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, EMS, IMLC, ASLP-IC
Consent Requirements: Yes

Last updated 08/25/2021

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STATUS: Active, until rescinded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STATUS: Active, until rescinded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: 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STATUS: Active, until rescinded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STATUS: Active, until rescinded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 on Medicaid Waiver Programs

STATUS: Active, until end of COVID-19 emergency

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

STATUS: Contingent on approval from CMS

Department of Health, Bureau of Health Services Financing: Emergency Rule extending audio-only services

STATUS: Active, 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 08/27/2021

Cross State Licensing

No reference found

Last updated 09/01/2021

Easing Prescribing Requirements

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

STATUS: Active, during COVID-19 emergency

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 08/26/2021

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)

SB 29 Act No. 223: The Commissioner of Insurance Granted Certain Public Health Emergency Powers Related to Telehealth Access

STATUS: Permanent

Last updated 08/24/2021

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: 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

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

STATUS: Active, during COVID-19 emergency

Last updated 08/31/2021

Private Payer

Senate Bill 29: Public Health Emergency Powers for Commissioner of Insurance 

STATUS: Permanent, effective August 1, 2021

Department of Insurance: Emergency Rule on Telemedicine Expansion

STATUS: Expired May 12, 2020

LA Division of Administration: : Worker’s Compensation Guidelines

STATUS: Expired

Department of Insurance:  Telemedicine and Network Adequacy

STATUS: Expired

Last updated 08/31/2021

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

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 08/24/2021

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: 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 on Medicaid Waiver Programs

STATUS: Active, until end of COVID-19 emergency

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

STATUS: Active, during COVID-19 emergency

Last updated 08/30/2021

Definitions

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages
  • Text messages
  • Facsimile transmissions

SOURCE: LA Revised Statutes 40:1223.3 as revised by HB No. 270(2021 Session) p. 1-2 (Accessed Aug. 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 Aug. 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 Aug. 2021). 

Telemedicine/telehealth is the use of a telecommunications system to render healthcare services when a physician or other licensed practitioner and an enrollee are not in the same location.

SOURCE: LA Medicaid MCO Manual (revised 3/5/21), p. 134 (Accessed Aug. 2021).

Last updated 08/30/2021

Email, Phone & Fax

Hospices may report some social worker calls as a visit. Hospices may not report any other types of phone calls.

SOURCE: LA Medicaid, Chapter 24: Hospice, Sec. 24.9, Medicaid Svcs. Manual, p. 60, (March 26, 2019), (Accessed Aug. 2021). 

Last updated 08/30/2021

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.

The beneficiary’s clinical record must include documentation that the service was provided through the use of telemedicine/telehealth. NOTE: The distant site provider must be enrolled as a Louisiana Medicaid provider to receive reimbursement for covered services rendered to Louisiana Medicaid beneficiaries.

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. 148-149 (Sept. 03, 2020). (Accessed Aug. 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, p. 2 (Accessed Aug. 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 RS 40:1255.2 (Accessed Aug. 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 Aug. 2021).

Behavioral Health Services

Assessments, evaluations, individual psychotherapy, family psychotherapy, and medication management services may be reimbursed when provided via telecommunication technology. The LMHP is responsible for acting within the telehealth scope of practice as decided by their licensing board. The provider must bill the procedure code (CPT codes) with modifier “95”, as well as Place of Service “02”. Reimbursement will be at the same rate as a face-to-face service.

SOURCE: LA Dept. of Health and Hospitals, Behavioral Health Services, Chapter Two of the Medicaid Svcs. Manual, Section 2.3, p. 52 (As revised on Aug. 23, 2021). (Accessed Aug. 2021).

Ambulance Providers – Managed Care Organizations

Ambulance providers that are dispatched by an emergent call for service may determine upon the scene that a telehealth visit with a licensed medical professional, who is enrolled in Medicaid, is more appropriate than transportation to an emergency department. In this case, the treatment-in-place service may be rendered.

SOURCE: LA Medicaid Managed Care Organization (MCO) Manual, p. 64 (As revised 3/5/21), (Accessed Aug. 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. 148 (As revised on Sept. 03, 2020). (Accessed Aug. 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 Aug. 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 Aug. 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. 148 (As revised on Sept. 03, 2020). (Accessed Aug. 2021).

Last updated 08/30/2021

Miscellaneous

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 Aug. 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. 148 (As revised on Sept, 03, 2020). (Accessed Aug. 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 Aug. 2021).

Last updated 08/30/2021

Out of State Providers

No Reference Found

Last updated 08/27/2021

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 08/30/2021

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-programmed to dispense and monitor the recipient’s compliance with medication therapy.  The 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. 33-35 (as revised on Mar. 16, 2021). (Accessed Aug. 2021).

Standards

Assistive Devices and Medical Supplies Provided by a Durable Medical Equipment (DME) provider that:

  • Is enrolled to provide DME; and
  • Has enrolled in Medicaid as an Assistive Devices and Medical Supplies CCW provider (Provider Type 17);

OR

Provided by a home health agency provider that:

  • Is licensed to provide home health services;
  • Is Medicare certified; and
  • Has enrolled in Medicaid as an OAAS – Community Choices Waiver assistive devices provider (Provider Type 17).

For personal emergency response systems (PERS), these services are provided by a provider that:

  • Is enrolled in Medicaid as a PERS provider; and
  • Has furnished verification (copy of letter from the manufacturer written on the manufacturer’s letterhead stationary) that the provider is an authorized dealer, supplier or manufacturer of a PERS product.

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. 74 and 84 (As revised on Mar. 2, 2020). (Accessed Aug. 2021).


CONDITIONS

Health status monitoring:

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

Services must be based on a verified need of the beneficiary and the service must have a direct or remedial benefit with specific goals and outcomes.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 34-35 (As revised on Mar. 2, 2020). (Accessed Aug. 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 beneficiary 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 beneficiary, as appropriate. This includes response to beneficiary

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.6, p. 84 (As revised on Mar. 2, 2020). (Accessed Aug. 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 or its designee.
  • A beneficiary will not be able to simultaneously receive telecare activity and sensor monitoring services and traditional PERS services.

Where applicable, beneficiaries must use Medicaid state plan services, Medicare, or other available payers first. The beneficiary’s preference for a certain brand or supplier is not grounds for declining another payer in order to access waiver services.

SOURCE: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, Section 7.1, p. 35 & 32 (As revised on Mar. 16, 2021). (Accessed Aug. 2021).

Last updated 08/30/2021

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. 148 (As revised on Sept. 03, 2020). (Accessed Aug. 2021). 


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 08/30/2021

Definitions

“Telemedicine” shall have the same meaning as defined in R.S. 37:1262, may be provided as described in R.S. 37:1271(B)(4), and may include audio-only conversations as provided for in R.S. 37:1271(B)(4)(b).

“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.”

“Telehealth” shall have the same meaning as defined in R.S. 40:1223.3 and may include audio-only conversations as provided for in R.S. 40:1223.3(5).

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages and text messages that are not compliant with applicable requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (42 U.S.C. 1320d et seq.).
  • Facsimile transmissions.

SOURCE: LA Revised Statute Sec. 22: 1841; Sec. 37: 1262  and 40:1233.3 as revised by HB No. 270 (2021 Session), (Accessed Aug. 2021).

Last updated 08/31/2021

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). (Accessed Aug. 2021).

Last updated 08/30/2021

Requirements

Newly Passed Legislation (Effective Now)

When the governor declares a state of emergency or a public health emergency, the commissioner may issue emergency rules or regulations that may remove restraints to telehealth/telemedicine, as well as other things. See statute for full details.

SOURCE: LA Revised Statute 22:11(C) (SB 29 – 2021 Session) (Accessed Aug. 2021).

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. (Accessed Aug. 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). (Accessed Aug. 2021).

Last updated 09/07/2021

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 Aug. 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. , p. 251 (Accessed Aug. 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 Aug. 2021).

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

SOURCE: LA Admin. Code 46: XLV.7507. p. 250 (Accessed Feb. 2021).

Licensed Professional Counselors

Licensees shall provide services consistent with the jurisdictional licensing laws and rules in both the jurisdiction in which licensee is physically located and where the client is physically located. Licensees providing teletherapy services to clients outside of Louisiana must comply with the regulations in the state in which the client is located at the time of service. The licensee shall contact the licensing board in the state where the client is located and document all relevant regulations regarding teletherapy. A nonresident of Louisiana who wishes to provide teletherapy health services in Louisiana must be licensed by the board. Teletherapy is a specialty area and requires board approval. Licensees who may provide teletherapy must meet the following requirements:

1. The licensee must be licensed in Louisiana.

2. The licensee must be licensed in the state where the client is located if licensing is required.

3. The licensee must complete: a. professional training with a minimum of 3 asynchronous or synchronous clock hours in teletherapy. The training shall meet continuing education standards established by the board.

SOUCE: LA Admin. Code 46: LX.505., p. 558-559 (Accessed Aug. 2021).

Teledentistry

  1. Treatment or diagnosis via teledentistry may be provided to patients in Louisiana only by a dentist who holds a license issued by the Board of Dentistry. The Louisiana licensed dentist need not be in Louisiana while providing the teledentistry
  2. An exception to the requirement that the provider of teledentistry services to a patient in Louisiana hold a Louisiana license is when a Louisiana licensed dentist with an in-person relationship with a patient consults an expert with a valid dental license in another United States jurisdiction for advice regarding the patient’s treatment or diagnosis; in this case the expert consulted need not have a Louisiana
  3. The standard of care applicable to a provider of teledentistry services, including obtaining informed consent and record documentation, is no different from the standard of care required in traditional dentistry.

SOURCE: Department of Health Board of Dentistry amendment to LAC 46:XXXIII.203 p. 12 (Accessed Aug. 2021)

Requirements listed under Title 37, Chapter 15, Part 1 do not apply  to a consultation without limitation between a practicing physician licensed in this state and a practicing physician licensed in another state or jurisdiction.

SOURCE: LA Revised Statute 37:1291 & HB 270 (2021 Session), (Accessed Aug. 2021).

Last updated 08/26/2021

Definitions

“Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data by a physician using technology that enables the physician and a patient at two locations separated by distance to interact. Such technology may include electronic communications, information technology, asynchronous store-and-forward transfer technology, or technology that facilitates synchronous interaction between a physician at a distant site and a patient at an originating site. The term “telemedicine” shall not include any of the following:

  • Electronic mail messages
  • Text messages
  • Facsimile transmissions

SOURCE: LA Revised Statute 37:1262(4) & HB No. 270 (2021 Session) (Accessed Aug. 2021). 

“Telehealth” means healthcare services, including behavioral health services, provided by a healthcare provider, as defined in this Section, to a person through the use of electronic communications, information technology, asynchronous store-and-forward transfer technology, or synchronous interaction between a provider at a distant site and a patient at an originating site, including but not limited to assessment of, diagnosis of, consultation with, treatment of, and remote monitoring of a patient, and transfer of medical data. The term “telehealth” shall not include any of the following:

  • Electronic mail messages and text messages that are not compliant with applicable requirements of the Health Insurance Portability and Accountability Act of 1996, as amended (42 U.S.C. 1320d et seq.).
  • Facsimile transmissions.

SOURCE: LA Revised Statute 40:1233.3 & HB No. 270 (2021 Session) (Accessed Aug. 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., p. 3-4 (Accessed Aug. 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., p. 225 (Accessed Aug. 2021).

 

 

 

Last updated 08/27/2021

Licensure Compacts

Member of Physical Therapy Compact.

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

Member of Nurse Licensure Compact.

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

Member of Audiology and Speech-Language Pathology Interstate Compact

SOURCE: SB 34(2021). (Accessed Aug. 2021) 

Member of Interstate Medical Licensure Compact

SOURCE: Interstate Medical Licensure Compact. U.S. State Participation in the Compact.  & SB 27 (2020) (Accessed Aug. 2021)

Member of Emergency Medical Services (EMS) Compact.

SOURCE: Interstate Commission for EMS Personnel Practice, Compact Governance (Accessed Sept. 2021).

Last updated 08/26/2021

Miscellaneous

Louisiana has specific standards for its telemedicine physicians.

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

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

SOURCE: LA Revised Statute 40:2156 (Accessed Aug. 2021).

Teledentistry

A dental hygienist licensed in Louisiana may perform radiographs, oral prophylaxis, place sealants and place fluoride varnish without a Louisiana licensed dentist being physically present in the clinic if all of the following conditions are met:

A Louisiana licensed dentist is providing direct supervision via teledentistry and reviews exams being done by the hygienist and images of the patient’s oral cavity via the teledentistry connection. Unless restricted by bandwidth considerations, the teledentistry must be contemporaneous (synchronist). If bandwidth prohibits contemporaneous viewing by the dentist, non-contemporaneous (asynchronist) viewing of the patient may be employed, but the dentist must review the exam before the patient is dismissed from the clinic on the day of treatment.

See rule for complete requirements.

SOURCE: Louisiana Admin Code XXXIII, Ch. 7, Sec. 701, (Accessed Aug. 2021)

Last updated 08/31/2021

Online Prescribing

Physicians utilizing telemedicine shall establish a proper physician-patient relationship by:

  • 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; e.g., history, mental status, appropriate diagnostic and laboratory testing;
  • Discuss the diagnosis and risks and benefits of various treatment options;
  • ·Ensure the availability of appropriate follow up care;
  • Create and/or maintain a medical record.

SOURCE: LA Admin. Code 46: XLV.7503. p. 249 (Accessed Aug. 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.

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. p. 251 (Accessed Aug. 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 Aug. 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 Aug. 2021).

Teledentistry

Controlled substances may not be prescribed via teledentistry except in emergency situations where the dentist determines:

  • That immediate administration of the controlled substance is necessary for proper treatment of the intended ultimate user, and
  • That no appropriate alternate treatment is available, including administration of a drug that is not a controlled substance.

In an emergency situation the prescription for a controlled substance must be limited to the amount adequate to treat the patient during the emergency period.

SOURCE: LA Admin. Code LAC 46:XXXIII.203 (Accessed Aug. 2021)

Last updated 09/01/2021

Professional Boards Standards

Louisiana Medical Board

SOUCE: LA Admin. Code 46: XLV.75 p. 225 (Accessed Aug. 2021).

Speech Language Pathology and Audiology

SOUCE: LA Admin. Code 46: LXXV.135. p. 18 (Accessed Aug. 2021).

Licensed Professional Counselors

SOUCE: LA Admin. Code 46: LX.505., p. 558-559 (Accessed Aug. 2021).

Physical Therapy Board

SOUCE: LA Admin. Code 46: LIV.319. p. 28-29 (Accessed Aug. 2021).

Registered Dietitians/Nutritionists

SOUCE: LA Admin. Code 46: LXIX.101. p. 4-5 (Accessed Aug. 2021).

Board of Dentistry

SOURCE: LA Admin. Code LAC 46:XXXIII.203 p. 12 (Accessed Aug. 2021)

Hearing Aid Dealers – The Louisiana Board for Hearing Aid Dealers have the power to promulgate rules for the provision of telehealth services by licensed hearing aid dealers that, at a minimum, comply with the Louisiana Telehealth Access Act, R.S. 40:1223.1 et seq.

SOURCE: LA Revised Statute 37:2457(11) & SB 93 Act 92, p. 1-2 (Accessed Aug. 2021).