AB 1399 Frequently Asked Questions

Assembly Bill (AB) 1399 (Friedman, Chapter 475, Statutes of 2023) went into effect on January 1, 2024, and places in statute the requirements for a veterinarian-client-patient relationship (VCPR) for a veterinarian to prescribe, dispense, or administer a drug, medicine, application, or treatment of whatever nature for the prevention, cure, or relief of a wound, fracture, bodily injury, or disease of animals, as specified. (Business and Professions Code (BPC), § 4826.6.) AB 1399 also clarifies the requirements for providing veterinary telehealth. (BPC, §§ 4825.1, 4826.6, 4829.5, and 4853.) Provided below are frequently asked questions (FAQs) the Veterinary Medical Board (Board) has received from the public on the new laws and answers thereto.

These FAQs are intended to provide guidance to veterinary professionals implementing the new laws. If there are any interpreted discrepancies between these FAQs and the text of the statutes, the statutes are controlling, and the Board will enforce the statutes. Veterinary professionals should review the statutes to ensure compliance.

1. Can a California licensed veterinarian use telemedicine to establish or continue treatment within an existing VCPR with an animal patient originally from California but currently not in California?

No. For a California licensed veterinarian to provide veterinary medical services via telehealth, the animal patient must be located in California. (BPC, § 4826.6, subd. (f).) Authorizing a refill of an existing prescription for an animal patient located out of state is not considered telehealth.

2. Does the client providing a California address suffice to satisfy the requirement that the animal patient is located in this state?

No. It is recommended the veterinarian confirm with the client the animal patient is located in California at the time the telehealth services are being provided. (BPC, § 4826.6, subd. (f).)

3. Can the veterinarian notify the client that “some prescription drugs or medications may be available at a pharmacy” by posting a notice in a virtual lobby?

Yes. The requirement is to provide notice to the client that some prescription drugs or medications may be available at a pharmacy, but there is no specification on how that notice is provided. (BPC, § 4826.6, subd. (i)(7).) It should be noted that the prescribing veterinarian still must comply with all statutes and regulations in the Veterinary Medicine Practice Act and Pharmacy Law as it relates to veterinarians. This includes, but is not limited to, prescriber dispensing requirements listed in BPC section 4170.

4. If the prescription notice can be posted in the lobby, can it be incorporated into the existing notice requirement so that both disclosures are in one posting?”

Yes. Both disclosures can be incorporated into one posting.

5. Since AB 1399 only requires veterinarians to notify the client that “some prescription drugs or medications may be available at a pharmacy,” does the veterinarian have to notify the client that the veterinarian can submit a prescription to the pharmacy of the client’s choice?

Yes, the veterinarian must provide the client with written disclosure that the client has a choice between obtaining the prescription from the veterinarian or obtaining the prescription at a pharmacy of the client’s choice. (BPC, § 4170, subd. (a)(7).) In addition, before prescribing, the veterinarian must offer to give a written prescription to the client that the client may elect to have filled by the prescriber or by any pharmacy. (BPC, § 4170, subd. (a)(6).)

6. What are the privacy protection laws with which the veterinarian practicing veterinary medicine via telehealth must comply?

Veterinarians practicing veterinary medicine via telehealth must comply with BPC section 4857. Since veterinarians may be subject to civil actions (not under the jurisdiction of the Board) for negligent release of confidential information, veterinarians may wish to familiarize themselves with laws related to such civil actions.

7. If the client does not provide the veterinarian with the animal patient’s relevant medical history or medical records, can the veterinarian provide veterinary telehealth for the animal patient?

Telehealth cannot be used if the veterinarian does not obtain and review relevant medical history for the animal patient. However, medical records are not required to provide the relevant medical history; if medical records are available, the veterinarian would have to obtain and review those medical records. (BPC, § 4826.6, subd. (h)(2).)

8. How will the Board verify that the veterinarian providing telehealth was familiar with available medical resources, including emergency resources, near the animal patient’s location?

If the Board asks the veterinarian whether they were familiar with available medical resources, including emergency resources, near the animal patient’s location, the veterinarian would need to explain their familiarity with the available medical resources near the animal patient location. (BPC, § 4826.6, subd. (h)(4).) The veterinarian may be asked to submit documentation validating the explanation provided to the Board.

9. If midway through an appointment the synchronous audio-visual communication is interrupted, can a VCPR be established solely by another form of electronic communication?

No. To establish a VCPR via telehealth, the veterinarian must possess sufficient knowledge of the animal patient by examining the animal patient by use of synchronous audio-video communication. (BPC, § 4826.6, subd. (b)(2).) Synchronous audio-video communication is not required for veterinary telehealth after a VCPR has been established, unless the veterinarian determines that it is necessary to provide care consistent with prevailing veterinary medical practice. (BPC, § 4826.6, subd. (d).)

10. Which definition of “antimicrobial” will the Board use to enforce the antimicrobial prescription by telehealth provision?

Antimicrobial drugs are those drugs listed in Appendix A of the federal Food and Drug Administration’s Guidance for Industry #152, including critically important, highly important, and important antimicrobial drugs, as that appendix may be amended.

11. If a veterinarian prescribes medication via telehealth unknowingly to a racehorse or to a trainer registered to the California Horse Racing Board (CHRB), what type of documentation would the Board need for the veterinarian to prove that they were unaware of these circumstances?

The veterinarian should confirm with the client that the horse is not engaged in racing or training at a facility under the jurisdiction of the CHRB prior to prescribing any drug or medication via telehealth. If the horse is engaged in racing or training at a facility under the jurisdiction of the CHRB, a veterinarian is prohibited from prescribing via telehealth any drug or medication for use on the horse. The veterinarian’s lack of knowledge at the time of prescribing of the location of the horse or potential use of the prescribed drug or medication while the horse is engaged in racing or training is irrelevant in determining a violation of this provision. (BPC, § 4826.6, subd. (i)(8).)

12. Can a veterinarian via telehealth change the dosage of a previously prescribed drug or medication for use on a horse engaged in racing or training at a facility under the jurisdiction of the CHRB?

No. Any change to a previously prescribed drug or medication would constitute a new prescription and could not be done via telehealth for use on a horse engaged in racing or training at a facility under the jurisdiction of the CHRB. (BPC, § 4826.6, subd. (i)(8).)

13. If a veterinary assistant and client are in a room located within a registered veterinary premises, can a veterinarian remotely perform an examination and ask the veterinary assistant to perform diagnostic tests as needed?

Yes. If the veterinarian has determined a VCPR can be established via telehealth, the veterinary assistant can perform the diagnostic tests under indirect supervision of the veterinarian. Note that a veterinary assistant cannot obtain or administer anesthesia or controlled substances to perform diagnostic tests. (BPC, § 4836.1.) In addition, a veterinary assistant must be trained in radiation safety and techniques to operate radiographic equipment, which must be performed under the direct supervision of a registered veterinary technician (RVT) or licensed veterinarian. (BPC, § 4840.7, subd. (b).)

14. Can a veterinary assistant give vaccinations under the direct supervision of the remote veterinarian performing the telemedicine examination?

If the veterinarian is performing an examination by telehealth, the veterinarian is not providing direct supervision of the veterinary assistant. “Direct supervision” means: (1) the supervisor is physically present at the location where animal health care job tasks are to be performed and is quickly and easily available; and (2) the animal has been examined by a veterinarian at such time as good veterinary medical practice requires consistent with the particular delegated animal health care job task. (California Code of Regulations (CCR), tit. 16, § 2034, subs. (e).)

If a vaccination prescribed by the veterinarian is not a controlled substance or a dangerous drug that is restricted against access by a veterinary assistant, the veterinary assistant may administer the vaccination to the animal patient at the registered veterinary premises under indirect supervision of the veterinarian or direct supervision of an RVT. (BPC, § 4836.1, subds. (a), (b); CCR, tit. 16, §§ 2034, subs. (f), 2036.5, subs. (b).)