limiting the exemption: out-of-state physicians may establish an initial relationship only when referred by the patient''s local doctor; any orders for diagnostics, prescriptions, or procedures to be performed in Hawaii must be approved or signed off by a Hawaii-licensed clinician. The committee also agreed to change the word "supervision" to language that minimizes implied hierarchy and to add reporting requirements for out-of-state physicians to disclose prior disciplinary actions to the Hawaii Medical Board before an initial consultation.

Supporters said the narrower approach balances access, especially for neighbor-island residents who lack local specialists, with safety and oversight. Opponents pressed for further clarity about malpractice responsibility and what constitutes an ongoing treating relationship.

The committee passed HB 2558 with amendments and directed staff to draft precise supervisory and liability language for the Hawaii Medical Board to implement.