Current through Register Vol. 49, No. 2, February 2024
Provider is defined as a person licensed by the Arkansas State
Medical Board. A Provider exhibits gross negligence if he provides and/or
recommends any form of treatment, including prescribing legend drugs, without
first establishing a proper Patient/Provider relationship.
A. For purposes of this regulation, a proper
Patient/Provider relationship, at a minimum requires that:
1.
A. The
Provider performs a history and an "in person" physical examination of the
patient adequate to establish a diagnosis and identify underlying conditions
and/or contraindications to the treatment recommended/provided, OR
B. The Provider has access to a patient's
personal health record, defined by ACA §
17-80-401
et
seq., as relevant clinical information required to treat a patient,
that is maintained by a Provider and uses any technology deemed appropriate by
the Provider, including the telephone, with a patient located in Arkansas to
diagnose, treat, and if clinically appropriate, prescribe a noncontrolled drug
to the patient.
1. A proper professional
relationship does not include one established only by internet questionnaire,
email message, patient-generated medical history, text message, facsimile, or
any combination of these means.
C. The Provider personally knows the patient
and the patient's general health status through an "ongoing" personal or
professional relationship;
1. Appropriate
follow-up be provided or arranged, when necessary, at medically necessary
intervals.
2. A health record may
be created with the use of telemedicine and consists of relevant clinical
information required to treat a patient, and is reviewed by the healthcare
professional who meets the same standard of care for a telemedicine visit as an
in-person visit.
B. For the purposes of this regulation, a
proper Patient/Provider relationship is deemed to exist in the following
situations:
1. When treatment is provided in
consultation with, or upon referral by, another Provider who has an ongoing
relationship with the patient, and who has agreed to supervise the patient's
treatment, including follow up care and the use of any prescribed
medications.
2. On-call or
cross-coverage situations arranged by the patient's treating
Provider.
C. Exceptions
- Recognizing a Provider's duty to adhere to the applicable standard of care,
the following situations are hereby excluded from the requirement of this
regulation:
1. Emergency situations where the
life or health of the patient is in danger or imminent danger.
2. Simply providing information of a generic
nature not meant to be specific to an individual patient.
3. This Regulation does not apply to
prescriptions written or medications issued for use in expedited heterosexual
partner therapy for the sexually transmitted diseases of gonorrhea and/or
chlamydia.
4. This Regulation does
not apply to the administration of vaccines containing tetanus toxoid (e.g.,
DTaP, DTP, DT, Tdap, Td, or TT) or inactive influenza vaccines.