Professional Requirements

Miscellaneous

Sometimes states have a variety of less common policies that apply to telehealth delivered services not addressed in the other topic areas.  Examples of these include the formation of telehealth committees or work groups by Boards, supervision requirements or liability rules.  Although these are not the focus of the research conducted by CCHP, when these policies are found, they are included in this Miscellaneous topic area.

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Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Federal

Last updated 12/14/2023

* The US Health and Human Services Administration maintains a

* The US Health and Human Services Administration maintains a website that summarizes information related to HIPAA Rules for telehealth technology.

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Alabama

Last updated 11/21/2023

This article, and the rules adopted by the Board of …

This article, and the rules adopted by the Board of Medical Examiners and the Medical Licensure Commission, shall apply only to the provision of telehealth medical services by physicians to individuals located in this state.

The Board of Medical Examiners, the Medical Licensure Commission, and its officers, agents, representatives, employees, and directors thereof, shall be considered to be acting pursuant to clearly expressed state policy as established in this article and under the active supervision of the state. The boards, agencies, and individuals in this section shall not be subject to state or federal antitrust laws while acting in the manner provided in this section.

SOURCE: AL Code Sec. 34-24-707 (Accessed Nov. 2023).

Alabama has a rural health plan that encourages use of telemedicine and telehealth.  See plan for details.

SOURCE: Alabama Admin. Code 410-2-2-.04, (Accessed Jun. 2023).

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Alaska

Last updated 11/27/2023

A health care provider may not be required to document …

A health care provider may not be required to document a barrier to an in person visit to provide health care services through telehealth. The department or a board may not limit the physical setting from which a health care provider may provide health care services through telehealth.

SOURCE: AK Statute Sec. 08.02.130, (Accessed Jun. 2023).

The Department of Commerce, Community and Economic Development has adopted regulations for establishing and maintaining a registry of businesses performing telemedicine in the state.  See business registry regulations for more details.

To be registered on the telemedicine business registry established and maintained under AS 44.33.381, and before providing telemedicine services to a recipient located in this state, a business performing telemedicine services must submit to the department:

  • a complete registration on a form provided by the department; the registration must include the business’s name, address, and contact information;
  • a copy of the business’s valid business license issued under AS 43.70 and 12 AAC 12; and
  • the applicable fee established in 12 AAC 02.106.

A business performing telemedicine services must register with the name it is using to perform telemedicine services in this state. A business operating under multiple names to perform telemedicine services shall file a separate registration for each name.

If the name, address, or contact information of a business on the telemedicine business registry changes, the business performing telemedicine services must submit to the department, not later than 30 days after the change or termination:

  • a complete report, on a form provided by the department, of each change; and
  • the applicable fee established in 12 AAC 02.106.

A business that fails to comply timely with (c) of this section may not perform telemedicine services in this state and must submit a new application under (a) of this section before resuming the provision of telemedicine services to a recipient located in this state.

If a business terminates the performance of telemedicine services in this state, the business shall notify the department, requesting that the department remove the business from the telemedicine business registry. If a business gives notification under this subsection, the business must submit a new application under (a) of this section before resuming the provision of telemedicine services to a recipient located in this state.

See telemedicine business registry webpage for more information on applying.

SOURCE: AK Admin Code. Sec. 600, (Accessed Nov. 2023).

The following fees are established for registration under AS 44.33.381 (telemedicine business registry) for businesses performing telemedicine services in this state;

  • initial registration fee, $50;
  • fee to report changes in the information on the initial registration, $50.

SOURCE: AK Admin Code 12-02.106 (Accessed Nov. 2023).

A person who is licensed or registered under AS 08.11 may provide telemedicine services to a client in the state if:

  • The telemedicine services are of the same scope, nature, and quality as those services provided in person;
  • The quality of electronic transmissions used to provide telemedicine services allow the licensee or registrant to provide services equivalent to those provided in person;
  • The licensee or registrant has the skill and ability to operate the equipment used to provide telemedicine services;
  • The licensee or registrant assesses the client’s level of comfort in receiving telemedicine services and makes appropriate adjustments to the treatment plan based on that assessment;
  • The licensee or registrant ensures the presence of a telemedicine facilitator who is physically present with the client when appropriate;
  • The licensee or registrant ensures that the client can contact a licensed health care provider in person as part of the client’s treatment plan;
  • The licensee or registrant ensures that the electronic transmissions used to provide telemedicine services have sufficient security to ensure the protection of the client’s medical records as if the client were receiving in-person treatment; and
  • The licensee or registrant does not provide telemedicine services solely through written correspondence; however, written correspondence may be used to supplement telemedicine services.
Nothing in this section prevents the use of asynchronous telemedicine.

SOURCE: AK Admin code 12-07.020 (Accessed Nov. 2023).

See telerehabilitation regulations for supervision requirements.

SOURCE: AK Admin Code Title 12, Sec. 54. 510-530. (Accessed Nov. 2023).

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Arizona

Last updated 02/09/2024

Beginning October 1, 2021 and on or before the first

Beginning October 1, 2021 and on or before the first of each month thereafter, each health care provider regulatory board or agency shall submit to the telehealth advisory committee on telehealth best practices established by section 36-3607 a report identifying the number and type of out-of-state health care providers who have applied for registration pursuant to section 36-3606 and the number and type of out-of-state health care providers whose registration pursuant to section 36-3606 has been approved.

SOURCE: Ariz. Code 36-3608 [repeal effective Jan. 1, 2026] (Accessed Feb. 2024).

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Arkansas

Last updated 02/06/2024

No Reference Found

No Reference Found

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California

Last updated 12/20/2023

Any individual, partnership, corporation or other entity that provides dental …

Any individual, partnership, corporation or other entity that provides dental services through telehealth shall make available the name, telephone number, practice address and California state license number of any dentist who will be involved in the provision of services to a patient prior to the rendering of services and when requested by a patient.

SOURCE: CA Business and Professions Code, Sec. 1683.1 (Accessed Dec. 2023).

All laws and regulations governing professional responsibility, unprofessional conduct, and standards of practice that apply to a health care provider under the health care provider’s license shall apply to that health care provider while providing telehealth services.

SOURCE: CA Business and Professions Code, Sec. 2290.5. (Accessed Dec. 2023).

An examination, assessment, or evaluation specified, required, or authorized for purposes of involuntary commitments may be conducted using telehealth.

SOURCE: CA Health and Safety Code 1799.111; Welfare and Institutions Code 5150.5 & 5151. (Accessed Dec. 2023).

An associate clinical social worker and a clinical counselor trainee or associate may provide services via telehealth that are in their scope of practice.

SOURCE: CA Business and Professions Code, Secs. 4996.23.24999.46.3, as amended by AB 1759 (2022 Session). (Accessed Dec. 2023).

On or after July 1, 2023, an applicant for licensure as a marriage and family therapist, educational psychologist, clinical social worker, and professional clinical counselor shall show, as part of the application, that they have completed a minimum of three hours of training or coursework in the provision of mental health services via telehealth, which shall include law and ethics related to telehealth. See statutes for additional details.

SOURCE: CA Business and Professions Code, Secs. 4980.3954989.23.14996.27.1, and 4999.67, as added by AB 1759 (2022 Session). (Accessed Dec. 2023).

California law governs in any action in this state, whether civil, administrative, or criminal, against any person who provides, receives, aids or abets in providing or receiving, or attempts to provide or receive, by any means, including telehealth, reproductive health care services and gender-affirming health care services if the provider was located in this state or any other state where the care was legal at the time of the challenged conduct.

SOURCE: CA Health and Safety Code Section 123468.5 as added by SB 345 (2023 Session). (Accessed Dec. 2023).

Nursing Facilities

Prior to prescribing a psychotherapeutic drug for a resident, the prescriber shall personally examine and obtain the informed written consent of the resident or the resident’s representative. For purposes of obtaining informed written consent pursuant to this subdivision, the use of remote technology, including, but not limited to, telehealth, to allow a prescriber to examine and obtain informed written consent, and for the prescriber, the resident or the resident’s representative to use electronic signatures, shall be permitted.

SOURCE: CA Health and Safety Code Section 1599.15 as added by AB 48 (2023 Session). (Accessed Dec. 2023).

Veterinarians

All veterinary premises shall be registered with the board. The location where a veterinarian practices telehealth shall be exempt from the requirement that it be registered pursuant to this section if certain requirements are satisfied.

SOURCE: CA Business and Professions Code Section 4853 as amended by AB 1399 (2023 Session). (Accessed Dec. 2023).

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Colorado

Last updated 01/29/2024

Colorado law includes in its definition of “health care services” …

Colorado law includes in its definition of “health care services” the rendering of the services through the use of telehealth, as defined in section 10-16-123 (4)(e).

SOURCE: CO Revised Statutes 10-16-102(33). (Accessed Jan. 2024).

Telehealth, telerehabilitation, and teletherapy are included within the practice of occupational therapy.

SOURCE: CO Revised Statutes 12-270-104. (Accessed Jan. 2024).

Specifies certain CPT codes that may be provided via telemedicine for Workers’ Compensation.  It also sets reimbursement requirements for distant site and originating site providers.

SOURCE: 7 CCR 1101-3 Rule 18 & Exhibits. (Access Jan. 2024).

Behavioral Health Entities may use telehealth methods for the provision of services except for services that specifically require in-person contact.

If the BHE uses telehealth methods, it shall develop and implement policies and procedures regarding telehealth services. Such policies may be for the BHE, a physical location, or an endorsement, as appropriate, and shall include, at a minimum, a requirement that telehealth services be provided only through synchronous, interactive audio-visual methods, not including voice-only or text-only methods such as telephone, text message, or email.

Services provided via telehealth methods shall be documented in the client record, consistent with documentation as required for in-person services.

SOURCE: 6 CCR 1011-1, Chap. 3, 2.8.3 (Accessed Jan. 2024).

Statewide Electronic Registry of Advance Directives: Considerations for Telehealth

  1. An individual or their authorized surrogate may sign an electronic affidavit in the presence of a Qualified Provider either in person or via telehealth (over video or telephone).
  2. In situations in which an individual is not able to access the Electronic Affidavit in the Registry, the individual may either electronically or physically sign the affidavit in the presence of a Qualified Provider either in person or via telehealth (over video or telephone)
  3. A signed affidavit must be submitted to the Qualified Provider by the individual either via mail, email, or fax to the Qualified Provider in a timely manner.
  4. It is the responsibility of the individual to ensure their documents have been received and appropriately uploaded to the Registry.
  5. If the visit occurs via telehealth, a Qualified Provider must follow their existing organizational telehealth policies to ensure identity verification and adequate privacy and confidentiality.

If an Electronic Affidavit is not required an individual or their authorized surrogate may elect to meet with a Qualified Provider to discuss Advance Care Planning in person or via telehealth, but it is not required.

If an individual or their authorized surrogate elects not to discuss their documents at a visit with a Qualified Provider, the Provider is responsible for uploading their documents to the registry in a timely manner. However, the individual or their authorized surrogate are responsible for ensuring that the provider has received their documents (electronically or in hard copy) and that their Provider has uploaded their documents to the Registry.

SOURCE: 5 CCR 1006-3, VIII. (Accessed Jan. 2024).

The practice of acupuncture includes the provision of acupuncture services through telehealth.

SOURCE: CO Revised Statutes 12-200-103. (Accessed Jan. 2024).

Legislation authorizes the Director to adopt rules regarding the ability of an acupuncture aide to perform specified tasks under the supervision of an acupuncturist, including rules establishing the appropriate use of telehealth to provide acupuncture services.

SOURCE: CO Revised Statutes 12-200-114. (Accessed Jan. 2024).

The scope of practice for a hearing aid provider includes prescribing, selecting and fitting appropriate hearing instruments and assistive devices, including appropriate technology, electroacoustic targets, programming parameters, and special applications, as indicated, whether in person or through the use of telehealth.

SOURCE: CO Revised Statutes 12-230-104(1)(e) (Accessed Jan. 2024).

The Behavioral Health Administration (BHA) shall In collaboration with the department of regulatory agencies, establish workforce standards that strengthen the behavioral health-care provider workforce, including telehealth providers, and increase opportunities for peer support professionals and behavioral health aides. The BHA shall also other departments to address licensing and credentialing portability issues that affect the ability of children, youth, and adults to access behavioral health-care services.

The Division of Professions and Occupations shall, on or before September 1, 2022 make recommendations to expand the portability of existing credentialing requirements through statutory changes, including the adoption of interstate compacts in order to facilitate for mental health and behavioral health-care providers the use of telehealth to practice in multiple jurisdictions.

SOURCE: CO Revised Statutes 27-60-303(1). (Accessed Jan. 2024).

A peer support professional may provide services on behalf of a Recovery Support Services Organization in a variety of clinical and nonclinical settings, that may include but are not limited to Services delivered via telehealth

SOURCE: 2 CO Code of Regulations 502-1 21.600.41(B)(4). (Accessed Jan. 2024).

For individuals who choose to delegate medical services, a delegating physician may utilize telehealth technologies, where appropriate, to satisfy the requirements for prompt personal consultation or follow-up care, but should not rely exclusively on such telehealth technologies to perform those services.

SOURCE: 3 CCR 713-1. (Accessed Jan. 2024).

For purposes of Certificates of Veterinary Inspection, virtual or telemedicine inspection is not accepted.

SOURCE: 8 CCR 1201-19. (Accessed Jan. 2024).

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Connecticut

Last updated 01/10/2024

Effective Now Until June 30, 2024

A telehealth provider may …

Effective Now Until June 30, 2024

A telehealth provider may only provide a telehealth service to a patient when the telehealth provider:

  • Is communicating through real-time, interactive, two-way communication technology or store and forward transfer technology;
  • Has determined whether the patient has health coverage that is fully insured, not fully insured or provided through the Connecticut medical assistance program, and whether the patient’s health coverage, if any, provides coverage for the telehealth service;
  • Has access to, or knowledge of, the patient’s medical history, as provided by the patient, and the patient’s health record, including the name and address of the patient’s primary care provider, if any;
  • Conforms to the standard of care applicable to the telehealth provider’s profession and expected for in-person care as appropriate to the patient’s age and presenting condition, except when the standard of care requires the use of diagnostic testing and performance of a physical examination, such testing or examination may be carried out through the use of peripheral devices appropriate to the patient’s condition; and
  • Provides the patient with the telehealth provider’s license number, if any, and contact information.

The Commissioner of Public Health may temporarily waive, modify or suspend any regulatory requirements adopted by the Commissioner of Public Health or any boards or commissions under chapters 368a, 368d, 368v, 369 to 381a, inclusive, 382a, 383 to 388, inclusive, 397a, 398, 399, 400a, 400c, 400j and 474 of the general statutes as the Commissioner of Public Health deems necessary to reduce the spread of COVID-19 and to protect the public health for the purpose of providing residents of this state with telehealth services from out-of-state practitioners.

Nothing prohibits a health care provider from:

  • Providing on-call coverage pursuant to an agreement with another health care provider or such health care provider’s professional entity or employer;
  • consulting with another health care provider concerning a patient’s care;
  • ordering care for hospital outpatients or inpatients; or
  • using telehealth for a hospital inpatient, including for the purpose of ordering medication or treatment for such patient in accordance with the Ryan Haight Online Pharmacy Consumer Protection Act, 21 USC 829(e), as amended from time to time.

“Health care provider” means a person or entity licensed or certified pursuant to chapter 370, 372, 373, 375, 376 to 376b, inclusive, 378, 379, 380, 381a, 383 to 383c, inclusive, 384b, 397a, 399 or 400j of the general statutes or licensed or certified pursuant to chapter 368d or 384d of the general statutes.

No telehealth provider shall provide health care or health services to a patient through telehealth unless the telehealth provider has determined whether or not the patient has health coverage for such health care or health services.

A telehealth provider who provides health care or health services to a patient through telehealth during the period beginning on May 10, 2021 and ending on June 30, 2024, shall accept as full payment for such health care or health services:

  • An amount that is equal to the amount that Medicare reimburses for such health care or health services if the telehealth provider determines that the patient does not have health coverage for such health care or health services; or
  • The amount that the patient’s health coverage reimburses, and any coinsurance, copayment, deductible or other out-of-pocket expense imposed by the patient’s health coverage, for such health care or health services if the telehealth provider determines that the patient has health coverage for such health care or health services. If the patient’s health coverage uses a provider network, the amount of such reimbursement, and such coinsurance, copayment, deductible or other out-of-pocket expense, shall not exceed the in-network amount regardless of the network status of such telehealth provider.

If a telehealth provider determines that a patient is unable to pay for any health care or health services described in subdivisions (1) and (2) of this subsection, the provider shall offer to the patient financial assistance, if such provider is otherwise required to offer to the patient such financial assistance, under any applicable state or federal law.

A telehealth provider may provide telehealth services from any location.

SOURCE: HB 5596 (2021 Session) & SB 2 (2022 Session). (Accessed Jan. 2024).

Family and Medical Leave Act

Recent regulations expanded the right to Family and Medical leave under the law to most workers in the state. Amendments include references to allowing telemedicine for the required continuing treatment and periodic visits by a health care provider in certain instances.

SOURCE: Regulations of CT State Agencies Section 31-51qq-1. (Accessed Jan. 2024).

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Delaware

Last updated 01/15/2024

No Reference Found

No Reference Found

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District of Columbia

Last updated 12/07/2023

Recently effective legislation creates requirements for members of licensing boards …

Recently effective legislation creates requirements for members of licensing boards related to residency and active practice, in addition to stating that they must demonstrate that their practice in the District is not primarily through telehealth.

SOURCE: DC Official Code Sec. 3-1204.01; B 25-0312 (2023 Session). (Accessed Dec. 2023).

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Florida

Last updated 02/23/2024

Mental health and substance abuse facilities are authorized to release …

Mental health and substance abuse facilities are authorized to release individuals subject to involuntary examination upon documented approval of a provider. The release may be approved through telehealth.

SOURCE: FL Statute 394.463(2)(f) (Accessed Feb. 2024).

 

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Georgia

Last updated 01/31/2024

When a law enforcement agency that has entered into a …

When a law enforcement agency that has entered into a co-responder partnership with a community service board responds to an emergency call involving an individual with a behavioral health crisis and a co-responder team is dispatched, a community service board team member shall be available to accompany the officer team member in person or via virtual means or shall be available for consultation via telephone or telehealth during such emergency call. The officer team member may consider input from the community service board team member in determining whether to refer an individual for behavioral health treatment or other community support or to transport the individual for emergency evaluation in accordance with Code Section 37-3-42 or 37-7-42, rather than making an arrest.

SOURCE: GA OCGA Sec. 37-12-2. (Accessed Jan. 2024).

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Hawaii

Last updated 02/13/2024

Unless otherwise provided by law, reimbursement for behavioral health services …

Unless otherwise provided by law, reimbursement for behavioral health services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via ink-person contact between a health care provider and a patient; provided that reimbursement for two-way, real-time audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient’s home shall be equivalent to eighty percent of the reimbursement for the same services provided via in-person contact between a health care provider and a patient. To be reimbursed for telehealth via an interactive telecommunications system using two-way, real-time audio-only communication technology in accordance with this subsection, the health care provider shall first conduct an in-person visit or a telehealth visit that is not audio-only, within six months prior to the initial audio-only visit, or within twelve months prior to any subsequent audio-only visit. The telehealth visit required prior to the initial or subsequent audio-only visit in this subsection shall not be provided using audio-only communication.

SOURCE:  HI Revised Statutes 453-1.3(h).  Amended by HB 907 (To be repealed December 31, 2025).(Accessed Feb. 2024).

Malpractice Insurance

Professional liability insurance for health care providers must provide malpractice coverage for telehealth equivalent to coverage for the same services provided via face-to-face contact.

SOURCE: HI Revised Statutes §671-7 (a). (Accessed Feb. 2024).

Network Adequacy

Health benefit plans must maintain a network sufficient in numbers and appropriate types of providers to assure that all covered benefits will be accessible without unreasonable travel or delay. Plans may use telehealth as a service delivery system option for ensuring network adequacy.

SOURCE: HI Revised Statutes § 431:26-103. (Accessed Feb. 2024).

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Idaho

Last updated 02/13/2024

When delivering health care services via virtual care, including a …

When delivering health care services via virtual care, including a prescription drug order or prescription medical device order, a provider shall obtain and document a patient’s relevant clinical history and current symptoms to establish the diagnosis and identify underlying conditions and contraindications to the treatment recommended. A provider delivering health care services via virtual care has a duty to practice in a manner consistent with the provider’s scope of practice and shall be held to the applicable Idaho community standard of care that applies in an in-person setting. Treatment based solely on a static online questionnaire does not constitute an acceptable standard of care.

SOURCE: ID Code 54-5706. (Accessed Feb. 2024).

A provider delivering health care services via virtual care or a provider who is a member of the same provider group as the provider delivering health care services via virtual care shall be available for follow-up care or to provide information to patients who make use of such services. Patients receiving care virtually shall be provided a method to contact the provider of record.

 

SOURCE: ID Code 54-5709. (Accessed Feb. 2024).

A provider delivering health care services via virtual care must document in the patient’s medical record the health care services rendered via virtual care according to the same standard used for equivalent in-person services. All virtual care medical records must be maintained in compliance with any applicable state and federal laws, rules, and regulations, including the health insurance portability and accountability act (HIPAA), P.L. 104-191 (1996), and the health information technology for economic and clinical health act (HITECH), P.L. 111-115 (2009). Such records shall be accessible to other providers, if the patient has given permission, and to the patient in accordance with applicable laws, rules, and regulations.

SOURCE: ID Code 54-5711. (Accessed Feb. 2024).

For purposes of this section, any act that constitutes the delivery of health care services is deemed to occur at the place where the patient is located at the time the act is performed. Venue for a civil or administrative action initiated by the appropriate regulatory licensing authority or by a patient who receives virtual care services from an out-of-state provider may be located in the patient’s county of residence, an applicable county in Idaho, or another venue as deemed proper by a court of competent jurisdiction.

SOURCE:  ID Code 54-5712(2). (Accessed Feb. 2024).

Physical Therapists

General Supervision – A physical therapist’s availability at least by means of telecommunications, which does not require a physical therapist to be on the premises where physical therapy is being provided, for the direction of a physical therapist assistant.

Supervising Physical Therapist – A licensed physical therapist who developed and recorded the initial plan of care and/or who has maintained regular treatment sessions with a patient. Such physical therapist’s designation of another licensed physical therapist if the physical therapist who developed and recorded the initial plan of care or maintained regular treatment sessions is not available to provide direction at least by means of telecommunications.

SOURCE: ID Admin Code IDAPA 24.13.01(010)(08) & (11).  (Accessed Feb. 2024).

Respiratory Therapists

The supervising respiratory care practitioner or licensed physician need not be physically present or on the premises at all times but must be available for telephonic consultation. The extent of communication between the supervising or consulting respiratory care practitioner or licensed physician and the person being supervised shall be determined by the competency of the person, the treatment setting, and the diagnostic category of the client.

SOURCE: ID Admin Code IDAPA 24.33.06.034.  (Accessed Feb. 2024).

Dietitian

The supervising monitor need not be physically present or on the premises at all times but must be available for telephonic consultation. The extent of communication between the monitor and the provisionally licensed dietitian will be determined by the competency of the individual, the treatment setting, and the diagnostic category of the patients.

SOURCE: ID Admin Code IDAPA 24.33.07.02.  (Accessed Feb. 2024).

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Illinois

Last updated 02/27/2024

A health care professional may engage in the practice of …

A health care professional may engage in the practice of telehealth services in Illinois to the extent of his or her scope of practice as established in his or her respective licensing Act consistent with the standards of care for in-person services. This Act shall not be construed to alter the scope of practice of any health care professional or authorize the delivery of health care services in a setting or in a manner not otherwise authorized by the laws of this State.

Telehealth services shall be consistent with all federal and State privacy, security, and confidentiality laws, rules, or regulations.

A health care professional with a temporary permit for full practice advanced practice registered nurse for health care, a temporary permit for advanced practice registered nurse for health care, or a temporary permit for health care may treat a patient located in this State through telehealth services in a manner consistent with the health care professional’s scope of practice and agreement with a sponsoring entity.

“Health care professional” includes, but is not limited to, physicians, physician assistants, optometrists, advanced practice registered nurses, clinical psychologists licensed in Illinois, prescribing psychologists licensed in Illinois, dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, hearing instrument dispensers, licensed certified substance use disorder treatment providers and clinicians, and mental health professionals and clinicians authorized by Illinois law to provide mental health services, and qualified providers listed under paragraph (8) of subsection (e) of Section 3 of the Early Intervention Services System Act, dietitian nutritionists licensed in Illinois, and health care professionals associated with a facility.

SOURCE: IL Compiled Statutes, Chapter 225, 150/5 & IL Compiled Statutes Chapter 225, 150/15. (Accessed Feb. 2024).

An optometrist may practice optometry through telehealth and must be licensed in the state to treat a patient in the state.

An optometrist practicing optometry through telehealth is subject to the same standard of care and practice standards that are applicable to optometric services provided in a clinic or office setting.

An optometrist may not provide telehealth services unless the optometrist has established a provider-patient relationship with the patient.

An in-person consultation is not required for new conditions relating to a patient with whom the optometrist has a provider-patient relationship unless the optometrist deems an in-person consultation is necessary to provide appropriate care. An optometrist may treat a patient through telehealth in the absence of a provider-patient relationship when, in the professional judgment of the optometrist, emergency care is required.

SOURCE: IL Compiled Statutes Chapter 225, 80/15.4. (Accessed Feb. 2024).

Occupational therapy may be provided via technology or telecommunication methods, also known as telehealth, however the standard of care shall be the same whether a patient or recipient is seen in person, through telehealth, or other method of electronically enabled health care.

SOURCE:  Illinois 225 ILCS 75/1. (Accessed Feb. 2024).

Veterinarian Medicine

Telemedicine occurs when either the animal who is receiving the care is located in the State when receiving telemedicine treatment or the veterinarian providing the care to the animal is located in the State when providing telemedicine treatment, pursuant to the provisions of Section 5. Telemedicine may only be used when a veterinarian has an established veterinarian-client-patient relationship.

SOURCE: Illinois 225 ILCS 115/4.5.  (Accessed Feb. 2024).
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Indiana

Last updated 12/05/2023

A juvenile court may recommend telehealth services as an alternative …

A juvenile court may recommend telehealth services as an alternative to a child receiving a diagnostic assessment.

SOURCE: Indiana Code 31-37-19-11.7. (Accessed Dec. 2023).

Every practitioner who is renewing online a license issued by a board must include the following information related to the practitioner’s work in Indiana under the practitioner’s license during the previous two (2) years:

(1) The practitioner’s specialty or field of practice.

(2) The following concerning the practitioner’s current practice:

  • The location or address.
  • The setting type.
  • The average hours worked weekly.
  • The health care services provided.

(3) The practitioner’s education background and training.

(4) For a practitioner (as defined in IC 25-1-9.5-3.5), whether the practitioner delivers health care services through telehealth (as defined in IC 25-1-9.5-6).

SOURCE: IN Code 25-1-2-10,(Accessed Dec. 2023).

The medical records must be created and maintained by the practitioner for the patient

A patient waives confidentiality of any medical information discussed with the practitioner that is:

  • Provided during a telehealth visit; and
  • Heard by another individual in the vicinity of the patient during a health care service or consultation.

An employer may not require a practitioner, by an employment contract, an agreement, a policy, or any other means, to provide a health care service through telehealth if the practitioner believes that providing a health care service through telehealth would:

  • Negatively impact the patient’s health; or
  • Result in a lower standard of care than if the health care service was provided in an in-person setting.

Any applicable contract, employment agreement, or policy to provide telehealth services must explicitly provide that a practitioner may refuse at any time to provide health care services if in the practitioner’s sole discretion the practitioner believes:

  • That health quality may be negatively impacted; or
  • The practitioner would be unable to provide the same standards of appropriate practice as those provided in an in-person setting.

SOURCE: IN Code, 25-1-9.5-7. (Accessed Dec. 2023)

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Iowa

Last updated 01/15/2024

The following persons and entities may use or access the …

The following persons and entities may use or access the network for data and video services including access to the Internet if the use is for telemedicine or educational purposes:

  • Licensed health care professionals or licensed health care professionals who function under the direction of or in collaboration with a physician or a hospital, or both, for example, other doctors, students, nurses, physician’s assistants, therapists, clinical social workers, psychologists;
  • Hospital or physician clinic staff members;
  • Professional boards on which health professionals serve, for example, a nurse serving on the board of the American Cancer Society;
  • Patients acting under the direction of a licensed health care professional;
  • Health care employees of facilities that have a contractual agreement with the hospital or physician;
  • Health care employees of facilities that do not have a contractual agreement with the hospital or physician clinic;
  • Employees of health care associations for various health care employees, for example, Association of Iowa Hospitals and Health Systems, Iowa Medical Society, Iowa Osteopathic Medical Association, Iowa Chiropractic Society, Iowa Nurses Association;
  • Professional board members where a health care professional serves as a member of a board, for example, a physician serving on the board of the American Cancer Society

SOURCE: IA Admin. Code, 751 7.11(8D). (Accessed Jan. 2024).

A licensee under the purview of the board who provides treatment for the correction of malpositions of human teeth or the initial use of orthodontic appliances shall not begin orthodontic treatment on a new patient unless one of the following conditions is met:

  • The licensee performs an initial in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to beginning orthodontic treatment.
  • The new patient provides the licensee with the portion of the dental record taken within the prior six months of an in-person or teledentistry examination of the teeth and supporting structures of the new patient prior to the licensee beginning orthodontic treatment.

SOURCE: Iowa Annotated Statute Sec. 153.24, (Accessed Jan. 2024).

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Kansas

Last updated 12/06/2023

Within the limits of appropriations therefor, the university of Kansas

Within the limits of appropriations therefor, the university of Kansas medical center is hereby authorized to establish, maintain and operate a telemedicine communications system, subject to the approval by the executive chief information technology officer under K.S.A. 75-4709, and amendments thereto. The telemedicine communications system shall apply telecommunications technology to the practice of medicine through compressed, full-motion, high-resolution, two-way interactive video communication and information transfer over long distances within a medical setting.

STATUS: KS Statute Annotated Sec. 76-389, (Accessed Dec. 2023).

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Kentucky

Last updated 12/11/2023

There is hereby created a Division of Telehealth Services within …

There is hereby created a Division of Telehealth Services within the Office of Inspector General to be headed by a director appointed by the secretary pursuant to KRS 12.050. The division shall:

  • Provide guidance and direction to healthcare providers delivering care using telehealth;
  • Develop guidance, resources, and education to help promote access to healthcare services in the Commonwealth;
  • Assist the Cabinet for Health and Family Services with the implementation of KRS 211.334; and
  • Provide the Department for Medicaid Services with any additional information deemed relevant by the division for inclusion in the report required by KRS 211.334(3).

SOURCE: KY Revised Statute 194A.105, (Accessed Dec. 2023).

See Medicaid Misc. section for regulation outlining requirements established by the Cabinet for Health and Family Services on health care providers performing a telehealth or digital health service, including those related to confidentiality, patient privacy, consent, credentialing.

Statewide system for heart attack response and treatment – Care levels and standards

Level I Comprehensive Cardiac Centers, Level II Primary Heart Attack Centers, and Level III Acute Heart Attack Ready hospitals are encouraged to coordinate, through a coordinating heart attack care agreement, within their service area to provide appropriate access to care for acute heart attack patients. A coordinating heart attack care agreement shall be in writing and include at a minimum:

  • Transfer protocols for the transport and acceptance of heart attack patients for treatment therapies which the transferring facility is not capable of providing; and
  • Communication criteria and protocols that include but are not limited to telemedicine systems.

The department may suspend or revoke a hospital’s designation as Level I Comprehensive Cardiac Center, Level II Primary Heart Attack Center, or Level III Acute Heart Attack Ready if the department determines that the hospital is not in compliance with the requirements of KRS 211.340 to 211.343.

SOURCE:  KY Revised Statutes 211.341. (Accessed Dec. 2023).

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Louisiana

Last updated 02/15/2024

Requires licensing standards be developed by the Department of Health …

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 Feb. 2024).

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 (asynchronous) 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 Feb. 2024).

Venue in any suit filed involving care rendered via telehealth pursuant to the provisions of this Part shall be proper and instituted before the district court of the judicial district in which the patient resides or in the district court having jurisdiction in the parish where the patient was physically located during the provision of the telehealth service. The patient is considered physically located at the originating site as defined in R.S. 40:1223.3.

SOURCE: LA Statute Sec. 40, Sec. 1223.5, as amended by Senate Bill 66 (2023 Session), (Accessed Feb. 2024).

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Maine

Last updated 02/04/2024

See Joint Rule on office-based treatment of opioid use disorder …

See Joint Rule on office-based treatment of opioid use disorder for telehealth practice requirements under the Board of Medicine, Nursing and osteopathic licensure.

SOURCE:  Joint Rule Regarding office-based treatment of opioid use disorder Sec. 02-373-12, 02-380-12, 02-383-12. (Accessed Feb. 2024).

Municipal Gigabit Broadband Network Access Fund

The fund is established to address the need in the State for access to broadband infrastructure that will enhance the State’s competitiveness in national and international economies.  Except as described in subsection 3-A, to the extent funds are available, the fund must be used to provide grants to municipalities to support public-private partnerships to support a municipal gigabit fiber-optic broadband network in their regions with the following goals:

  • Provide high-speed broadband access to attract, create and grow the State’s economy and market the products and services of businesses in the State in national and international markets with symmetric connectivity and address challenges in geography;
  • Provide expanded health care services by facilitating access to telehealth, as defined in Title 24‐A, section 4316, subsection 1, and state and local services for senior citizens and persons with disabilities;
  • Expand educational opportunities for students across the State through virtual and distance learning;
  • Facilitate broader access for the public to services provided by municipal and county governments, including, but not limited to, law enforcement entities, the judicial system and child, youth and family social services; and
  • Provide expanded residential services to support employment opportunities.

In order to facilitate the achievement of the goals and policies of this section, the authority shall establish and regularly update, after opportunity for public comment and taking into consideration relevant federal policies, definitions of “gigabit fiber-optic broadband network” and “broadband infrastructure.”

Purpose of the fund; grant match funding

In addition to grants provided in accordance with subsection 3, the fund may be used to provide grant match funding to municipal entities applying for project grants from other sources that require applicants to provide matching funds. To the extent that funds are available, grant match funding may be awarded for a project under this subsection only if the authority finds the project is consistent with the purposes stated in subsection 3. A municipal entity selected for grant match funding under this subsection must provide services to any unserved community anchor institution in the project area to which the municipal entity is extending services that provides or will provide open access to the Internet for the public. For purposes of this subsection, “municipal entity” means a municipality or a group of municipalities working together to support a gigabit fiber-optic broadband network project. The authority shall, by rule, define an applicant’s “project area” and “unserved community anchor institution” for the purposes of this subsection. The authority may also adopt other rules to administer grant match funding awards under this subsection.

SOURCE: ME Revised Statutes Title 35-A, Part 7, Ch. 93, Sec. 9211. (Accessed Feb. 2024).

Board of Social Worker Licensure

Social workers who choose to provide telehealth services shall:

  • At a minimum, ensure that the electronic communication is secure to maintain confidentiality of the client’s health and/or educational information as required by the Health Insurance Portability and Accountability Act (HIPAA) and other applicable Federal and State laws.
  • Absent exigent circumstances, strive to deliver telehealth services in private settings, with no other persons present who can see or hear the client while telehealth services are being delivered.
  • Social workers shall develop and disclose policies and procedures for notifying clients as soon as possible of any breach of confidential information.

SOURCE: ME Regulation, 02-416-18. (Accessed Feb. 2024).

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Maryland

Last updated 02/21/2024

Statute specifies that a health occupations board may adopt regulations …

Statute specifies that a health occupations board may adopt regulations related to telehealth, however they may not establish a separate standard of care for telehealth; and must allow for the establishment of a practitioner-patient relationship through synchronous or asynchronous telehealth interaction provided by a health care practitioner who is complying with their standard of care.

SOURCE: MD Code, Health Occupations Sec. 1-1006. (Accessed Feb. 2024).

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Massachusetts

Last updated 01/12/2024

The board shall allow a physician licensed by the board …

The board shall allow a physician licensed by the board to obtain proxy credentialing and privileging for telehealth services with other health care providers, as defined in Section 1 of chapter 111, or facilities that comply with the federal Centers for Medicare and Medicaid Services’ conditions of participation for telehealth services.  Applicable providers in Section 1, Chapter 111 include:

  • any doctor of medicine, osteopathy, or dental science
  • registered nurse
  • social worker
  • doctor of chiropractic
  • psychologist

SOURCE: Massachusetts General Laws Part I, Title  XVI, Ch. 112, Sec. 5O & Title XVI, Chapter 111, Section 1, Massachusetts General Laws (Accessed Jan. 2024).

Involuntary Commitment

The requirement for examination may be satisfied through utilization of telemedicine or other technology pursuant to protocols approved by the Department.  See regulation for details.

SOURCE: 104 Code of Massachusetts Regulations (CMR) 27, (Accessed Jan. 2024).

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Michigan

Last updated 01/19/2024

In a manner consistent with this part and in addition …

In a manner consistent with this part and in addition to the provisions set forth in this part, a disciplinary subcommittee may place restrictions or conditions on a health professional’s ability to provide a telehealth service if the disciplinary subcommittee finds that the health professional has violated section 16284 or 16285.

SOURCE: MI Compiled Law Section 333.16286 (Accessed Jan. 2024).

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Minnesota

Last updated 11/28/2023

Chemical Dependency Licensed Treatment Facilities

“Face-to-face” means two-way, real-time, interactive …

Chemical Dependency Licensed Treatment Facilities

“Face-to-face” means two-way, real-time, interactive and visual communication between a client and a treatment service provider and includes services delivered in person or via telehealth.

SOURCE: MN Statutes  254G.01. (Accessed Nov. 2023).

$1,200,000 in fiscal year  2024 is from the general fund for studies of telehealth expansion and payment parity. This is a onetime appropriation and is available until June 30, 2025.

SOURCE: MN Senate File 2995 (2023 Session), (Accessed Nov. 2023).

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Mississippi

Last updated 12/23/2023

A physician treating a patient through a telemedicine network must …

A physician treating a patient through a telemedicine network must maintain a complete record of the patient’s care. The physician must maintain the record’s confidentiality and disclose the record to the patient consistent with state and federal laws. If the patient has a primary treating physician and a telemedicine physician for the same medical condition, then the primary physician’s medical record and the telemedicine physician’s record constitute one complete patient record.

SOURCE: MS Admin. Code Title 30, Sec. 2635, Rule 5.6. (Accessed Dec. 2023).

State Department of Health has ability to promulgate rules and regulations, and to collect data and information, on (i) the delivery of services through the practice of telemedicine; and (ii) the use of electronic records for the delivery of telemedicine services.

SOURCE: MS Code Sec. 41-3-15. (Accessed Dec. 2023).

The Mississippi Center for Rural Health Innovation within the Office of Rural Health of the State Department was established with the purpose of providing services and resources to rural hospitals, critical access hospitals, rural health clinics and rural federally qualified health centers, including expert analysis, guidance, training opportunities and telehealth investment.

SOURCE: MS Code Sec. 41-3-15.1. (Accessed Dec. 2023).

“Real-Time Telemedicine” is defined as real-time communication using interactive audio and visual equipment, such as a video conference with a specialist, also known as ‘synchronous communication.’

“Emergency Telemedicine” is a unique combination of telemedicine used in a consultative interaction between a physician board certified, or board eligible, in emergency medicine, and an appropriate skilled health professional (nurse practitioner or physician assistant).

SOURCE: MS Code Title 30 Part 2635, Ch. 5 Rule 5.1. (Accessed Dec. 2023).

Physical Therapy

Telehealth is an appropriate model of service delivery when it is provided in a manner consistent with the standards of practice, ethical principles, rules and regulations for Mississippi physical therapy practitioners.

SOURCE: MS Admin Code Title 30, Part 3101, Rule 1.3, (Accessed Dec. 2023).

Licensed Professional Counselors

Asynchronous methods: Communication takes place in separate time frames. The transmission does not take place simultaneously. These methods may include, but not limited to, text messaging, email, and chat rooms. (Asynchronous methods are not an acceptable practice of counseling in Mississippi.)

Group Supervision: The process of clinical supervision of more than one person but no more than six (6) persons in a group setting provided by an LPC-S, not to include asynchronous methods.

Individual Supervision: “Face-to-face” supervision of the individuals involved in the supervisory relationship during one-to-one supervision, not to include asynchronous methods.

SOURCE: MS Code Title 30 Part 2201 Ch. 1 Rule 1.4, (Accessed Dec. 2023).

Any person providing counseling or supervision services through the means of Distance Professional Services (Telemental Health) must meet the following requirements:

  • Be a practicing P-LPC, LPC, or LPC-S in Mississippi.
  • Hold a license in good standing in both the location where services are provided by the professional as well as in the location of the recipient of the services.
  • Submit to the Board verification of training (including synchronous or asynchronous audio/video webinars) in TeleMental Health counseling (see regulation for options).
  • At the time of license renewal, LPCs must document two (2) hours of continuing education in Telemental Health counseling and P-LPCs must document one (1) hour of continuing education in Telemental Health counseling. These continuing education hours are included as part of the required continuing education requirements for renewal.
  • No licensing fee will be assessed for the Distance Professional Services provider designation.

SOURCE: Title 30, Part 2201, Rule 7.5, (Accessed Dec. 2023).

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Missouri

Last updated 01/20/2024

Telehealth Dental Pilot Project in Medically Underserved Populations

Pursuant to …

Telehealth Dental Pilot Project in Medically Underserved Populations

Pursuant to the provisions of section 332.325, RSMo, the board is collaborating with the Office of Dental Health (ODH) within the Missouri Department of Health and Senior Services (DHSS) to create a pilot project designed to examine new methods of extending dental care to residents in assisted living facilities, intermediate care facilities, residential care facilities, skilled nursing facilities, and homebound special needs patients.  Specific provisions of sections 332.093 and 332.098, RSMo, and 20 CSR 2110-2.120 in order to allow a dentist to supervise a dental assistant, certified dental assistant, or expanded functions dental assistant using telehealth technology.  See regulation for additional details.

SOURCE:  20 CSR 2110-2.133, (Accessed Jan. 2024).

Utilization of telehealth by nurses

No later than January 1, 2014, there is hereby established within the state board of registration for the healing arts and the state board of nursing the “Utilization of Telehealth by Nurses”.  An advanced practice registered nurse (APRN) providing nursing services under a collaborative practice arrangement under section 334.104 may provide such services outside the geographic proximity requirements of section 334.104 if the collaborating physician and advanced practice registered nurse utilize telehealth in the care of the patient and if the services are provided in a rural area of need.  Telehealth providers shall be required to obtain patient consent before telehealth services are initiated and ensure confidentiality of medical information.

The boards shall jointly promulgate rules governing the practice of telehealth under this section.  Such rules shall address, but not be limited to, appropriate standards for the use of telehealth.

ny rule or portion of a rule, as that term is defined in section 536.010, that is created under the authority delegated in this section shall become effective only if it complies with and is subject to all of the provisions of chapter 536 and, if applicable, section 536.028.  This section and chapter 536 are nonseverable and if any of the powers vested with the general assembly pursuant to chapter 536 to review, to delay the effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then the grant of rulemaking authority and any rule proposed or adopted after August 28, 2013, shall be invalid and void.

SOURCE: MO Annotated Statute, Title 22, Sec. 335.175, (Accessed Jan. 2024).

No later than July 1, 2022, there shall be established within the department a statewide telehealth network for forensic examinations of victims of sexual offenses in order to provide access to sexual assault nurse examiners (SANE) or other similarly trained appropriate medical providers. A statewide coordinator for the telehealth network shall be selected by the director of the department of health and senior services and shall have oversight responsibilities and provide support for the training programs offered by the network, as well as the implementation and operation of the network. The statewide coordinator shall regularly consult with Missouri-based stakeholders and clinicians actively engaged in the collection of forensic evidence regarding the training programs offered by the network, as well as the implementation and operation of the network.  See statute for further details.

SOURCE: MO Annotated Statute, Title 12, Sec. 192.2520 (Accessed Jan. 2024).

Beginning January 1, 2023, or no later than six months after the establishment of the statewide telehealth network under section 192.2520, whichever is later, any hospital licensed under this chapter shall perform a forensic examination using an evidentiary collection kit upon the request and consent of the victim of a sexual offense, or the victim’s guardian, when the victim is at least fourteen years of age.  In the case of minor consent, the provisions of subsection 2 of section 595.220 shall apply.  Victims under fourteen years of age shall be referred, and victims fourteen years of age or older but less than eighteen years of age may be referred, to a SAFE CARE provider, as such term is defined in section 334.950, for medical or forensic evaluation and case review.  Nothing in this section shall be interpreted to preclude a hospital from performing a forensic examination for a victim under fourteen years of age upon the request and consent of the victim or victim’s guardian, subject to the provisions of section 595.220 and the rules promulgated by the department of public safety.  See statute for further details.

SOURCE: MO Annotated Statute, 197.135, (Accessed Jan. 2024).

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Montana

Last updated 02/13/2024

MT has a Sexual assault response network program that delivers …

MT has a Sexual assault response network program that delivers care through tele SANE.  “teleSANE” means the use of audio, video, or other telecommunications technology or media, including audio-only communication, to provide remote, real-time support by an off-site qualified provider to both the on-site nurse and the patient to ensure best practices, proper evidence collection, and a supportive environment.

See statute for details.

SOURCE: House Bill 79 (2023 Session), (Accessed Feb. 2024).

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Nebraska

Last updated 01/04/2024

A stroke system of care task force shall recommend eligible …

A stroke system of care task force shall recommend eligible essential health care services for acute stroke care provided through telehealth.

SOURCE: NE Revised Statutes 71-4209. (Accessed Jan. 2024).

The commission may establish a telehealth system to provide access for deaf and hard of hearing persons in remote locations to mental health, alcoholism, and drug abuse services. The telehealth system may (a) provide access for deaf or hard of hearing persons to counselors who communicate in sign language and are knowledgeable in deafness and hearing loss issues, (b) promote access for hard of hearing persons through contacts with counselors in which hard of hearing persons receive both visual cues, or reading lips, and auditory cues, (c) offer remote interpreter services for deaf or hard of hearing persons to interact with counselors who are not fluent in sign language, and (d) promote participation in educational programs.

The commission shall set and charge a fee between the range of twenty and one hundred fifty dollars per hour for the use of the telehealth system. The commission shall remit all fees collected pursuant to this section to the State Treasurer for credit to the Telehealth System Fund.

For purposes of this section, telehealth has the same meaning as in section 71-8503.

SOURCE: NE Revised Statute 71-4728.04. (Accessed Jan. 2024).

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Nevada

Last updated 12/18/2023

To the extent money is available, the Department shall establish …

To the extent money is available, the Department shall establish a data dashboard that allows for the analysis of data relating to access to telehealth by different groups and populations in this State. The data dashboard must, to the extent authorized by federal law:

  • Include, without limitation, data concerning health care services, behavioral health services and dental services provided through telehealth; and
  • Allow for the user to sort data based on the race, ethnicity, ancestry, national origin, color, sex, sexual orientation, gender identity or expression, mental or physical disability, income level or location of residence of the patient, type of telehealth service and any other category determined useful by the Department; and
  • Make the data dashboard available on an Internet website maintained by the Department.

SOURCE: NV Revised Statutes Ch. 439.245, (Accessed Dec. 2023).

A hospital may grant staff privileges to a provider of health care who is at another location for the purpose of providing services through telehealth.

SOURCE: NV Revised Statutes Sec. 449.1925. (Accessed Dec. 2023).

Supervising Physicians

At least once a month, the supervising physician shall spend part of a day at any location where the physician assistant provides medical services to act as a consultant to the physician assistant and to monitor the quality of care provided by the physician assistant. The requirements of this subsection are satisfied if the supervising physician spends part of a day at any location where the physician assistant uses telehealth to provide medical services.

SOURCE: NV Admin Code, Sec. 630.370, (Accessed Dec. 2023).

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New Hampshire

Last updated 12/19/2023

A Commission was created to study telehealth services and report …

A Commission was created to study telehealth services and report to the legislature by December 1, 2022.

SOURCE: NH Revised Statutes 329:1-f.  (Accessed Dec. 2023).

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New Jersey

Last updated 02/03/2024

Telemedicine and Telehealth Organization Registry

Each telehealth or telemedicine organization …

Telemedicine and Telehealth Organization Registry

Each telehealth or telemedicine organization operating in the State shall annually register with the Department of Health and submit an annual report.  See statute for details.

SOURCE: NJ Statute C.45:1-64. (Accessed Feb. 2024).

A telemedicine or telehealth organization, whether operating as a distant site, originating site, or both, shall register with the Department prior to providing services in the State.

See rule for additional requirements.

SOURCE: NJ Administrative Code 8:53-2.1 (Accessed Feb. 2024).

The Telemedicine and Telehealth Review Commission shall review information reported by telemedicine and telehealth organizations and make recommendations to promote and improve the quality, efficiency, and effectiveness of telemedicine and telehealth services provided by New Jersey.

SOURCE: NJ Statute C.45:1-65. (Accessed Feb. 2024).

All Telehealth and/or Telemedicine companies providing or intending to provide telehealth or telemedicine services in New Jersey must register with the New Jersey Department of Health (Department). The Department of Health has received many inquiries seeking clarification of what constitutes a telemedicine or telehealth organization that is subject to the registration requirement. Please utilize the following guidance in determining whether you are subject to the registration requirement:

  • “Telemedicine or telehealth organization” means a business entity organized as a corporation, sole proprietorship, partnership, or limited liability company with the primary purpose of administering services in the furtherance of telemedicine or telehealth. “In furtherance of telemedicine or telehealth” means the organization is involved in the development, production or administration of telehealth technology.
  • Any individual licensed or certified to provide healthcare services in person may provide those services (in whole or in part) through telehealth when the provision of such healthcare services is consistent with the standard of care applicable for those services.
  • A licensed or certified healthcare provider utilizing telehealth technology as an end-user incidental to the delivery of clinical services is not required to register as a telemedicine or telehealth organization. For example, licensed social workers providing services via video conference technology they did not develop are not required to register.
  • Facilities licensed by the New Jersey Department of Health or Private Practices with a physical location used for treatment of patients are not required to register.

See NJ Department of Health website for more information.

SOURCE: NJ Dept. of Health. Telemedicine and Telehealth Organization Registry. (Accessed Feb. 2024).

Statutory Telehealth Practice Standards for Health Care Providers

Telemedicine services shall be provided using interactive, real-time, two-way communication technologies.

A health care provider engaging in telemedicine or telehealth may use asynchronous store-and-forward technology to provide services with or without the use of interactive, real-time, two-way audio if, after accessing and reviewing the patient’s medical records, the provider determines that the provider is able to meet the same standard of care as if the health care services were being provided in person and informs the patient of this determination at the outset of the telemedicine or telehealth encounter.

See statute for additional telemedicine/telehealth practice standards.

SOURCE: NJ Statute C.45:1-62(c)(2). (Accessed Feb. 2024).

A mental health screener, screening service, or screening psychiatrist subject to C.30:4-27.1:

  • Shall not be required to obtain a separate authorization in order to engage in telemedicine or telehealth for mental health screening purposes; and
  • Shall not be required to request and obtain a waiver from existing regulations, prior to engaging in telemedicine or telehealth.

SOURCE: NJ Statute C.45:1-62(f). (Accessed Feb. 2024).

Standard of Care

Prior to providing services through telemedicine or telehealth, a licensee shall determine whether providing those services through telemedicine or telehealth would be consistent with the standard of care applicable for those services when provided in-person.

If a licensee determines, either before or during the provision of health care services, that services cannot be provided through telemedicine or telehealth in a manner that is consistent with in-person standards of care, the licensee shall not provide services through telemedicine or telehealth.

A licensee who determines that services cannot be provided through telemedicine or telehealth pursuant to (b) above shall advise the patient to obtain services in-person.

A licensee who provides a diagnosis, treatment, or consultation recommendation, including discussions regarding the risk and benefits of a patient’s treatment options, through telemedicine or telehealth shall be held to the same standard of care or practice standards as are applicable to in-person settings.

See administrative code for other requirements, such as fraud and abuse, privacy and notice to patients. (NOTE: Regulations for different professions are very similar though changes are made to name that specific profession or the services they provide).

SOURCE:  NJ Admin Code 13:30-9.3 (Dentist), 13:34-6A.3 & 13:34-32.3 (Marriage and Family Therapy Examiners), 13:34C-7.3 (Alcohol & Drug Counselor), 13:34D-8.2 (Art Therapists), 13:35-2C.3 (Physician Assistants), 13:35-6B.3 (Physician), 13:35-9.23 (Acupuncture), 13:35-12A.3 (Electrologists), 13:35-14.21 (Genetic Counselor), 13:37-8A.3 (Nurse), 13:39A-10.3 (Physical Therapy), 13:42-13.3 (Psychologists), 13:42A-8.3 (Psychoanalysts), 13:44-4A.3 (Veterinarian), 13:44C-11.3 (Audiologist & Speech-Language Pathologists), 13:44F-11.3 (Respiratory Care), 13:44G-15.3 (Social Worker), 13:44H-11.3 (Orthotics & Prosthetics), 13:4K-7.3 (Occupational Therapy), 13:44L-7.3 (Polysomnography). (Accessed Feb. 2024).

Legislation requires the State Board of Agriculture and Department of Agriculture to adopt rules and regulations concerning confinement of breeding pigs and calves raised for veal. The bill allows examination and treatment exceptions for veterinary purposes if performed by or under veterinarian supervision either in-person or via telehealth.

SOURCE: NJ A1970 (2023 Session). (Accessed Feb. 2024).

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New Mexico

Last updated 02/26/2024

New Mexico is also the home of Project ECHO.

SOURCE: …

New Mexico is also the home of Project ECHO.

SOURCE: University of New Mexico School of Medicine. Project ECHO. (Accessed Jun. 2023).

The delivery of health care via telehealth is recognized and encouraged as a safe, practical and necessary practice in New Mexico. No health care provider or operator of an originating site shall be disciplined for or discouraged from participating in telehealth pursuant to the New Mexico Telehealth Act. In using telehealth procedures, health care providers and operators of originating sites shall comply with all applicable federal and state guidelines and shall follow established federal and state rules regarding security, confidentiality and privacy protections for health care information.

SOURCE: NM Statutes Annotated Sec. 24-25-4. (Accessed Feb. 2024).

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New York

Last updated 11/18/2023

Services may be provided by OASAS certified, approved or otherwise

Services may be provided by OASAS certified, approved or otherwise authorized programs. OASAS programs must apply in accordance with these Telehealth Standards for OASAS Designated Providers (hereinafter Standards) for approval to deliver services via telehealth. OASAS certified programs are required to submit the Attestation for Telehealth (attached herein as Appendix B) requesting a designation be added to their operating certificate prior to service delivery via this method. The purpose of this document is to provide guidance to programs seeking to deliver services via telehealth.

OASAS has specific telepractice standards for its providers.  See regulation for details.

SOURCE: OASAS Telehealth Standards for OASAS Designated Providers, p. 3. Aug. 2023. (Accessed Nov. 2023).

Adverse action against legal reproductive health care

Every insurer that issues or renews medical malpractice insurance covering a health care provider licensed to practice in this state shall be prohibited from taking any adverse action against a health care provider solely on the basis that the health care provider performs an abortion or provides reproductive health care that is legal in this state on someone who is from out of the state. Such policy shall include health care providers who legally prescribe abortion medication to out-of-state patients by means of telehealth.

As used in this section, “adverse action” shall mean but not be limited to: (1) refusing to renew or execute a contract or agreement with a health care provider; (2) making a report or commenting to an appropriate private or governmental entity regarding practices of such provider which may violate abortion laws in other states; and (3) increasing in any charge for, or a reduction or other adverse or unfavorable change in the terms of coverage or amount for, any medical malpractice insurance contract or agreement with a health care provider.

SOURCE: NY Insurance Law Article 34 Section 3436*2-a, as added by S 9080 (2022 Session) and amended by S 4007 (2023 Session). (Accessed Nov. 2023).

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North Carolina

Last updated 12/12/2023

Telemedicine may be utilized for neonatal or infant echocardiograms.

SOURCE: …

Telemedicine may be utilized for neonatal or infant echocardiograms.

SOURCE: 10A N.C.A.C. 43K.0102(c)(3). (Accessed Dec. 2023).

Telehealth may be used to perform the initial examination for purposes of involuntary commitment.

SOURCE: N.C. Gen. Stat. § 122C-263(c), (Accessed Dec. 2023).

The Commission is required to address follow-up protocols to ensure early treatment for newborn infants diagnosed with congenital heart defects, including by means of telemedicine (live video).

SOURCE: NC General Statute 130A-125(b2)(1). (Accessed Dec. 2023).

Audiology Assistants may utilize telehealth to extend access to clinical care.

SOURCE: 21 NCAC 64 .1104(a)(7). (Accessed Dec. 2023).

Teledentistry

The licensee shall ensure that any electronic and digital communication used in the practice of teledentistry is secure to maintain confidentiality of the patient’s medical information as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all other applicable laws and administrative regulations. Patients receiving services through teledentistry under this section are entitled to protection of their medical information no less stringent than the requirements that apply to patients receiving in-person services.

SOURCE: NC General Statutes Sec. 90-30.2. (Accessed Dec. 2023).

Involuntary Commitment

For an involuntary commitment, the respondent may either be in the physical face-to-face presence of the person conducting the screen or may be examined utilizing telehealth equipment and procedures. See statute for additional information.

SOURCE: NC General Statutes 122C-263 & 122C-266, (Accessed Dec. 2023).

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North Dakota

Last updated 02/19/2024

Under the Worker’s Compensation Act, the originating sites may receive …

Under the Worker’s Compensation Act, the originating sites may receive a facility fee at the scheduled amount.

SOURCE: ND Admin. Code 92-01-02-34 (3d). p. 35 (Accessed Feb. 2024).

Dentistry

Each patient shall have access to health provider information as it pertains to their treating doctor or potential doctors. Any entity utilizing telehealth shall provide upon request of a patient the name of the dentist, telephone number, practice address, and state license number of any dentist who was involved with the provision of services to a patient before or during the rendering of dental services.

SORUCE: ND Admin. Code 20-02-01-9, (Accessed Feb. 2024).

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Ohio

Last updated 02/16/2024

“Facility fee” means any fee charged or billed for telehealth …

“Facility fee” means any fee charged or billed for telehealth services provided in a facility that is intended to compensate the facility for its operational expenses and is separate and distinct from a professional fee.

A health care professional providing telehealth services shall not charge a patient or a health plan issuer covering telehealth services under section 3902.30 of the Revised Code any of the following: a facility fee, an origination fee, or any fee associated with the cost of the equipment used at the provider site to provide telehealth services.

SOURCE:  OH Revised Code, Section 4743.09 (Accessed Feb. 2024).

A physician may provide telehealth services in accordance with sections 4743.09 of the Revised Code.

SOURCE: OH Revised Code Section 4731.741 (Accessed Feb. 2024).

An advanced practice registered nurse may provide telehealth services in accordance with section 4743.09 of the Revised Code.

SOURCE: OH Revised Code Section 4723.94 (Accessed Feb. 2024).

General supervision of ancillary personnel is required when a licensed optometrist provides telehealth services from a remote site and delegates ministerial and administrative duties, tasks and functions to ancillary personnel in accordance with 4725-25-01.

SOURCE: OAC 4725-5-18, (Accessed Feb. 2024).

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Oklahoma

Last updated 12/04/2023

OK provides, to each eligible healthcare entity, Special Universal Services …

OK provides, to each eligible healthcare entity, Special Universal Services for telemedicine providers. This includes the provision of bandwidth per standards as recommended by the Federal Communications Commission sufficient for providing telemedicine services including the telemedicine line, reasonable installation and network termination equipment owned and operated by the eligible provider. See statute for additional eligibility requirements.

SOURCE: OK Statutes, Title 17 Sec. 139.109.1 & OK Admin Code Title 165:59-7-6. (Accessed Dec. 2023).

The OK Dept. of Health established a statewide telemedicine network: Oklahoma Center for Telemedicine (Office of Telehealth)

SOURCE: Oklahoma Statutes, Title 63 Sec. 1-2702. & Office of Telehealth. (Accessed Dec 2023).

A licensed dentist may allow a dental hygienist with an elder care advanced procedure permit to treat patients under general supervision by utilizing teledentistry on a patient in:

  • A nursing facility, specialized facility, or nursing care component of a continuum of care facility licensed under or otherwise subject to the Nursing Home Care Act, Section 1-1901 et seq. of Title 63 of the Oklahoma Statutes;
  • An assisted living center or continuum of care facility licensed under the Continuum of Care and Assisted Living Act, Section 1-890.1 et seq. of Title 63 of the Oklahoma Statutes;
  • A residential care home licensed under the Residential Care Act, Section 1-819 et seq. of Title 63 of the Oklahoma Statutes;
  • An adult day care center or adult day care component of a continuum of care facility licensed under or otherwise subject to the Adult Day Care Act, Section 1-870 et seq. of Title 63 of the Oklahoma Statutes; or
  • Another healthcare facility or long-term care facility as specifically approved by the Board of Dentistry.

Upon receipt of the advanced procedure permit, the dental hygienist may provide hygiene treatments to a new or existing patient in a facility listed in subsection A of this section, utilizing mobile or other applicable dental equipment. In addition to a written record and patient file, the hygienist shall complete a visual recording of the patient’s mouth through video or live teledentistry to aid the dentist in completing an evaluation and diagnosis of the patient. The video recording shall be maintained as part of the patient record.

A dentist shall complete an in-person, live, or recorded teledentistry assessment, diagnosis, and treatment plan for the patient taking into consideration the needs, health, and physical abilities of the patient a minimum of every thirteen (13) months.

The supervising dentist shall maintain all patient records including teledentistry recordings for a period of seven (7) years.

A dental assistant having a minimum of two (2) years of active dental assisting practice may apply to the Board for an expanded duty permit for elder care and public health. Upon receipt of the expanded duty permit, the dental assistant may assist a hygienist while providing treatment in a facility listed in subsection A of this section under the general supervision of the supervising dentist. The patient records shall list the dental assistant providing treatment while assisting the dental hygienist.

SOURCE: OK Statute Title 59, Ch. 7, 328.58 (Accessed Dec. 2023).

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Oregon

Last updated 12/20/2023

Oregon requires out-of-state physicians to acquire active telemonitoring status through …

Oregon requires out-of-state physicians to acquire active telemonitoring status through the Oregon Medical Board before they can perform intraoperative tele-monitoring on patients during surgery.

The Administrative Code defines “telemonitoring” as the “intraoperative monitoring of data collected during surgery and electronically transmitted to a physician who practices in a location outside of Oregon via a telemedicine link for the purpose of allowing the monitoring physician to notify the operating team of changes that may have a serious effect on the outcome or survival of the patient. The monitoring physician is in communication with the operation team through a technician in the operating room.”

The facility where the surgery is to be performed must be a licensed hospital or ambulatory surgical center licensed by the Department of Human Services, must grant medical staff membership and/or clinical privileges to the monitoring physician, and must request the Board grant Telemonitoring active status to the monitoring physician to perform intraoperative telemonitoring on patients during surgery.

Physicians granted Telemonitoring active status must register and pay a biennial active registration fee.

The physician with Telemonitoring active status desiring to have active status to practice in Oregon must submit the reactivation application and fee and satisfactorily complete the reactivation process before beginning active practice in Oregon.

SOURCE: OR Admin. Rules. 847-008-0023. (Accessed Dec. 2023).

Optometry

Telehealth optometrists are subject to all of the provisions of the Oregon optometry law and rules and must meet the same standard of care.

Telehealth prescriptions may only be issued on an initial spectacle or contact lens prescription only after conducting an in-person eye exam prior to delivering telemedicine services.

SOURCE: OAR 852-020-0050. (Accessed Dec. 2023).

Scope of School Psychologist

The School Psychologist and Professional School Psychologist License authorizes the holder to perform the following duties:

  • Provide telemental health supports and services for behavioral and mental health, as trained.

SOURCE: OAR 584-245-0200 Teacher Standards and Practices Commission, Personnel Service Licenses. (Accessed Dec. 2023).

Occupational Therapy Licensing Board Supervision

“Routine supervision” requires the supervisor to have direct contact in person at least every two weeks at the work site or via telehealth as defined in OAR 339-010-0006(9) with interim supervision occurring by other methods, such as telephone or written communication;

“General supervision” requires the supervisor to have at least monthly direct contact in person with the supervisee at the work site or via telehealth as defined in OAR 339-010-0006(9) with supervision available as needed by other methods.

SOURCE: OAR 339-010-0005. (Accessed Dec. 2023).

Supervision of Occupational Therapy Assistants under 339-010-0035 for routine and general supervision, can be done through telehealth, but cannot be done when close supervision as defined in 339-010-0005 is required. The same considerations in (7)(A) through (F) must be considered in determining whether telehealth should be used.

SOURCE: OAR 339-010-0006. (Accessed Dec. 2023).

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Pennsylvania

Last updated 01/22/2024

No Reference Found

No Reference Found

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Puerto Rico

Last updated 12/18/2023

La expedición de una licencia, a cualquier médico cirujano u …

La expedición de una licencia, a cualquier médico cirujano u osteólogo, bajo las disposiciones de este capítulo se entenderá que somete a tal médico cirujano u osteólogo a la jurisdicción del Tribunal Examinador de Médicos en todos los asuntos relacionados con su práctica médica y le será aplicable cualquier legislación o reglamentación relacionada con la misma e, inclusive, estará sujeto a cualquier sanción disciplinaria que pudiera imponérsele, así mismo se entenderá que la tenencia de una licencia en conformidad con este capítulo somete a tal médico cirujano u osteólogo a la jurisdicción del Sistema de Justicia del Estado Libre Asociado de Puerto Rico. Cualquier médico cirujano u osteólogo al que se expida una licencia bajo las disposiciones de este capítulo, se entiende presta su conformidad a producir cualquier récord médico o cualquier material o informe, según le sea solicitado por el Tribunal Examinador y/o a presentarse ante el Tribunal Examinador o cualquier Comité de éste, dentro del término que le indique el Tribunal Examinador luego de ser debidamente notificado por escrito para ello. Tal solicitud será expedida por el Tribunal Examinador a tenor con cualquier querella radicada o investigación iniciada y cuando los récords, materiales o informes sean pertinentes para resolver la referida querella o investigación.

SOURCE: 20 LPRA Section 6004 (Accessed Dec. 2023).

Cualquier médico cirujano u osteólogo que practique la telemedicina, deberá cumplir con la legislación o reglamentación existente en el Estado Libre Asociado de Puerto Rico sobre el manejo y mantenimiento de récords médicos de sus pacientes incluyendo la confidencialidad de los mismos. El médico cirujano u osteólogo será responsable de mantener aquellos controles o mecanismos que aseguren la integridad de la información del récord médico electrónico de forma tal que no pueda ser accesada o alterada por terceras personas que no mantengan una relación médico-paciente, y cuya intervención podría afectar el proceso de diagnóstico y tratamiento del paciente. En el caso de los médicos cirujanos u osteólogos fuera de la jurisdicción también deberán cumplir con cualquier otra disposición existente en el estado o territorio donde se encuentre dicho médico cirujano u osteólogo.

SOURCE: 20 LPRA Section 6005 (Accessed Dec 2023).

Las disposiciones de este capítulo no serán aplicables a la práctica de la telemedicina que realice un médico cirujano u osteólogo fuera de la jurisdicción por razón de una emergencia médica. [Disponiéndose,] que el término emergencia médica será aquella determinada por el médico cirujano u osteólogo, y se entenderá como la práctica que ocurre una sola vez por paciente y que envuelva a un máximo de diez (10) pacientes en una base anual.

Tampoco serán aplicables las disposiciones de este capítulo a un médico cirujano u osteólogo que realice una práctica irregular de telemedicina sin recibir compensación o remuneración de cualquier tipo, ni a las consultas ocasionales que pueda hacer cualquier médico cirujano u osteólogo con un colega fuera de la jurisdicción del Estado Libre Asociado de Puerto Rico, donde no existe una relación directa del médico cirujano u osteólogo que práctica en esa otra jurisdicción con el paciente. No se entenderá como práctica irregular aquella desarrollada o ejercida conforme a cualquier relación contractual.

SOURCE:  20 LPRA Section 6007 (Accessed Dec. 2023).

Toda persona que violare cualesquiera de las disposiciones de este capítulo, o de cualquier reglamento adoptado en virtud de la misma, se entenderá ejerce ilegalmente la medicina, o cirugía o la osteología y estará sujeta a las penalidades dispuestas en la sec. 39 de este título.  El Tribunal Examinador podrá imponer una multa administrativa no mayor de quince mil dólares ($15,000) a cualquier persona que violare cualquier disposición de este capítulo o reglamento adoptado en virtud de la misma o que rehusare obedecer o cumplir cualquier orden o resolución emitida por el mismo. Los derechos que se cobren por concepto de la imposición de multas administrativas ingresarán al Fondo de Salud en una cuenta especial del Tribunal Examinador para el uso exclusivo del mismo. El Tribunal Examinador podrá solicitar del Tribunal de Primera Instancia la expedición de un auto [de] injunction para impedir cualquier violación a este capítulo o al Reglamento adoptado en virtud de la misma.

SOURCE:  20 LPRA Section 6008 (Accessed Dec 2023).

Se crea, adscrito al Departamento de Salud, el Comité de Telemedicina compuesto por once (11) personas, nombradas por el Secretario de Salud. El Comité deberá tener representación de las instituciones hospitalarias, de las compañías aseguradoras, de los médicos participantes, y del Tribunal Examinador, entre otros. El Comité tendrá como función principal definir los servicios a ser reembolsados a través de telemedicina, los métodos para el reembolso de servicios prestados, los mecanismos de financiamiento para la telemedicina, incentivos, aspectos médicos-legales y definiciones de cualesquiera estándares operacionales, entre otros. El Comité deberá rendir al Secretario de Salud informes mensuales y un informe final a los seis (6) meses de su constitución con sus recomendaciones, incluyendo posible legislación a ser presentada.  Nada de lo establecido en esta sección afectará el desarrollo e implantación del Programa Piloto de Telemedicina de los Departamentos de Desarrollo Económico y Comercio y de Salud.

SOURCE:  20 LPRA Section 6010. (Accessed Dec. 2023).

La expedición de una certificación a cualquier médico o profesional de salud cubierto por este capítulo significa, que se somete a la jurisdicción de Puerto Rico y de la Junta de Licenciamiento o de la Junta Examinadora u Organismo Rector, según sea el caso, siéndole aplicable cualquier legislación o reglamentación relacionada con estas e inclusive, estará sujeto a cualquier sanción disciplinaria que pudiera imponérsele. Se entenderá que la tenencia de una certificación de conformidad con este capítulo somete a tal médico o profesional de la salud a la jurisdicción de los Tribunales de Puerto Rico. Cualquier médico o profesional de la salud al que se le expida una certificación bajo las disposiciones de este capítulo, se entiende presta su conformidad a producir cualquier récord médico o cualquier material o informe, según le sea solicitado por la Junta de Licenciamiento o las Juntas Examinadores u Organismo Rector, según sea el caso.

SOURCE:  20 LPRA Section 6011(g). (Accessed Dec. 2023).

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Rhode Island

Last updated 02/01/2024

See Department of Health Policy for Department of Health Telemedicine …

See Department of Health Policy for Department of Health Telemedicine Guidelines for other requirements on RI providers, including medical records, disclosures, and advertising.

SOURCE: RI Department of Health. Telemedicine. (Accessed Feb. 2024).

Virtual Assessment Mechanisms for Eye Exams

An assessment mechanism to conduct an eye assessment or to generate a prescription for contact lenses or visual aid glasses in Rhode Island shall:

  • Provide synchronous or asynchronous interaction between the patient and the provider;
  • Collect the patient’s medical history, previous prescription for corrective eyewear, and length of time since the patient’s most recent in-person comprehensive eye health examination.
  • Disclose to patients and require acceptance in advance as a term of use that:
    • This assessment is not a replacement of an in-person comprehensive eye health examination;
    •  This assessment cannot be used to generate an initial prescription for contact lenses or a follow-up or first renewal of the initial prescription.
    • This assessment may only be used if the patient has had an in-person comprehensive eye health examination within the previous twenty-four (24) months if the patient is conducting an eye assessment or receiving a prescription for visual aid glasses; and
    • The United States Centers for Disease Control and Prevention (CDC) advises contact lens wearers to visit an eye doctor one time a year or more often if needed.

SOURCE:  RI General Law Title 23-97-3. (Accessed Feb. 2024).

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South Carolina

Last updated 02/08/2024

Specific tasks may be delegated to a certified medical assistant …

Specific tasks may be delegated to a certified medical assistant (CMA) by a physician, physician assistant if authorized to do so in his scope of practice guidelines, or advanced practice registered nurse if authorized to do so in his practice agreement. The scope of practice guidelines for a physician assistant and the practice agreement for an advanced practice registered nurse must address what tasks may be appropriately delegated to a CMA, provided, however, that certain tasks, including performing a clinical decision‑making task by means of telemedicine, must not be delegated to a CMA by a physician assistant or advanced practice registered nurse.

SOURCE: SC Code Annotated Sec. 40-47-196. (Accessed Feb. 2024).

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South Dakota

Last updated 12/21/2023

A health care professional or the originating site treating a …

A health care professional or the originating site treating a patient through telehealth shall:

  • Maintain a complete record of the patient’s care;
  • Disclose the record to the patient consistent with state and federal laws; and
  • Follow applicable state and federal statutes and regulations for medical record retention and confidentiality.

SOURCE: SD Codified Laws Sec. 34-52-8. (Accessed Dec. 2023).

Office of Adult Service and Aging

In-home services, which is defined as including “telehealth services”, may be provided to an individual who demonstrates a need for long-term supports and services through an assessment and the following criteria:

  • The individual is residing at home;
  • The individual is age 60 or older or is age 18 or older with a disability; and
  • The individual is not eligible for other programs which provide the same type of service.

SOURCE: SD Regulation 67:40:19:04. (Accessed Dec. 2023).

Mental Health

Reimbursable services are limited to faceto-face and telehealth contacts for the purpose of providing comprehensive mental health treatment pursuant to § 67:62:10:02. (Outpatient)

SOURCE: SD Regulation 67:62:10:03. (Accessed Dec. 2023).

Substance Use Disorder

Telehealth interaction included in the definition for “family counseling,” “group counseling,” and “individual counseling.”

SOURCE: SD Regulation 67:61:01:01. (Accessed Dec. 2023).

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Tennessee

Last updated 01/21/2024

Worker’s Compensation Reimbursement

Payment shall be based on the Medicare …

Worker’s Compensation Reimbursement

Payment shall be based on the Medicare guidelines and coding, with the exception of any geographic restriction.

SOURCE: TN Rule Annotated, 0800-2-17-.05. (5) (Accessed Jan. 2024).

A speech language pathologist who uses an endoscope shall meet all of the following conditions: … Have protocols in place for emergency medical backup for every setting in which the speech language pathologist performs a procedure using an endoscope. A physician must provide general supervision and be readily available in the event of an emergency, including, but not limited to, physical presence at the setting or availability by telephone or telehealth, as defined in § 63-1-155.

SOURCE: TN Code Annotated Sec. 63-17-103 (Accessed Jan. 2024).

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Texas

Last updated 01/07/2024

The e-Health Advisory Committee (committee) is established under Texas Government …

The e-Health Advisory Committee (committee) is established under Texas Government Code §531.012 and is subject to §351.801 of this division (relating to Authority and General Provisions).

The committee advises the Texas Health and Human Services Commission (HHSC) Executive Commissioner and Health and Human Services system agencies (HHS agencies) on strategic planning, policy, rules, and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth, and home telemonitoring services.

The committee is abolished and this section expires on December 31, 2025.

SOURCE: TX Admin. Code, Title 1, Sec. 351.823.  (Accessed Jan. 2024).

Direct observation of a patient by a health professional or direct care or services provided to a patient by a health professional includes the provision of that observation, care, or service using telehealth services.

The commission may adopt rules as necessary to:

  • Ensure that patients receiving telehealth services receive appropriate, quality care;
  • Prevent abuse and fraud in the use of telehealth services, including rules relating to the filing of claims and records required to be maintained in connection with telehealth services;
  • Implement the requirements of Chapter 111 or other laws of this state regarding the provision of telehealth services or the protection of patients receiving telehealth services;
  • Provide for the remote supervision of assistants and other authorized persons performing duties within their existing scope of practice using telecommunications or information technology; and
  • Provide for the remote supervision of experience for apprentices, interns, or other similar trainees using telecommunications or information technology.

Rules under this section may allow for the provision of:

  • Remote education or distance learning for public or private schools; and
  • Continuing education using telecommunications or information technology.

SOURCE: TX Occupations Code Title 2, Ch. 51, Subchapter J, Sec. 51.501, (Accessed Jan. 2024).

Licensed Dyslexia Practitioners and Licensed Dyslexia Therapists

A licensed dyslexia practitioner may practice only in, or provide telehealth services from a remote location only to, an educational setting, including a school, learning center, or clinic.

A licensed dyslexia therapist may practice in, or provide telehealth services from a remote location to, a school, learning center, clinic, or private practice setting.

A license holder may provide telehealth services only in a practice setting described by this section, regardless of the physical location of the license holder or the recipient of the telehealth services.

SOURCE: TX Occupations Code 403.151, (Accessed Jan. 2024).

Occupational Therapists

The occupational therapist is responsible for determining whether any aspect of the evaluation may be conducted via telehealth or must be conducted in person.

The occupational therapist must have contact with the client during the evaluation. The contact must be synchronous audio and synchronous visual contact that is in person, via telehealth, or via a combination of in-person contact and telehealth. Other telecommunications or information technology may be used to aid in the evaluation but may not be the primary means of contact or communication.

SOURCE: TX Admin. Code, Title 40 Sec. 372.1. (Accessed Jan. 2024).

Hospital Level of Care Designation for Maternal Care

See rule for program requirements around telemedicine for hospital level of care designation for maternal care.

SOURCE: TX Admin. Code, Title 25, Part 1, Sec. 133.205. (Accessed Jan. 2024).

Inmate Welfare

The department, in conjunction with The University of Texas Medical Branch at Galveston and the Texas Tech University Health Sciences Center, shall establish procedures to increase opportunities and expand access to telemedicine medical services and telehealth services, as those terms are defined by Section 111.001, Occupations Code, and on-site medical care for inmates, including on-site mobile care units that provide diagnostic imaging, physical therapy, and other appropriate mobile health services.

SOURCE: TX Government Code 501.071 (Accessed Jan. 2024).

The commission, with the assistance of the center, shall establish a pilot project to provide emergency medical services instruction and emergency prehospital care instruction through a telemedicine medical service or telehealth service provided by regional trauma resource centers to:

  • health care providers in rural area trauma facilities; and
  • emergency medical services providers in rural areas.

See statute for details.

SOURCE: Health and Safety Code 771.152, (Accessed Jan. 2024).

The Texas Medical Board, in consultation with the commissioner of insurance, as appropriate, may adopt rules necessary to:

  • Ensure that patients using telemedicine medical services receive appropriate, quality care;
  • Prevent abuse and fraud in the use of telemedicine medical services, including rules relating to the filing of claims and records required to be maintained in connection with telemedicine medical services;
  • Ensure adequate supervision of health professionals who are not physicians and who provide telemedicine medical services; and
  • Establish the maximum number of health professionals who are not physicians that a physician may supervise through a telemedicine medical service.

The State Board of Dental Examiners, in consultation with the commissioner of insurance, as appropriate, may adopt rules necessary to:

  • Ensure that patients using teledentistry dental services receive appropriate, quality care;
  • Prevent abuse and fraud in the use of teledentistry dental services, including rules relating to the filing of claims and records required to be maintained in connection with teledentistry dental services;
  • Ensure adequate supervision of health professionals who are not dentists and who provide teledentistry dental services under the delegation and supervision of a dentist; and
  • Authorize a dentist to simultaneously delegate to and supervise through a teledentistry dental service not more than five health professionals who are not dentists.

SOURCE: TX Occupational Code Title 3, Subtitle A, Chapter 111, Sec. 111.004.  (Accessed Jan. 2024).

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Utah

Last updated 11/29/2023

If a licensee participates in telehealth, it shall develop and …

If a licensee participates in telehealth, it shall develop and implement policies governing the practice of telehealth in accordance with the scope and practice of the hospital and in accordance with Section 26B-4-704.

The licensee’s telehealth policies shall address security, access, and retention of telemetric data.

The licensee’s telehealth policies shall define the privileging of physicians and allied health professionals who participate in telehealth.

SOURCE: UT Admin. Code R432-100-33. (Accessed Nov. 2023).

Utah established the Early Childhood Psychotherapeutic Telehealth Consultation Program.

SOURCE: UT Code Sec. 26B-1-328, (Accessed Nov. 2023)

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Vermont

Last updated 12/05/2023

“Store and forward” means an asynchronous transmission of medical information, …

“Store and forward” means an asynchronous transmission of medical information, such as one or more video clips, audio clips, still images, x-rays, magnetic resonance imaging scans, electrocardiograms, electroencephalograms, or laboratory results, sent over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191 to be reviewed at a later date by a health care provider at a distant site who is trained in the relevant specialty. In store and forward, the health care provider at the distant site reviews the medical information without the patient present in real time and communicates a care plan or treatment recommendation back to the patient or referring provider, or both.

SOURCE: VT Statutes Annotated, Title 26, Ch. 56, Sec. 3052, (Accessed Dec. 2023).

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Virgin Islands

Last updated 12/18/2023

For Medicine, Surgery, Dentistry, Pharmacy, Nursing and Nurse-Midwifery

The Board …

For Medicine, Surgery, Dentistry, Pharmacy, Nursing and Nurse-Midwifery

The Board of Medical Examiners may establish regulations for telemedicine licensure as follows:

  • The Board of Medical Examiners shall issue a telemedicine license to authorize certain physicians, who hold a full and unrestricted license to practice medicine in another state or territory of the United States, to provide telemedicine services in the Virgin Islands.
  • Telemedicine licenses shall be without private practice rights and without subversion of reciprocity. Any healthcare professional licensed in the Virgin Islands may practice telemedicine without restriction.
  • The Board of Medical Examiners shall establish by rules and regulations the requirements for telemedicine licensure in accordance with this subchapter, provided that the rules and regulations include the following:
    1. A physician holding only a telemedicine license under this subchapter shall not open an office in the Virgin Islands, shall not meet with patients in the Virgin Islands, and shall not receive calls from patients in the Virgin Islands.
    2. The physician, when examining a patient by telemedicine, shall establish a bona fide physician-patient relationship by:
      • Establishing a relationship and coordinating with the patient’s Virgin Islands-licensed healthcare professional.
      • 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 of Medical Examiners.
  • Any physician licensed to practice telemedicine in accordance with this subchapter, shall be subject to the provisions of this subchapter, the jurisdiction of the Board of Medical Examiners, applicable Virgin Islands law, and the jurisdiction of the courts of the Virgin Islands with respect to providing medical services to Virgin Islands residents.
  • The Department of Health and the Territory’s hospitals and medical centers and Virgin Islands-licensed health care professionals are authorized to bill third-party payers for consultations and follow-up care provided by licensed providers of telemedicine services.

SOURCE: V.I. Code Title 27, § 45d (2019). (Accessed Dec. 2023).

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Virginia

Last updated 01/05/2024

Telemedicine Guidance from VA Medical Board includes:

  • Establishing the practitioner-patient

Telemedicine Guidance from VA Medical Board includes:

  • Establishing the practitioner-patient relationship
  • Guidelines for appropriate use of telemedicine services
  • Prescribing
  • Electronic medical services that do not require licensure

See guidance for details and statutory references.

SOURCE: Telemedicine Guidance. Doc. # 85-12. VA Board of Medicine. (Aug. 19, 2021). (Accessed Jan. 2024).

The Board shall amend and maintain, in consultation with the Virginia Telehealth Network, as a component of the State Health Plan a Statewide Telehealth Plan to promote an integrated approach to the introduction and use of telehealth services and telemedicine services. The Board shall contract with the Virginia Telehealth Network, or another Virginia-based nongovernmental, nonprofit organization focused on telehealth if the Virginia Telehealth Network is no longer in existence, to (i) provide direct consultation to any advisory groups and groups tasked by the Board with implementation and data collection as required by this section, (ii) track implementation of the Statewide Telehealth Plan, and (iii) facilitate changes to the Statewide Telehealth Plan as accepted medical practices and technologies evolve.  See code for details.

SOURCE: VA Code Annotated Sec. 32.1-122.03:1 (C(1), (Accessed Jan. 2024).

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Washington

Last updated 12/15/2023

Beginning Jan. 1, 2021, a health care professional who provides …

Beginning Jan. 1, 2021, a health care professional who provides clinical services through telemedicine, other than a physician licensed under chapter 18.71 RCW or an osteopathic physician licensed under chapter 18.57 RCW, shall complete a telemedicine training. By January 1, 2020, the telemedicine collaborative shall make a telemedicine training available on its web site for use by health care professionals who use telemedicine technology. If a health care professional completes the training, the health care professional shall sign and retain an attestation. The training:

  • Must include information on current state and federal law, liability, informed consent, and other criteria established by the collaborative for the advancement of telemedicine, in collaboration with the department and the Washington state medical quality assurance commission;
  • Must include a question and answer methodology to demonstrate accrual of knowledge; and
  • May be made available in electronic format and completed over the internet.

A health care professional is deemed to have met the requirements of subsection (2) of this section if the health care professional:

  • Completes an alternative telemedicine training; and
  • Signs and retains an attestation that he or she completed the alternative telemedicine training.

SOURCE: RCW 43.70.495 (WA SB 6061 – 2020). (Accessed Dec. 2023).

Collaborative for the advancement of telemedicine was created to develop recommendations on improving reimbursement and access to care, and review the concept of telemedicine payment parity.  They were required to submit policy reports with recommendations in December 2017, 2018, and December 2021.  Recent legislation requires the collaborative to study store and forward technology with an emphasis on utilization, whether it should be paid for at parity, the potential for store and forward to improve rural health outcomes and ocular services.

SOURCE: RCW 28B.20.830. (Accessed Dec. 2023).

The insurance commissioner, in collaboration with the Washington state telehealth collaborative and the health care authority, shall study and make recommendations for audio-only telemedicine, among other items.

SOURCE: HB 1196 (2021 Session), (Accessed Dec. 2023).

During a telemedicine visit, supervision over a medical assistant assisting a health care practitioner with the telemedicine visit may be provided through interactive audio and video telemedicine technology.

SOURCE: Revised Code of Washington Sec. 18.360.010 & WAC 246-827-0140 as added by Permanent Rule. (Accessed Dec. 2023).

Home Health and Hospice

“Established relationship” means the patient has had, within the past two years, at least one in-person appointment with the agency provider providing audio-only telemedicine or with a provider employed at the same agency as the provider providing audio-only telemedicine; or the patient was referred to the agency provider providing audio-only telemedicine by another provider who has had, within the past two years, at least one in-person appointment with the patient and has provided relevant medical information to the provider providing audio-only telemedicine.

SOURCE: WAC 246-335-510(8)WAC 246-335-610. (Accessed Dec. 2023).

For patients receiving acute care services, supervision of the home health aide services with or without the home health aide present must occur once a month to evaluate compliance with the plan of care and patient satisfaction with care. The supervisory visit may be conducted on-site, via telemedicine, or via audio-only telemedicine and must be conducted by a licensed nurse or therapist in accordance with the appropriate practice acts.

For patients receiving maintenance care or home health aide only services, supervision of the home health aide services with or without the home health aide present must occur every six months to evaluate compliance with the plan of care and patient satisfaction with care. The supervisory visit may be conducted on-site, via telemedicine, or via audio-only telemedicine and must be conducted by a licensed nurse or licensed therapist in accordance with the appropriate practice acts.

A supervisory visit conducted via audio-only telemedicine in subsection (7) or (8) of this section is only permitted for patients that have an established relationship with the provider consistent with WAC 246-335-510(8).

A supervisory visit conducted via telemedicine or via audio-only telemedicine in subsection (7) or (8) of this section may not be used to fulfill the annual performance evaluations and on-site observation of care and skills requirements in WAC 246-335-525(16).

SOURCE: WAC 246-335-545(7-10)WAC 246-335-645. (Accessed Dec. 2023).

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West Virginia

Last updated 02/16/2024

Final Rule (Effective until August 1, 2030) – Social Workers

Final Rule (Effective until August 1, 2030) – Social Workers

A social worker shall maintain current competence in the use of telehealth and technology through relevant continuing education or consultation.

SOURCE: WV Admin Law 25-1-5. (Accessed Feb. 2024).

Final Rule (Effective until August 1. 2032) – Teledentistry

A dentist registered to provide teledentistry services shall complete continuing education as required by the State her or she is licensed in, but shall complete 3 hours of drug diversion as set forth in subdivision 3.5.4. of this rule every two years.5.2. A dental hygienist registered to provide teledentistry services shall complete continuing education as required by the State her or she is licensed in.

SOURCE: WV Admin Law 5-11-5. (Accessed Feb. 2024)

HB 4333 (2022 Session) – Speech-Language Pathology and Audiology & Hearing-Aid Dealers and Fitters

The Board of Examiners for Speech-Language Pathology and Audiology is required to propose rules including guidelines for telepractice that also apply to hearing aid fitters.

SOURCE: WV Statute Sec. 30-32-7 and 30-26-21. (Accessed Feb. 2024).

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Wisconsin

Last updated 01/11/2024

No reference found.

No reference found.

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Wyoming

Last updated 01/31/2024

Boards have power to adopt rules and regulations allowing the …

Boards have power to adopt rules and regulations allowing the practice of telemedicine/telehealth and the use of telemedicine/telehealth technologies within an applicable profession or occupation consistent with the profession’s or occupation’s duties and obligations. For purposes of this paragraph, telemedicine/telehealth shall be defined within each promulgated rule in a manner applicable to the individual profession or occupation and in a manner which facilitates the development and promotion of uniform, system wide standards for the practice of telemedicine/telehealth and the use of telemedicine/telehealth technologies.  Any board promulgating rules under this paragraph shall first confer with the office of rural health for the purpose of promoting the goals established by W.S. 9-2-117(a)(vi) through (viii).

SOURCE:  WY Code 33-1-303(a(iv)). (Accessed Jan. 2024).

Connect Wyoming Program

Applicants of the Connect Wyoming Program are certifying that the funds shall be used to fund projects that create and retain local jobs and result in purposeful outcomes, including distance learning, telehealth public safety, commerce, and overall well-being.

SOURCE: WY Admin Rules and Regulations, Agency 085, Broadband Development Grant Program, Ch. 4, Sec. 12, (Accessed Jan. 2024).

Office of Rural Health

The office of rural health is created within the department of health. The office shall:

In collaboration with the state health officer and the state chief information officer, represent the department of health in a consortium of state agencies, private health organizations and professional and community organizations to facilitate the operations of a statewide interoperable telemedicine/telehealth network using existing internet protocol based communication and videoconferencing infrastructure and telecommunication services to the extent possible. The consortium shall:

  • Consist of members appointed by the director of the department of health, to include the Wyoming chief information officer or the officer’s designee;
  • Coordinate the development and promotion of statewide standards for an interoperable telemedicine/telehealth network and, where applicable, promote definitions and standards for statewide electronic health transactions
  • Promote and conduct education programs that inform network users that information communicated through the use of telemedicine/telehealth shall conform with state and federal privacy and security laws and information security programs established by the state chief information officer
  • Have the authority to seek funds for consortium operation and contract as needed to carry out its responsibilities.

In collaboration with the state health officer and the state chief information officer or their designees, coordinate with appropriate state agencies to establish incentives to implement, promote and facilitate the voluntary exchange of secure telemedicine/telehealth network information between and among individuals, entities and agencies that are providing and paying for services authorized under the Medicaid program, in conformity with rules adopted by the state chief information officer

In collaboration with the state health officer and the state chief information officer or their designees, develop and promote a common direction for a statewide interoperable telemedicine/telehealth network among state agencies, in conformity with rules adopted by the department of enterprise technology services

As required by W.S. 33-1-303(a)(iv) and in collaboration with the state health officer and the state chief information officer or their designees, collaborate with professional and occupational licensure boards concerning the promulgation of rules and definitions related to the practice of telemedicine/telehealth and the use of telemedicine/telehealth technologies.

SOURCE: WY Statutes Annotated, 9-2-117. (Accessed Jan. 2024).

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Professional Requirements

Miscellaneous

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