WeVote
Log In

Bill

Bill

SB 1453

SB 1453 - Currently, the establishment of a physician-patient relationship for purposes of telehealth shall include an interview and a physical examination. Under this act, an evaluation is required, but a physical examination shall be required only if needed to meet the standard of care. Current law prohibits the use of an internet or telephone questionnaire completed by a patient from constituting an acceptable medical interview for the provision of treatment by telehealth. This act permits such questionnaires if the information provided is sufficient as though the medical evaluation was performed in person and has been reviewed by the treating health care professional. Any provider that uses a questionnaire to establish a physician-patient relationship through telemedicine shall be employed or contracted with a business entity that is licensed to provide health care in this state. A health care provider using a medical evaluation questionnaire completed by a patient over the internet or telephone shall provide a written report to the patient's primary health care provider within 14 days of evaluation regarding the diagnosis and treatment of the patient. Additionally, current law requires a physician-patient relationship for purposes of telehealth to include a sufficient dialogue with the patient regarding treatment. This act changes "dialogue" to "exchange" with the patient regarding treatment. Finally, current law prohibits a health care provider from prescribing any drug, controlled substance, or other treatment to a patient based solely on an internet request or questionnaire. Under this act, a health care provider shall not prescribe any drug, controlled substance, or other treatment to a patient in the absence of a proper provider-patient relationship. Medical records of any drug, controlled substance, or treatment prescribed to a patient through telemedicine shall be collected, stored, and maintained, in compliance with the federal Health Insurance Portability and Accountability Act (HIPAA). This act is identical to provisions of the truly agreed to and finally passed SS/SCS/HCS/HB 2372 (2026) and SS/SCS/SB 841 (2026), substantially similar to HCS/HB 710 (2025) and similar to SB 108 (2025), SB 851 (2024), SCS/SB 418 (2023), and HB 710 (2023). SARAH HASKINS

2026 Regular Session

Missouri SB 1453 tightens telemedicine by requiring a valid provider-patient relationship with a possible exam, permits reviewed online questionnaires, and mandates rapid reporting

Second Read and Referred S Families, Seniors and Health Committee
0
WeVote Research Nonpartisan
Bill Summary · SB 1453

Overview

SB 1453 (Missouri, 2026) revises the standards for establishing a physician-patient relationship and the appropriate use of telehealth/telemedicine. It modulates when a physical examination is required, allows internet/telephone questionnaires under certain conditions, requires reporting to a patient’s primary care provider, updates terminology from “dialogue” to “exchange,” and strengthens safeguards around prescribing via telemedicine. The bill aligns with similar provisions in companion/related bills and prior versions.

Purpose and intent

  • Modernize telehealth practice standards to reflect when a physical examination is necessary.
  • Permit certain internet or telephone questionnaires as part of establishing a medical relationship, provided the information is sufficient to meet the standard of care and reviewed by the treating health care professional.
  • Ensure continuity of care by mandating communication of evaluations to the patient’s primary health care provider.
  • Tighten protections around prescribing via telemedicine, ensuring a proper provider-patient relationship is in place before prescribing any drug, including controlled substances.
  • Align terminology and processes to emphasize the quality and safety of telemedicine exchanges.

Key provisions

  • Establishment of physician-patient relationship for telehealth
    • An evaluation is required; a physical examination is required only if needed to meet the standard of care.
  • Internet/telephone questionnaires
    • Current law: questionnaires alone cannot constitute an acceptable medical interview for telehealth treatment.
    • SB 1453: permits questionnaires if the information provided is sufficient as though an in-person evaluation occurred and has been reviewed by the treating professional.
    • Providers using such questionnaires must be employed or contracted with a health care entity licensed in Missouri.
  • Reporting to primary care provider
    • A health care provider who uses an internet/telephone medical evaluation questionnaire must issue a written report to the patient’s primary health care provider within 14 days, detailing diagnosis and treatment.
  • Treatment dialogue terminology
    • Replaces the term “dialogue” with “exchange” with the patient regarding treatment.
  • Prescribing via telemedicine
    • Prohibits prescribing any drug, including controlled substances, or other treatment based solely on an internet request or questionnaire.
    • Requires a proper provider-patient relationship before prescribing any drug or treatment via telemedicine.
  • Records and privacy
    • Drug/controlled substance/treatment records prescribed through telemedicine must be collected, stored, and maintained in compliance with HIPAA.

Who/what is affected

  • Health care providers who use telemedicine/telehealth to evaluate or treat patients.
  • Health care entities/entities licensed to provide health care in Missouri that employ or contract with such providers.
  • Patients receiving telemedicine services, particularly those who may be evaluated or treated based on online or telephone questionnaires.
  • Primary care providers who must receive timely written reports within 14 days of telemedicine evaluations.
  • Entities involved in prescribing telemedicine treatments, including controlled substances, by ensuring proper patient-provider relationships.

Procedural and timeline aspects

  • Effective practice conditions hinge on the existence of an evaluation with possible physical examination as needed.
  • Internet/telephone questionnaires must be reviewed and considered sufficient to meet the standard of care before establishing a physician-patient relationship.
  • Written report to the patient’s primary care provider due within 14 days of the telemedicine evaluation.
  • The act requires that a valid provider-patient relationship be established before prescribing any medication via telemedicine.
  • The bill is part of a broader set of similar Missouri telehealth reforms and mirrors prior versions and related bills.

Practical impact

  • Potentially expands the use of asynchronous telehealth tools (online/phone questionnaires) within safety guardrails.
  • Increases accountability by requiring documentation to a patient’s primary care provider within two weeks.
  • Strengthens prescribing safeguards to ensure telemedicine prescriptions are based on a robust provider-patient relationship.
  • May affect how telehealth services are organized, with providers needing to ensure compliance with licensing, reporting, and HIPAA requirements.

Notes

  • SB 1453 is stated to be identical to or closely aligned with several related bills from 2026 and earlier sessions, suggesting a coordinated regulatory approach to telehealth standards in Missouri.
  • The bill’s action history shows committee referral and prior readings, indicating it was advancing through the legislative process.

Compiled from official sources — confirm details with the bill’s official record.

Sign in to ask a question.