Teledentristy safety

(a)

Requirement for teledentistry

Not later than 180 days after the date of the enactment of this Act, the Federal Trade Commission shall promulgate regulations under section 553 of title 5, United States Code, that require the following: (1)Except as provided in paragraphs (2) and (3), a dentist to perform an in-person examination of a patient before the dentist may provide dental services or medical devices to that patient through teledentistry. (2)A provider to establish a relationship with a patient through teledentistry only— (A)for the purpose of emergent care; (B)as part of a public health program; or (C)to make an initial diagnosis of a malposition of teeth and a determination of the need for an orthodontic appliance by a dentist exercising independent clinical judgment, and not solely through automated or algorithmic processes. (3)Any initial diagnosis and determination described in paragraph (2)(C) to be made or affirmed by a dentist exercising independent clinical judgment and to be confirmed through an in-person visit and review of any radiographic record of the patient before the patient begins using the orthodontic appliance. (b)

Rulemaking by Commission

Rules so prescribed shall be exempt from the requirements of the Magnuson-Moss Warranty—Federal Trade Commission Improvement Act (15 U.S.C. 2301 et seq.). Any such regulations shall be issued in accordance with section 553 of title 5, United States Code. (c)

Enforcement by Federal Trade Commission

(1)

Unfair or deceptive acts or practices

A violation of subsection (a) or a regulation promulgated under such subsection shall be treated as a violation of a regulation under section 18(a)(1)(B) of the Federal Trade Commission Act (15 U.S.C. 57a(a)(1)(B)) regarding unfair or deceptive acts or practices. (2)

Powers of Commission

The Commission shall enforce this section and any regulation promulgated under this section in the same manner, by the same means, and with the same jurisdiction, powers, and duties as though all applicable terms and provisions of the Federal Trade Commission Act (15 U.S.C. 41 et seq.) were incorporated into and made a part of this section. Any person who violates this section or a regulation promulgated under this section shall be subject to the penalties and entitled to the privileges and immunities provided in the Federal Trade Commission Act. (d)

Enforcement by States

(1)

In general

In any case in which the attorney general of a State, or an official or agency of a State, has reason to believe that an interest of the residents of that State has been or is threatened or adversely affected by an act or practice in violation of subsection (a) or a regulation promulgated under such subsection, the attorney general, official, or agency of the State, as parens patriae, may bring a civil action on behalf of the residents of the State in an appropriate district court of the United States— (A)to enjoin such act or practice; or (B)to obtain damages on behalf of residents of the State, in an amount equal to the greater of— (i)the actual monetary loss suffered by such residents; or (ii)the amount determined under paragraph (4). (2)

Notice

Before filing an action under this subsection, the attorney general, official, or agency of the State involved shall provide to the Commission a written notice of such action and a copy of the complaint for such action. If the attorney general, official, or agency determines that it is not feasible to provide the notice described in this paragraph before the filing of the action, the attorney general, official, or agency shall provide written notice of the action and a copy of the complaint to the Commission immediately upon the filing of the action. (3)

Authority of Federal Trade Commission

(A)

In general

On receiving notice under paragraph (2) of an action under this subsection, the Commission shall have the right— (i)to intervene in the action; (ii)upon so intervening, to be heard on all matters arising therein; and (iii)to file petitions for appeal. (B)

Limitation on State action while Federal action is pending

If Commission or the Attorney General of the United States has instituted a civil action for violation of subsection (a) or a regulation promulgated under such subsection (referred to in this paragraph as the Federal action), no State attorney general, official, or agency may bring an action under this subsection during the pendency of the Federal action against any defendant named in the complaint in the Federal action for any violation of such subsection or regulation alleged in such complaint. (C)

Tolling of statute of limitations during Federal action

If the Commission or the Attorney General institutes a civil action under this paragraph, the time limit for filing such civil action for a State attorney general, official, or agency shall be tolled during the pendency of the Federal action. (4)

Statutory damages

For purposes of paragraph (1)(B)(ii), the amount determined under this paragraph is the amount calculated by multiplying the number of violations (each separate remote visit or service provided to an individual in violation of subsection (a) shall be 1 violation) by $1,000. The court may increase a damage award to an amount equal to not more than three times the amount otherwise available under this paragraph if the court determines that the defendant committed the violation willfully and knowingly. (5)

Attorney fees

In the case of any successful action under paragraph (1), the court, in its discretion, may award the costs of the action and reasonable attorney fees to the State. (e)

Definitions

In this section: (1)

Asynchronous transmission

The term asynchronous transmission means store and forward technology that allows a provider to transmit the health information of a patient to another provider for viewing at a later time. (2)

Commission

The term Commission means the Federal Trade Commission. (3)

Dental services

The term dental services means diagnostic, preventive, or corrective procedures provided by or under the supervision of a dentist, including treatment of— (A)the teeth and associated structures of the oral cavity; and (B)disease, injury, or impairment that may affect the oral or general health of an individual. (4)

Dentist

The term dentist means an individual licensed to practice dentistry or dental surgery. (5)

Distant site

The term distant site means the location of the dentist who is providing teledentistry services to a patient located at an originating site. (6)

Emergent care

The term emergent care— (A)means the provision of dental services for the treatment of pain, infection, or any other intraoral or perioral condition which presents immediate harm to the well-being of the individual and for which treatment cannot be postponed using electronic or telecommunication technology; and (B)includes patient education related to such dental services and the administration of such dental services. (7)

Medical device

The term medical device has the meaning given the term device in section 201 of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 321). (8)

Originating site

The term originating site means the location of the site where a patient is receiving teledentistry services from a dentist located at a distant site. (9)

Public health program

The term public health program means a program for dental services approved by a State Dental Board or any health program administered by— (A)the United States Department of Health and Human Services; or (B)a health district or State health department. (10)

State

The term State means each of the several States, the District of Columbia, each commonwealth, territory, or possession of the United States, and each federally recognized Indian Tribe. (11)

Teledentistry

The term teledentistry— (A)means the use of telehealth by a dentist who is located at a distant site to facilitate the diagnosis, treatment, education, care management, and self-management of or consultation with a patient who is located at an originating site; and (B)includes, without limitation— (i)real-time interactions between a patient at an originating site and a provider at a distant site; (ii)the asynchronous transmission of medical and dental information concerning a patient from an originating site to a provider at a distant site; (iii)interaction between a provider at a distant site who is providing dental services to a patient at an originating site and another provider at the originating site; and (iv)monitoring of a patient at an originating site by a provider at a distant site. (f)

Relationship with State law

This section does not prohibit a State from adopting or enforcing supplemental law or regulation that is consistent with this section, including any criminal, civil, or administrative fine for a violation of any such law or regulation.