Louisiana

CURRENT STATE LAWS & POLICY

AT A GLANCE

Medicaid Program

Louisiana Medicaid

Administrator

Louisiana Dept. of Health and Hospitals

Regional Telehealth Resource Center

TexLa Telehealth Resource Center

Medicaid Reimbursement

Live Video: Yes
Store-and-Forward: No
Remote Patient Monitoring: Yes

Private Payer Law

Law Exists: Yes
Payment Parity: No

Professional Requirements

Licensure Compacts: PTC, NLC
Consent Requirements: Yes

Last updated 02/28/2021

Audio Only Delivery

Medicaid: Teledentistry

STATUS: Active, during COVID-19 emergency

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: SUD Treatment Services

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on COVID-19 Policy (includes telemedicine)

STATUS: Active, during COVID-19 emergency

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Department of Health: Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Department of Health: Mental Health Rehabilitation

STATUS: Active, until rescinded

Department of Health: Emergency Rule on Medicaid Waiver Programs

STATUS: Active, until end of COVID-19 emergency

LA Division of Administration: Emergency Rule Emergency Telemedicine

STATUS: Effective Nov. 13, 2020 through declared emergency

Department of Health: Amendments to Additional Programs and Services Due to COVID-19 PHE

STATUS: Contingent on approval from CMS

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Medicaid 1915(c) Waiver: Appendix K – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Last updated 02/28/2021

Cross State Licensing

No Reference Found

Last updated 02/28/2021

Easing Prescribing Requirements

Medicaid: Informational Bulletin on COVID-19 Policy (includes telemedicine)

STATUS: Active, during COVID-19 emergency

Department of Health: Opioid Treatment Providers

STATUS: Active

Medical Board: Telehealth Guidance During COVID-19

STATUS: Active

Medical Board: Plain Language Guidance Regarding Board Changes During the COVID-19 Crisis

STATUS: Active

Last updated 02/28/2021

Miscellaneous

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Medicaid 1915(c) Waiver: Appendix K – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Extension – New Opportunities Waiver, Residential Options Waiver, Children’s Choice Waiver, Supports Waiver

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Last updated 02/28/2021

Originating Site

Medicaid: Teledentistry

STATUS: Active, during COVID-19 emergency

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: SUD Treatment Services

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on COVID-19 Policy (includes telemedicine)

STATUS: Active, during COVID-19 emergency

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Department of Health: Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Department of Health: Opioid Treatment Providers

STATUS: Active

Department of Health: Mental Health Rehabilitation

STATUS: Active, until rescinded

Bureau of Health Services Financing: Programs and Services Amendments – Hospice in-person visit

STATUS: Active, during COVID-19 emergency

Last updated 02/28/2021

Private Payer

Department of Insurance: Emergency Rule on Telemedicine Expansion

STATUS: Expired May 12, 2020

LA Division of Administration: : Worker’s Compensation Guidelines

STATUS: Expired

Last updated 02/28/2021

Provider Type

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on COVID-19 Policy (includes telemedicine)

STATUS: Active, during COVID-19 emergency

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Department of Health: Emergency Rule Teletherapy

STATUS: Active, effective November 2020 for  120 days

Medicaid 1915(c) Waiver: Appendix K – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Expired January 26, 2021; extended through Addendum

Medicaid 1915(c) Waiver: Appendix K Addendum – Communities Choices & Adult Day Health Care Waiver Combined

STATUS: Active, expires 6 months after the conclusion of the Public Health Emergency (PHE)

Last updated 02/28/2021

Service Expansion

Medicaid: Teledentistry

STATUS: Active, during COVID-19 emergency

Medicaid: Response to COVID-19

STATUS: Active, until rescinded

Medicaid: Outpatient SUD Treatment

STATUS: Active, until rescinded

Medicaid: SUD Treatment Services

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on Telehealth Facilitation by Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Medicaid: Informational Bulletin on COVID-19 Policy (includes telemedicine)

STATUS: Active, during COVID-19 emergency

Medicaid: Information Bulletin on Telehealth Facilitation of Mental Health Rehabilitation Services

STATUS: Active, until rescinded

Department of Health: Licensed Mental Health Practitioners

STATUS: Active, until rescinded

Department of Health: Mental Health Rehabilitation

STATUS: Active, until rescinded

Department of Health: Emergency Rule on Medicaid Waiver Programs

STATUS: Active, until end of COVID-19 emergency

Department of Health: Emergency Rule Teletherapy

STATUS: Active, effective November 2020 for  120 days

Bureau of Health Services Financing: Programs and Services Amendments – Hospice in-person visit

STATUS: Active, during COVID-19 emergency

Last updated 02/28/2021

Definitions

“Telehealth” has the meaning ascribed in R.S. 40:1223.3. – Telehealth means a mode of delivering healthcare services, including behavioral health services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education care management and self-management of patients at a distance from healthcare providers.  Telehealth allows services to be accessed when providers are in a distant site and patients are in the originating site.  Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store-and-forward transfers.”

SOURCE: LA Revised Statutes 40:1223.3 & HB 589 & HB 449 (2020 Session). (Accessed Feb. 2021).

“Telemedicine/telehealth is the use of a telecommunications system to render healthcare services when a physician or other licensed practitioner and a beneficiary are not in the same location. The telecommunications system shall include, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the beneficiary at the originating site and the physician or other licensed practitioner at the distant site. The telecommunications system must be secure, ensure patient confidentiality, and be compliant with the requirements of the Health Insurance Portability and Accountability Act.”

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151. (Sept 03, 2020) (Accessed Feb. 2021).

Telecare is a delivery of care services to recipients in their home by means of telecommunications and/or computerized devices to improve outcomes and quality of life, increase independence and access to health care, and reduce health care costs. Telecare services include:

  • Activity and sensor monitoring;
  • Health status monitoring; and
  • Medication dispensing and monitoring.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 22 (As revised on Mar. 2, 2020). (Accessed Feb. 2021). 

Behavioral Health Services

Telehealth means a mode of delivering healthcare services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education, care management, and self-management of patients at a distance from healthcare providers. Additionally, “telehealth” means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between a provider and a patient.

Telehealth allows services to be accessed when providers are in a distant site and patients are in the originating site. Telehealth facilitates patient self-management and caregiver support for patients.

SOURCE: LA Dept. of Health and Hospitals, Behavioral Health Services, Chapter Two of the Medicaid Svcs. Manual, Section 2.3, p. 7 (As revised on Aug. 04, 2020). (Accessed Feb. 2021).

Last updated 02/28/2021

Email, Phone & Fax

Hospices may report some social worker calls as a visit.

SOURCE: LA Medicaid, Chapter 24: Hospice, Sec. 24.9, Medicaid Svcs. Manual, p. 11, (March 26, 2019), (Accessed Feb. 2021). 

Last updated 02/28/2021

Live Video

POLICY

Louisiana Medicaid only reimburses the distant site for services provided via telemedicine. Reimbursement for services provided by telemedicine/telehealth is at the same level as services provided in person.

Covered services must be identified on claims submissions by appending the modifier “95” to the applicable procedure code and indicate Place of Service (POS) 02. Both the correct POS and modifier must be present on the claim to receive reimbursement.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151-152 (As revised on Sept. 03, 2020). (Accessed Feb. 2021).

Louisiana Medicaid services provided via an interactive audio and video telecommunications system shall be identified on claim submissions by appending the HIPPA compliant POS or modifier to the appropriate procedure code, in line with current policy.

SOURCE: LA Admin. Code 50: I.503, (Accessed Feb. 2021).


ELIGIBLE SERVICES/SPECIALTIES

Recently Passed Legislation (Now Effective)

The department shall periodically review policies regarding Medicaid reimbursement for telehealth services to identify variations between permissible reimbursement under that program and reimbursement available to healthcare providers under the Medicare program.

The department may modify its administrative rules, policies, and procedures applicable to Medicaid reimbursement for telehealth services as necessary to provide for a reimbursement system that is comparable to that of the Medicare program for those services.

SOURCE:  LA Statute Sec. 1255.1 (HB 589 – 2020 Session). (Accessed Feb. 2021). 

When otherwise covered, services located in the Telemedicine appendix of the CPT manual, or its successor, may be reimbursed when provided by telemedicine/telehealth. In addition, other specified services may be reimbursed when provided by telemedicine/telehealth and these services are explicitly noted in this manual.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151. (Sept. 3, 2020). (Accessed Feb. 2021).

Behavioral Health Services

Family psychotherapy, individual psychotherapy, and medication management services may be reimbursed when provided via telecommunication technology.

SOURCE: LA Dept. of Health and Hospitals, Behavioral Health Services, Chapter Two of the Medicaid Svcs. Manual, Section 2.3, p. 6 (As revised on Aug. 04, 2020). (Accessed Feb. 2021).


ELIGIBLE PROVIDERS

The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered services.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151 (As revised on Sept. 03, 2020). (Accessed Feb. 2021). 

Behavioral Health

“Healthcare provider,” as used herein, means a person, partnership, limited liability partnership, limited liability company, corporation, facility, or institution licensed or certified by this state to provide health care or professional services as a physician assistant, hospital, nursing home, registered nurse, advanced practice registered nurse, licensed practical nurse, psychologist, medical psychologist, social worker, or licensed professional counselor.

SOURCE: LA Dept. of Health and Hospitals, Behavioral Health Services, Chapter Two of the Medicaid Svcs. Manual, Section 2.3, p. 7 (As revised on Aug. 04, 2020). (Accessed Feb. 2021).

Reimbursement for FQHCs will be set at the all-inclusive prospective payment rate on file for the date of service.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (Jan. 10, 2020). (Accessed Feb. 2021). 

FQHC manual refers to provider manual for billing instructions.

SOURCE: LA Dept. of Health and Hospitals, Federally Qualified Health Centers Provider Manual, Chapter 22, Sec. 22.4, pp. 6, 07/14/2020. (Accessed Feb. 2021).


ELIGIBLE SITES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


FACILITY/TRANSMISSION FEE

Louisiana Medicaid only reimburses the distant site provider.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151 (As revised on Sept. 03, 2020). (Accessed Feb. 2021).

Last updated 02/28/2021

Miscellaneous

Recently Passed Legislation (Now Effective)

The department shall include in its Medicaid policies and procedures all of the following information relating to telehealth:

  1. An exhaustive listing of the covered healthcare services which may be furnished through telehealth.
  2. Processes by which providers may submit claims for reimbursement for healthcare services furnished through telehealth.
  3. The conditions under which a managed care organization may reimburse a provider or facility that is not physically located in this state for healthcare services furnished to an enrollee through telehealth.

SOURCE: LA Statute Sec. 46:460.51 (HB 589 – 2020 Session). (Accessed Feb. 2021). 

The beneficiary’s clinical record must include documentation that the service was provided through the use of telemedicine/telehealth.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, p. 158 (As revised on Sept, 03, 2020). (Accessed Feb. 2021).

FQHC and RHC

Effective August 1, 2019, FQHCs and RHCs must use POS 02 with modifier 95 when billing for telemedicine/telehealth services.

SOURCE: LA Dept. of Health, Informational Bulletin 20-1. (Jan. 10, 2020). (Accessed Feb. 2021).

Last updated 02/28/2021

Out of State Providers

No Reference Found

Last updated 02/28/2021

Overview

Live video telemedicine is covered for distant site providers enrolled in Louisiana Medicaid.  There is no reimbursement for the originating site.  Activity and sensor monitoring, health status monitoring and medication dispensing and monitoring are forms of remote patient monitoring that are covered by Louisiana Medicaid.  There is no reference to store-and-forward.

Last updated 02/28/2021

Remote Patient Monitoring

POLICY

Under the Community Choices Waiver, Louisiana Medicaid will reimburse for telecare, including:

  • Activity and Sensor Monitoring,
  • Health status monitoring, and
  • Medication dispensing and monitoring.

Monthly telecare services consist of:

  • Delivering, furnishing, maintaining and repairing/replacing equipment on an ongoing basis. This may be done remotely as long as all routine requests are resolved within three business days;
  • Monitoring of recipient-specific service activities by qualified staff;
  • Training the recipient and/or the recipient’s responsible representative in the use of the equipment;
  • Cleaning and storing equipment;
  • Providing remote teaching and coaching as necessary to the recipient and/or caregiver(s); and
  • Analyzing data, developing and documenting interventions by qualified staff based on information/data reported.

Personal Emergency Response System (PERS) is also reimbursed under Community Choices Waiver, which sends alerts when emergency services are needed by the recipient.

Activity and Sensor Monitoring

This service is a computerized system that monitors the recipient’s in-home movement and activity for health, welfare and safety purposes.  At a minimum the system must:

  • Monitor the home’s points of egress;
  • Detect falls;
  • Detect movement or lack of movement;
  • Detect whether doors are opened or closed; and
  • Provide a push button emergency alert system.

Some systems also monitor the home’s temperature.

Health Status Monitoring

This service collects health-related data to assist the health care provider in assessing the recipient’s health condition and in providing recipient education and consultation. Could be beneficial for patient with chronic conditions for monitoring weight, oxygen saturation measurements and vital signs.

Medication Dispensing and Monitoring

A remote monitoring system that is individually pre-programed to dispense and monitor the recipient’s compliance with medication therapy.  Provider or caregiver is notified when there are missed doses or non-compliance with medication therapy.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 22-24 (as revised on Mar. 2, 2020). (Accessed Feb. 2021).

Standards

Providers of assistive devices and medical equipment must:

  • Be a licensed home health agency or DME provider;
  • Comply with Louisiana Department of Health rules and regulations;
  • Be enrolled as a Medicaid provider to provide these services; and
  • Be listed as a provider of choice on the Freedom of Choice form.

PERS providers must:

  • Comply with OAAS’ standards for participation;
  • Be enrolled as the applicable Medicaid provider type; and
  • Be listed as a provider of choice on the FOC form.

The PERS provider must install and support PERS equipment in compliance with all of the applicable federal, state, parish and local laws and regulations, as well as meet manufacturer’s specifications, response requirements, maintenance records, and recipient education.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.6, p. 16 (As revised on Mar. 2, 2020). (Accessed Feb. 2021).


CONDITIONS

Health status monitoring:

May be beneficial to individuals with congestive heart failure, diabetes or pulmonary disease.

Services must be based on verified need.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 24 (As revised on Mar. 2, 2020). (Accessed Feb. 2021).


PROVIDER LIMITATIONS

Telecare providers must meet the following requirements:

  • Be UL listed/certified or have 501(k) clearance;
  • Be web-based;
  • Be compliant with the requirements of the Health Insurance Portability and Accountability Act (HIPAA);
  • Have recipient specific reporting capabilities for tracking and trending;
  • Have a professional call center for technical support based in the United States; and
  • Have on-going provision of web-based data collection for each recipient, as appropriate. This includes response to recipient self-testing, manufacturer’s specific testing, self-auditing and quality control.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.6, p. 17 (As revised on Mar. 2, 2020). (Accessed Feb. 2021). 


OTHER RESTRICTIONS

Limitations

  • Services must be based on verified need and have a direct or remedial benefit with specific goals and outcomes.
  • Benefit must be determined by an independent assessment on any item that costs over $500 and on all communication devices, mobility devices, and environmental controls.
  • Independent assessments must be performed by individuals who have no fiduciary relationship with the manufacturer, supplier, or vendor of the item.
  • All items must reduce reliance on other Medicaid state plan or waiver services
  • All items must meet applicable standards of manufacture, design and installation
  • The items must be on the Plan of Care developed by the support coordinator and are subject to approval by OAAS Regional Office of its designee.

A recipient is not able to receive simultaneously Telecare Activity and Sensor Monitoring services and traditional PERS services.

Where applicable, recipients must use Medicaid State Plan, Medicare or other available payers first.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 22 & 24-25 (As revised on Mar. 2, 2020). (Accessed Feb. 2021).

Last updated 02/28/2021

Store and Forward

POLICY

Louisiana Medicaid will not provide reimbursement for store-and-forward based upon the definition of “telemedicine” which describes telemedicine as including “audio and video equipment permitting two-way, real time interactive communication” therefore excluding store-and-forward.

SOURCE: LA Dept. of Health and Hospitals, Professional Svcs. Provider Manual, Chapter Five of the Medicaid Svcs. Manual, Section 5.1, p. 151 (As revised on Sept. 03, 2020). (Accessed Feb. 2021). 


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 02/28/2021

Definitions

Newly Passed Legislation (Effective Now)

“Telemedicine” shall have the same meaning as defined in R.S. 37: 1262 – “Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data using interactive telecommunication technology that enables a health care practitioner and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither a telephone conversation nor an electronic mail message between a health care practitioner and patient, or a true consultation as may be defined by rules promulgated by the board pursuant to the Administrative Procedure Act, constitutes telemedicine.”

SOURCE: LA Revised Statute Sec. 22: 1841 & Sec. 37: 1262. (HB 530 – 2020 Session). (Accessed Feb. 2021).

Last updated 02/28/2021

Parity

SERVICE PARITY

No Reference Found


PAYMENT PARITY

The payment, benefit, or reimbursement to such a licensed physician at the originating facility or terminus shall not be less than seventy-five percent of the reasonable and customary amount of payment, benefit, or reimbursement which that licensed physician receives for an intermediate office visit.

SOURCE: LA Revised Statutes 22:1821(F) (2012). (Accessed Feb. 2021).

Last updated 02/28/2021

Requirements

Newly Passed Legislation (Effective Now)

Each issuer of a health coverage plan shall display in a conspicuous manner on the health coverage plan issuer’s website information regarding how to receive covered telemedicine medical services, telehealth healthcare services, and remote patient monitoring services.

A link clearly identified on the health coverage plan’s issuer’s website to the information shall be sufficient to meet the requirements.

Certain requirements apply in order to receive reimbursement for remote patient monitoring.  See text of legislation.

SOURCE: LA Revised Statute Sec. 22: 1842 & 1843 (HB 530 – 2020 Session). (Accessed Feb. 2021).

Payment, benefit, or reimbursement under such policy or contract shall not be denied to a licensed physician conducting or participating in the transmission at the originating health care facility or terminus who is physically present with the individual who is the subject of such electronic imaging transmission and is contemporaneously communicating and interacting with a licensed physician at the receiving terminus of the transmission.   The payment, benefit, or reimbursement to such a licensed physician at the originating facility or terminus shall not be less than seventy-five percent of the reasonable and customary amount of payment, benefit, or reimbursement which that licensed physician receives for an intermediate office visit.

No reference found for distant-site physician reimbursement.

SOURCE: LA Revised Statutes 22:1821(F) (2012). (Accessed Feb. 2021).

Last updated 02/28/2021

Cross State Licensing

The board shall issue a telemedicine license to allow the practice of medicine across state lines to an applicant who holds a full and unrestricted license to practice medicine in another state or territory of the United States.

The board shall establish by rule in accordance with the Administrative Procedure Act the requirements for licensure including not opening an office in Louisiana, not meeting with patients in Louisiana, and not receiving calls in Louisiana from patients. The physician, when examining a patient by telemedicine, shall establish a bona fide physician-patient relationship by:

  • Conducting an appropriate examination of the patient as determined by the board.
  • Establishing a diagnosis through the use of accepted medical practices including but not limited to patient history, mental status, and appropriate diagnostic and laboratory testing.
  • Discussing with the patient any diagnosis as well as the risks and benefits of various treatment options.
  • Ensuring the availability for appropriate follow-up care.
  • Fulfilling any other requirements as deemed appropriate and necessary by the board.

SOURCE: LA Revised Statutes 37:1276.1. (Accessed Feb. 2021). 

A physician who practices telemedicine by virtue of a telemedicine permit issued by the board shall not:

  • Open an office in this state;
  • Meet with patients in this state;
  • Receive telephone calls in this state from patients; or
  • Engage in the practice of medicine in this state beyond the limited authority conferred by his or her telemedicine permit.

No physician shall supervise, collaborate or consult with an allied health care provider located in this state via telemedicine unless he or she possesses a full and unrestricted license to practice medicine in this state and satisfies and complies with the prerequisites and requirements specified by all applicable laws and rules.

No physician shall utilize telemedicine to provide care to a patient who is physically located outside of this state, unless the physician possesses lawful authority to do so by the licensing authority of the state in which the patient is located.

SOURCE: LA Admin. Code 46: XLV. 7513. (Accessed Feb. 2021).

LA state agencies and professional boards can regulate the use of telehealth including licensing of out-of-state healthcare providers.  See rule for requirements.

SOURCE: LA Revised Statutes 40:1223.4 (Accessed Feb. 2021).

 A physician may practice in the state with a full license, or hold a telemedicine permit.

SOURCE: LA Admin. Code 46: XLV.7507. (Accessed Feb. 2021).

Last updated 02/28/2021

Definitions

Medical Board

“Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data using interactive telecommunication technology that enables a health care practitioner and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither a telephone conversation nor an electronic mail message between a health care practitioner and patient, or a true consultation as may be defined by rules promulgated by the board pursuant to the Administrative Procedure Act, constitutes telemedicine.”

SOURCE: LA Revised Statutes 37:1262(4). (Accessed Feb. 2021). 

Public Health & Safety

Telehealth means a mode of delivering healthcare services, including behavioral health services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education care management and self-management of patients at a distance from healthcare providers.  Telehealth allows services to be accessed when providers are in a distant site and patients are in the originating site.  Telehealth facilitates patient self-management and caregiver support for patients and includes synchronous interactions and asynchronous store-and-forward transfers.

SOURCE: LA Revised Statutes 40:1223.3 & HB 449 (2020 Session). (Accessed Feb. 2021).

Speech-Language Pathology & Audiology

Telehealth is a mode of delivering audiology and speech-language pathology services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education care management, and self-management of clients at a distance from the audiologist or speech-language pathologist provider services to be accessed when providers are in a distant site and patients are in the originating site. Telehealth facilitates self-management and caregiver support for patients and includes synchronous interactions and asynchronous store and forward transfers.

SOURCE: LA Admin. Code 46: LXXV.103. (Accessed Feb. 2021).

Physician’s Use of Telemedicine in Practice

Telemedicine – the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data by a physician using interactive telecommunication technology that enables a physician and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither an electronic mail message between a physician and a patient, or a true consultation constitutes telemedicine for the purposes of this Part. A physician practicing by telemedicine may utilize interactive audio without the requirement of video if, after access and review of the patient’s medical records, the physician determines that he or she is able to meet the same standard of care as if the healthcare services were provided in-person.

SOURCE: LA Admin. Code 46: XLV.7503. (Accessed Feb. 2021).

Last updated 02/28/2021

Licensure Compacts

Member of Physical Therapy Compact.

SOURCE:  SB 203 (2018).  PT Compact. Compact Map. (Accessed Feb. 2021). 

Member of Nurse Licensure Compact.

SOURCE:  Nurse Licensure Compact.  Current NLC States and Status.  NCSBN.  (Accessed Feb. 2021). 

Last updated 02/28/2021

Miscellaneous

Louisiana has specific standards for its telemedicine physicians.

SOURCE: LA Statute Sec. 37:1271 (Accessed Feb. 2021). 

Recently Passed Legislation (Now Effective)

Requires licensing standards be developed by the Department of Health on the delivery of behavioral health services through telehealth.

SOURCE: HB 449 (Accessed Feb. 2021).

 

 

Last updated 02/28/2021

Online Prescribing

Louisiana law requires that a physician who uses telemedicine establish a proper physician-patient relationship.  Physicians must:

  • Verify the identity of the patient.  Appropriate contact and identifying information shall be made part of the medical record;
  • Conduct an appropriate exam. The examination does not require an in-person visit if the technology is sufficient to provide the physician the pertinent clinical information reasonably necessary to practice at an acceptable level of skill and safety;
  • Establish a proper diagnosis through the use of accepted medical practices;
  • Discuss the diagnosis and risks and benefits of various treatment options;
  • ·Ensure the availability of follow up care;
  • Create and/or maintain a medical record.

SOURCE: LA Admin. Code 46: XLV.7503. (Accessed Feb. 2021). 

Telemedicine, including the issuance of any prescription via electronic means, shall be held to the same prevailing and usually accepted standards of medical practice as those in traditional, face-to-face settings.

An online, electronic or written mail message, or a telephonic evaluation by questionnaire or otherwise, does not satisfy the standards of appropriate care.

To establish a physician-patient relationship an in-person visit is not required if the technology is sufficient to provide the physician the pertinent clinical information reasonably necessary to practice at an acceptable level of skill and safety.

No physician shall utilize telemedicine:

  1. for the treatment of non-cancer related chronic or intractable pain, as set forth in §§6915-6923 of the board’s rules;
  2. for the treatment of obesity, as set forth in §§6901-6913 of the board’s rules;
  3. to authorize or order the prescription, dispensation or administration of any controlled substance unless;
    1. the physician has had at least one in-person visit with the patient within the past year; provided, however, the requirement for an in-person visit shall not apply to a physician who holds an unrestricted license to practice medicine in LA and who practices telemedicine upon any patient being treated at a healthcare facility that is required to be licensed pursuant to the laws of LA and which holds a current registration with the U.S. Drug Enforcement Administration;
    2. the prescription is issued for a legitimate medical purpose;
    3. the prescription is in conformity with the standard of care applicable to an in-person visit; and
    4. the prescription is permitted by and in conformity with all applicable state and federal laws and regulations.

The Board may grant an exception if the physician submits a written application.

SOURCE: LA Admin. Code 46: XLV.7503,7505 & 7513. (Accessed Feb. 2021).

For physicians practicing telemedicine and treating a patient at a healthcare facility that is required to be licensed according to the laws of LA and holds a current registration with the US Drug Enforcement Administration:

  • Physician must use the same standard of care as in-person.
  • Physician must be authorized to prescribe any controlled dangerous substance without necessity of conducting an appropriate in-person patient history or physical examination.
  • Physician shall not be subject to any regulation prohibition or restriction on the use of telemedicine that is more restrictive than those that are otherwise applicable to their entire profession.

SOURCE: LA Statute Sec. 37:1271.1. (Accessed Feb. 2021). 

No physician practicing telemedicine can prescribe a controlled dangerous substance prior to conducting an appropriate in-person patient history or physical examination of the patient as determined by the Board.

SOURCE: LA Revised Statutes 37:1271(B)(3). (Accessed Feb. 2021).

Last updated 02/28/2021

Professional Boards Standards

Louisiana Medical Board

SOUCE: LA Admin. Code 46: XLV.75 (Accessed Feb. 2021).

Speech Language Pathology and Audiology

SOUCE: LA Admin. Code 46: LXXV.135. (Accessed Feb. 2021).

Licensed Professional Counselors

SOUCE: LA Admin. Code 46: LX.505. (Accessed Feb. 2021).

Physical Therapy Board

SOUCE: LA Admin. Code 46: LIV.319. (Accessed Feb. 2021).

Registered Dietitians/Nutritionists

SOUCE: LA Admin. Code 46: LXIX.101. (Accessed Feb. 2021).