Fiscal Note - 25LSO-0391

Telehealth Freedom Act.

25LSO-0391, 1.1

FISCAL NOTE

	FY 2026	FY 2027	FY 2028
NON-ADMINISTRATIVE IMPACT
Anticipated Revenue (decrease)
Special Revenue Fund (Board of Registration in Podiatry)	($8,400)	($8,400)	($8,400)
Special Revenue Fund (Board of Chiropractic Examiners)	($9,000)	($9,000)	($9,000)
Special Revenue Fund (Board of Dental Examiners)	($77,250)	($77,250)	($77,250)
Special Revenue Fund (Board of Midwifery)	($16,800)	($16,800)	($16,800)
Special Revenue Fund (Board of Examiners of Optometry)	($8,290)	($8,290)	($8,290)
Special Revenue Fund (Board Of Examiners for Speech Language Pathology and Audiology)	($29,000)	($29,000)	($29,000)
Special Revenue Fund (Board Of Physical Therapy)	($30,585)	($30,585)	($30,585)
Special Revenue Fund (Board Of Psychology)	($49,725)	($49,725)	($49,725)
Special Revenue Fund (Mental Health Professionals Licensing Board)	($84,338)	($84,338)	($84,338)
Special Revenue Fund (Board Of Occupational Therapy)	($15,780)	($15,780)	($15,780)
Special Revenue Fund (Board Of Acupuncture)	($2,450)	($2,450)	($2,450)
Special Revenue Fund (Board Of Medicine)	($549,550)	($549,550)	($549,550)
Special Revenue Fund (Board Of Nursing)	($154,000)	($529,000)	($154,000)

Source of revenue (decrease):

This bill allows a health care provider, with a valid, unencumbered license and who is in good standing to practice in any other state, United States territory or the District of Columbia to be permitted to conduct telehealth services without first obtaining a Wyoming license from certain boards, resulting in a revenue decrease in renewal and initial license fees to each board's special revenue fund as estimated in the above table.

Assumptions:

Each board impacted by this bill estimated the revenue decrease in the form of fee revenues based on the number of current licensees with addresses outside Wyoming and using those as proxies for the number of licensees that would no longer be required to be licensed in Wyoming or that must apply for an initial license to provide telehealth services to residents of Wyoming. Each board used the current fees charged for an initial license or to renew a license and the renewal requirements to estimate the revenue decrease for the particular board.

Prepared by: Matthew Willmarth, LSO Phone: 777-7881

(Information provided by JoAnn Reid, Department of Administration and Information for the supported boards (Board of Registration in Podiatry, Board of Chiropractic Examiners, Board of Dental Examiners, Board of Midwifery, Board of Examiners of Optometry, Board of Examiners for Speech Language Pathology and Audiology, Board of Physical Therapy, Board of Psychology, Mental Health Professionals Licensing Board, Board of Occupational Therapy, and Board of Acupuncture), 777-3507; Laura Hudspeth, Department of Health, 777-6882; Kevin Bohnenblust and Mary Ann Majszak, Board of Medicine, 777-7053; Rachael Fillbrandt, Board of Nursing, 777-7053)

HB0241

2025

STATE OF WYOMING

25LSO-0391

Numbered

2.0

HOUSE BILL NO. HB0241

Telehealth Freedom Act.

Sponsored by: Representative(s) Smith, S and Kelly and Senator(s) Pearson

A BILL

for

AN ACT relating to professions and occupations; authorizing health care providers to provide telehealth services to persons in Wyoming without a Wyoming license; providing requirements; requiring rulemaking; making conforming amendments; and providing for effective dates.

Be It Enacted by the Legislature of the State of Wyoming:

Section 1. W.S. 33‑1‑121 is created to read:

33‑1‑121. Health care providers; telehealth services; definitions.

(a) A health care provider, as defined in W.S. 26‑55‑102(a)(xii), with a valid, unencumbered license and who is in good standing to practice in any other state, United States territory or the District of Columbia shall be permitted to conduct telehealth services with persons who are physically present in Wyoming when telehealth services are rendered without first obtaining a license under this title. In addition:

(i) The health care provider who is not licensed in Wyoming shall be physically present outside Wyoming in order to conduct telehealth services under this section;

(ii) The appropriate licensing board shall be notified before the health care provider begins providing telehealth services under this section unless a patient has an established relationship with the health care provider;

(iii) As used in this section, \"telehealth\" means the practice of medicine by electronic communication or other means from a health care provider in one (1) location to a patient in another location.

Section 2. W.S. 33‑9‑103, 33‑10‑105(a), 33‑15‑108(a) and (h), 33‑15‑114(a) by creating a new paragraph (xiii), 33‑21‑120(a)(i)(D), 33‑21‑145(a)(i), 33‑21‑151(a)(i) and (iii), 33‑23‑101(a)(iv), 33‑23‑103(a), 33‑25‑101(a)(i), (ii) and (vi), 33‑25‑102(a)(intro) and (f) by creating a new paragraph (viii), 33‑25‑116(a)(i) and (iii), 33‑26‑301(a), 33‑26‑410(a), 33‑26‑504(a), 33‑27‑113(a)(xi) and (xii), 33‑27‑114 by creating a new subsection (j), 33‑27‑119(b), 33‑33‑103(b), 33‑33‑202(b), 33‑38‑102(a)(x) through (xii) and (xvi), 33‑38‑103 by creating a new subsection (g), 33‑40‑102(a)(ii) and (iv), 33‑40‑103(a), 33‑40‑115(b) and (d)(ii), 33‑46‑105(a), 33‑49‑102(a)(iii), 33‑49‑106(a)(x) and 33‑49‑107(a)(intro) and (e) are amended to read:

33‑9‑103. License required to practice.

It is unlawful for a person to profess to be a podiatrist, to practice or assume the duties incident to podiatry or to advertise in any form or hold himself out to the public as a podiatrist, or in a sign or advertisement to use the word \"podiatrist\", \"foot correctionist\", \"foot expert\", \"foot specialist\", \"chiropodist\" or any other term or designation indicating to the public that he is holding himself out as a podiatrist or foot correctionist in any manner, without first obtaining from the board a license authorizing the practice of podiatry in this state under this act or as provided by W.S. 33‑1‑121.

33‑10‑105. License required.

(a) It shall be unlawful for any person to practice chiropractic in this state without first obtaining a license, as provided for in this act, or as provided by W.S. 33‑1‑121.

33‑15‑108. Licensing; qualifications; examinations; fees.

(a) Except as provided by W.S. 33‑1‑121, any person who has a background that does not evidence conduct adverse to the practice of dentistry or to the ability to practice dentistry, who has graduated and attained the degree of doctor of dental surgery or doctor of dental medicine from a college or university in the United States or Canada accredited by the commission on dental accreditation of the American Dental Association, may apply to the board to have the applicant's qualifications considered for licensure to practice dentistry. The applicant shall pass a written, clinical and state examination that follows national standards as determined by rule of the board.

(h) The board may make and prescribe rules and regulations for the licensure and practice of dentistry in the state of Wyoming, including rules and regulations pertaining to telehealth services under W.S. 33‑1‑121, not inconsistent with this act. For purposes of this subsection, \"practice of dentistry\" includes the work of dental hygienists, dental auxiliaries, dental technicians and dental laboratories.

33‑15‑114. Persons deemed to be practicing dentistry; work authorizations from licensed dentist.

(a) Except as provided by paragraph (xii) of this subsection, any person is deemed to be practicing dentistry within the meaning of this act:

(xiii) Who provides telehealth services under W.S. 33‑1‑121.

33‑21‑120. Definitions.

(a) As used in this act:

(i) \"Advanced practice registered nurse (APRN)\" means a nurse who:

(D) Has completed an advanced program of study in a specialty area in an accredited nursing program, has taken and passed a national certification examination in the same area and has been granted licensure by the board to practice as an APRN or is providing telehealth services under W.S. 33‑1‑121.

33‑21‑145. Violations; penalties.

(a) No person shall:

(i) Engage in the practice of nursing or nurse assisting as defined in this act without a valid, current license, certificate or temporary permit, except as otherwise permitted under this act, under W.S. 33‑1‑121 or the Nurse Licensure Compact or the Advanced Practice Registered Nurse Compact;

33‑21‑151. Injunctive relief; grounds.

(a) The board may petition in its own name for an injunction to a proper court of competent jurisdiction to enjoin:

(i) Any person from practicing nursing or nurse assisting, within the meaning of this act or under W.S. 33‑1‑121, without a valid license, certificate or temporary permit, unless so exempted under W.S. 33‑21‑154;

(iii) Any person, firm, corporation, institution or association from employing any individual to practice nursing or nurse assisting who is not licensed or certified under this act, providing telehealth services under W.S. 33‑1‑121 or exempted under W.S. 33‑21‑154.

33‑23‑101. Definitions; authorized scope of practice; prohibited procedures; exceptions.

(a) As used in this act:

(iv) \"Optometrist\" or \"doctor of optometry\" means a person licensed by the board under this act or providing telehealth services under W.S. 33‑1‑121;

33‑23‑103. License required; civil suit; damages.

(a) It is unlawful for any person in the state of Wyoming to practice or attempt to practice optometry or to advertise, or hold himself out as qualified to fit or adjust any lenses or lens in any manner or form as an aid to human eyesight, without first obtaining a license to practice optometry or providing telehealth services under W.S. 33‑1‑121.

33‑25‑101. Definitions.

(a) As used in this act:

(i) \"Physical therapy\" or \"physiotherapy\" means the care and services provided by or under the direction and supervision of a physical therapist or physiotherapist who is licensed pursuant to this act or providing telehealth services under W.S. 33‑1‑121. The practice of physical therapy includes:

(ii) \"Physical therapist\" or \"physiotherapist\" means a person who is licensed to practice physical therapy pursuant to this act or is providing telehealth services under W.S. 33‑1‑121;

(vi) \"Physical therapy services\" means the care and services provided by a licensed physical therapist or a certified physical therapist assistant pursuant to this act or providing telehealth services under W.S. 33‑1‑121;

33‑25‑102. Practice of physical therapy; license or certificate required; exceptions; false representations.

(a) No individual shall engage in the practice of physical therapy services nor hold himself out as being able to practice physical therapy in the state of Wyoming unless he is practicing under W.S. 33‑1‑121 or is licensed or certified in accordance with the provisions of this act and such license or certificate is in good standing and has not been suspended or revoked, except nothing in this act shall:

(f) The following persons are exempt from the licensure and certification requirements of this act:

(viii) Persons practicing under W.S. 33‑1‑121.

33‑25‑116. Injunctive relief; grounds.

(a) The board may petition in its own name for an injunction to an appropriate court to enjoin:

(i) Any person violating W.S. 33‑25‑102(a), unless specifically exempt from licensure or certification pursuant to W.S. 33‑25‑102(f) or providing telehealth services under W.S. 33‑1‑121;

(iii) Any person, firm, corporation, institution, association, business or other entity from employing any individual to practice physical therapy who is not licensed or certified as required by this act or providing telehealth services under W.S. 33‑1‑121.

33‑26‑301. License required.

(a) No person shall practice medicine in this state without a license granted by the board, as provided by W.S. 33‑1‑121 or as otherwise provided by law.

33‑26‑410. Effect of violation.

(a) Any person engaged in the practice of medicine or aiding and abetting another in the practice of medicine without a license granted by the board or providing telehealth services under W.S. 33‑1‑121 is guilty of a misdemeanor and upon conviction shall be punished by a fine of not more than one thousand dollars ($1,000.00) or by imprisonment in the county jail for not more than one (1) year, or both. Each violation constitutes a separate offense for which the penalty in this subsection may be assessed.

33‑26‑504. License required; application; qualifications; consideration of applications; exception for telehealth services.

(a) Except as provided by W.S. 33‑1‑121, no person shall practice as a physician assistant or represent oneself as a physician assistant without a license granted by the board.

33‑27‑113. Definitions.

(a) As used in this act:

(xi) \"Licensed assistant behavior analyst\" means a person licensed under this act for the practice of behavior analysis and who is supervised in accordance with W.S. 33‑27‑124(c) or who is providing telehealth services under W.S. 33‑1‑121;

(xii) \"Licensed behavior analyst\" means a person licensed under this act for the practice of behavior analysis or who is providing telehealth services under W.S. 33‑1‑121;

33‑27‑114. Exemptions.

(j) Nothing in this act shall prevent a person from practicing psychology or behavior analysis under W.S. 33‑1‑121.

33‑27‑119. Practice without license.

(b) Unless exempt under W.S. 33‑1‑121, 33‑27‑114 or 33‑27‑125, any person who represents himself as a psychologist and who engages in the practice of psychology or represents himself as a behavior analyst or assistant behavior analyst and who engages in the practice of behavior analysis in violation of this act, is guilty of a misdemeanor punishable by a fine of not more than seven hundred fifty dollars ($750.00), imprisonment for not more than six (6) months, or both. Each violation shall constitute a separate offense.

33‑33‑103. Persons and practices affected.

(b) No person shall practice or represent himself as a speech‑language pathologist or audiologist unless licensed pursuant to this act or providing telehealth services pursuant to W.S. 33‑1‑121.

33‑33‑202. Functions of the board.

(b) The board shall adopt rules and regulations to implement and enforce the provisions of this act and W.S. 33‑1‑121.

33‑38‑102. Definitions.

(a) As used in this act:

(x) Certified addictions practitioner (CAP) means a person certified under this act to practice addictions treatment, prevention, intervention, diagnosis, referral and follow up under the supervision of a qualified clinical supervisor licensed in the state of Wyoming or providing telehealth services under W.S. 33‑1‑121;

(xi) Certified social worker (CSW) means a person certified under this act to perform social work treatment, prevention, intervention, case management, referral and follow up with individuals diagnosed with mental illnesses or mental disorders under the supervision of a qualified clinical supervisor licensed in the state of Wyoming or a person providing telehealth services under W.S. 33‑1‑121;

(xii) Certified mental health worker (CMHW) means a person certified under this act to perform the application of human services or psychological theory and methods to the assessment, treatment or prevention of psychosocial dysfunction, disability or impairment, including emotional or mental disorders, under the supervision of a qualified clinical supervisor licensed in the state of Wyoming or a person providing telehealth services under W.S. 33‑1‑121. The practice of a CMHW shall not include assigning a diagnosis or acting as a primary treatment provider;

(xvi) \"Certified addictions practitioner assistant\" means a person certified under this act to assist in the practice of addictions treatment, prevention, intervention, referral and followup under the supervision of a qualified clinical supervisor licensed in the state of Wyoming or a person providing telehealth services under W.S. 33‑1‑121;

33‑38‑103. Exemptions.

(g) Nothing in this act shall prevent a person from providing telehealth services under W.S. 33‑1‑121.

33‑40‑102. Definitions.

(a) As used in this act:

(ii) \"Occupational therapy assistant\" or \"OTA\" means a person licensed under this act to assist in the practice of occupational therapy and who works under the supervision of an occupational therapist to perform tasks requiring occupational therapy professional knowledge or judgment or a person providing telehealth services under W.S. 33‑1‑121;

(iv) \"Occupational therapist\" means a person licensed to practice occupational therapy under this act or a person providing telehealth services under W.S. 33‑1‑121;

33‑40‑103. License required.

(a) No person shall hold himself out as an occupational therapist, an occupational therapy assistant or as being able to practice occupational therapy in Wyoming unless he is licensed under this act, providing telehealth services under W.S. 33‑1‑121 or is otherwise authorized under the Occupational Therapy Licensure Compact under W.S. 33‑40‑202 through 33‑40‑216. An unlicensed person holding himself out as an occupational therapist or occupational therapist assistant by using additional or modifying words in his title, printed materials, advertisements or otherwise shall be deemed to be holding himself out as an occupational therapist or occupational therapist assistant.

33‑40‑115. Board of occupational therapy practice; powers and duties.

(b) The board shall establish rules and regulations according to the Wyoming Administrative Procedure Act to carry out the purpose of this act and W.S. 33‑1‑121, including establishing rules for professional conduct, for professional licensure and to establish ethical standards of practice for persons licensed to practice occupational therapy in Wyoming.

(d) The board may, with the approval and assistance of the attorney general, petition the district court in the name of the state of Wyoming to enjoin:

(ii) Any person or other entity from advertising or claiming to provide occupational therapy services in this state when the services are not or will not be provided by a person licensed under this act, providing telehealth services under W.S. 33‑1‑121 or is otherwise authorized under the Occupational Therapy Licensure Compact under W.S. 33‑40‑202 through 33‑40‑216.

33‑46‑105. Prohibited acts and exceptions.

(a) Unless licensed pursuant to this act or practicing under W.S. 33‑1‑121, no person shall practice midwifery or hold himself out to be a midwife, a licensed midwife or a certified professional midwife except that a certified nurse midwife may hold himself out to be a midwife.

33‑49‑102. Definitions.

(a) As used in this chapter:

(iii) \"Acupuncturist\" means any person to whom a license to practice acupuncture in this state has been issued under this chapter or who is providing telehealth services under W.S. 33‑1‑121;

33‑49‑106. Board responsibilities and duties.

(a) The board shall:

(x) Promulgate rules and regulations as necessary to carry out this chapter or W.S. 33‑1‑121.

33‑49‑107. Licensure required; components; exemptions; other licensed health care professionals.

(a) Beginning January 1, 2018, unless the person is licensed to practice acupuncture in compliance with this chapter, is providing telehealth services under W.S. 33‑1‑121 and the rules and regulations adopted pursuant thereto, no person shall:

(e) Nothing in this chapter shall be construed to prohibit or restrict any other licensed health care provider in this state from practicing acupuncture within their statutory scope of practice. However, no person may represent themselves as an acupuncturist in any manner unless licensed in accordance with this chapter or providing telehealth services under W.S. 33‑1‑121.

Section 3. The state board of nursing, the state board of medicine, the state board of psychology, the state board of registration in podiatry, the board of chiropractic examiners, the board of physical therapy, the mental health professionals licensing board, the board of examiners for speech‑language pathology and audiology, the board of dental examiners, the board of examiners of optometry, the board of occupational therapy, the board of acupuncture and the board of midwifery shall promulgate all rules necessary to implement this act.

Section 4.

(a) Except as provided in subsection (b) of this section, this act is effective July 1, 2025.

(b) Sections 3 and 4 of this act are effective immediately upon completion of all acts necessary for a bill to become law as provided by Article 4, Section 8 of the Wyoming Constitution.

(END)

HB0241