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.

Click the map to scroll down to the state

Federal

Last updated 10/10/2021

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Alabama

Last updated 09/27/2021

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Alaska

Last updated 07/29/2021

The Department of Commerce, Community and Economic Development has adopted …

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.

SOURCE: AK Admin Code. Sec. 600 (Accessed July 2021) & AK Dept. of Commerce, Community, and Economic Development, Occupational Licensing Centralized Regulations, Article 5. June 2021. (Accessed July 2021).

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Arizona

Last updated 09/20/2021

Arizona established a telehealth advisory committee on telehealth best practices …

Arizona established a telehealth advisory committee on telehealth best practices in order to adopt telehealth best practice guidelines and recommendations regarding the health care services that may be appropriately provided through an audio-only telehealth format and make updates, when applicable.

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: House Bill 2454 (2021 Session), (Accessed Sept. 2021).

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Arkansas

Last updated 10/08/2021

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California

Last updated 08/28/2021

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 (AB 1519 – 2019 Legislative Session). (Accessed Aug. 2021).

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 (AB 1519 – 2019 Legislative Session). (Accessed Aug. 2021).

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

SOURCE: AB 3242 (2019-2020 Legislative Session). (Accessed Aug. 2021).

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Colorado

Last updated 08/19/2021

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

Colorado law includes in its definition of “health care services” the rendering of services via telehealth.

SOURCE: CO Revised Statutes 10-16-102(33).  (Accessed Aug. 2021).

HB 20-1230 Sunset Occupational Therapy Practice Act

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

SOURCE: Sunset Occupational Therapy Practice Act HB 20-1230 co. (Accessed Aug. 2021).

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

SOURCE: 7 CCR 1101-3, Rule 18-4(I)(4) (Accessed Aug. 2021).

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 Aug. 2021).

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 Aug. 2021).

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Connecticut

Last updated 06/30/2021

Effective Now Until June 30, 2023

A telehealth provider may …

Effective Now Until June 30, 2023

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 Medicaid or the Children’s Health Insurance 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 the effective date of this section and ending on June 30, 2023, 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 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) (Accessed June 2021).

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Delaware

Last updated 07/12/2021

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District of Columbia

Last updated 08/23/2021

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Florida

Last updated 07/17/2021

HB 5001 makes appropriations to certain telehealth programs and pilots.…

HB 5001 makes appropriations to certain telehealth programs and pilots.

SOURCE: FL State Senate. HB 5001 (Mar. 19, 2020). (Accessed July 2021).

 

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Georgia

Last updated 10/01/2021

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Hawaii

Last updated 09/29/2021

Professional liability insurance for health care providers must provide malpractice …

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 Sept. 2021).

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Idaho

Last updated 10/05/2021

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Illinois

Last updated 08/25/2021

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.

“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 & 15/15. As amended by HB 3308 (2021 Session). (Accessed Aug. 2021).

Optometrists: Effective January 1, 2022

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: SB 567 (2021 Session). (Accessed Aug. 2021).

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Indiana

Last updated 08/25/2021

Every practitioner who is renewing online a license issued by …

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: … 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, as amended by Senate Bill 3 (Accessed Aug. 2021).

The medical records must be created and maintained by the practitioner under the same standards of appropriate practice for medical records for patients in an in-person setting.

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. as amended by SB 3 (2021). (Accessed Aug. 2021).

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Iowa

Last updated 10/13/2021

Iowa provides a list of persons and entities authorized to …

Iowa provides a list of persons and entities authorized to use the fiber optic network to provide services via telemedicine. The list includes:

  • Licensed health care professionals or licensed health care professionals who function under the direction of or collaboration with a physician or a hospital;
  • Hospital or physician clinic staff members;
  • Professional boards on which health professionals serve;
  • 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;
  • Professional board members where the health care professional serves as a member of the board.

SOURCE: IA Admin. Code, 751 7.11(8D). (Accessed Oct. 2021). 

An intern psychologist may also provide services via telehealth, to underserved populations, and to Medicaid members in the location of the intern psychologist’s placement, notwithstanding any change in the mental health professional shortage area designation of such location.

SOURCE: IA HF 891 (2021) p. 10. (Accessed Oct. 2021). 

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: HF 685 (2021). (Accessed Oct. 2021). 

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Kansas

Last updated 08/30/2021

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Kentucky

Last updated 09/15/2021

There is hereby created a Division of Telehealth Services within …

There is hereby created a Division of Telehealth Services within the Office of Health Data and Analytics to be headed by a director appointed by the secretary pursuant to 12 KRS 12.050. The division shall provide oversight, guidance, and direction to Medicaid providers delivering care using telehealth. The division shall implement telehealth services and develop standards, guidance, resources, and education to help promote access to healthcare services in the Commonwealth.

SOURCE: KY Revised Statute 194A.105 as amended by HB 140 (2021 Session), (Accessed Sept. 2021).

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.

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Louisiana

Last updated 08/26/2021

Louisiana has specific standards for its telemedicine physicians.

SOURCE: LA

Louisiana has specific standards for its telemedicine physicians.

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

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

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

Teledentistry

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

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

See rule for complete requirements.

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

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Maine

Last updated 08/06/2021

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

See Joint Rule on office-based treatment of opioid use disorder for telemedicine 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 Aug. 2021).

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Maryland

Last updated 08/31/2021

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: HB 448/SB 402. (2020 Session). (Accessed Aug. 2021).

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Massachusetts

Last updated 09/01/2021

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 include:

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

SOURCE: Massachusetts Senate No. 2984. Section 27, para. 407 (Accessed Sept. 2021)Title XVI, Chapter 111, Section 1, Massachusetts General Laws (Accessed Sept. 2021)

Involuntary Commitment

The requirement for examination may be satisfied through utilization of telemedicine or other technology pursuant to protocols approved by the Department that assure verbal and visual observation and communication between the patient and an off-premises authorized clinician and adequate on-premises clinical staff only in cases where restraint or seclusion episode has ended, the patient has been permanently released from restraint or seclusion in accordance with 104 CMR 27.12(8)(h)8., and there are no apparent medical or physical conditions, including injury, related to the mechanical restraint or seclusion restraint that require an in-person examination.

SOURCE: 104 Code of Massachusetts Regulations (CMR) 27.12, (Accessed Sept. 2021).

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Michigan

Last updated 09/02/2021

A health care provider or health care facility that provides …

A health care provider or health care facility that provides health care services (including telehealth) in support of this state’s response to the COVID-19 pandemic is not liable for an injury, including death, sustained by an individual by reason of those services, regardless of how, under what circumstances, or by what cause those injuries are sustained, unless it is established that the provision of the services constituted willful misconduct, gross negligence, intentional and willful criminal misconduct, or intentional infliction of harm by the health care provider or health care facility.

SOURCE: MI HB 6159 (2020 Session. (Accessed Sept. 2021). 

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Minnesota

Last updated 09/14/2021

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Mississippi

Last updated 08/13/2021

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 Aug. 2021). 

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 Aug. 2021).

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 Aug. 2021).

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Missouri

Last updated 08/04/2021

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Montana

Last updated 09/07/2021

An audiology assistant or a speech-language pathology assistant may engage …

An audiology assistant or a speech-language pathology assistant may engage in telehealth or provide other services as directed by a speech language pathologist or audiologist that otherwise comply with board rules for scope of practice by speech language pathology assistants and audiology assistants.

SOURCE: Senate Bill 357 (2021 Session), (Accessed Sept. 2021)

 

 

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Nebraska

Last updated 08/02/2021

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 Aug. 2021).

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Nevada

Last updated 07/28/2021

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.

The Patient Protection Commission; the Legislative Committee on Healthcare; the Commission on Behavioral Health; Regional Behavioral Health Policy Boards; shall review access by different groups and populations to services provided through telehealth evaluate policies to make such access more equitable (if data dashboard is established). The Commission shall also make data available on the internet.

SOURCE: Senate Bill 5 (2021 Session) & NV Revised Statute Ch. 439; 439.916; 439B.220; 433.314; 433.4295 (Accessed Jul. 2021).

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 Jul. 2021).

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New Hampshire

Last updated 07/26/2021

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 Jul. 2021).

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New Jersey

Last updated 07/21/2021

Each telehealth or telemedicine organization operating in the State shall …

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 Jul. 2021).

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

SOURCE: NJ Statute C.45:1-65. (Accessed Jul. 2021).

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 allow for the electronic transmission of images, diagnostics, data, and medical information; except that the health care provider may use interactive, real-time, two-way audio in combination with asynchronous store-and-forward technology, without video capabilities, 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.

See statute for additional telemedicine/telehealth practice standards.

SOURCE: NJ Statute C.45:1-62(c)(2). (Accessed Jul. 2021).

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 Jul. 2021).

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New Mexico

Last updated 07/19/2021

New Mexico is also the home of Project ECHO.  The …

New Mexico is also the home of Project ECHO.  The project’s mission is to develop the capacity to safely and effectively treat chronic, common, and complex diseases in rural and underserved areas, and to monitor outcomes of this treatment utilizing technology.

SOURCE: University of New Mexico School of Medicine. Project ECHO. (Accessed Jul. 2021).

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New York

Last updated 07/15/2021

Telemental health services may only be utilized in personalized Recovery …

Telemental health services may only be utilized in personalized Recovery Oriented Services program or Assertive Community Treatment programs under certain conditions.

SOURCE: NY Code of Rules and Regs.  Title 14, Sec. 596.3 (Accessed Jul. 2021).

Office of Alcoholism and Substance Abuse Services (OASAS)

Telepractice services, as defined in this Part, may be authorized by the office for the delivery of certain addiction services provided by practitioners employed by, or pursuant to a contract or memorandum of understanding (MOU) with a program certified by the office.  See regulation for details.

SOURCE:  NY Codes, Rules and Regulations, Title 14, Chapter XXI, Part 830.5. (Accessed Jul. 2021).

Providers requesting authorization to use this means of service delivery must submit a Telepractice Plan and Attestation (Appendix B) to their Regional Office and to the OASAS Bureau of Certification.

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

SOURCE:  NY Office of Alcoholism and Substance Abuse Services.  Telepractice Standards for OASAS Designated Providers.  (Dec. 2019).  (Accessed Jul. 2021).

Demonstration rates of payment or fees shall be established for telehealth services provided by a certified home health agency, a long term home health care program or AIDS home care program, or for telehealth services by a licensed home care services agency under contract with such an agency or program, in order to ensure the availability of technology-based patient monitoring, communication and health management. Reimbursement is provided only in connection with Federal Food and Drug Administration-approved and interoperable devices that are incorporated as part of the patient’s plan of care.

SOURCE: NY Public Health Law Article 36 Section 3614(3-c). (Accessed Jul. 2021).

Independent Practitioner Services for Individuals with Developmental Disabilities (IPSIDD) are prohibited from being delivered via telehealth.

SOURCE: NY Code of Rules and Regs. Title 14, Sec. 635-13.4(c). (Accessed Jul. 2021).

Each agency that operates a clinic treatment facility shall provide the Office for People with Developmental Disabilities (OPWDD) information it requests, including but not limited to the following: services provided by CPT/HCPCS and/or CDT codes, where such services were delivered, including the location of both the provider and the individual when services are delivered via telehealth, (i.e., on-site or at a certified satellite site, or, prior to April 1, 2016, off-site) and revenues by funding SOURCE or payee. These data shall correspond to the identical time period of the cost report.

SOURCE: NY Code of Rules and Regs. Title 14, Sec. 679.6(b). (Accessed Jul. 2021).

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North Carolina

Last updated 09/26/2021

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 Jul. 2021).

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

SOURCE: N.C. Gen. Stat. § 122C-263(c) & House Bill 734 (2021 Session), (Accessed Jul. 2021).

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 Jul. 2021).

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

SOURCE: 21 NCAC 64 .1104(a)(8). (Accessed Feb. 2021).

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 SB 146 (2021 Session) (Accessed Sept. 2021).

If a commitment examiner is not available, whether on-site, on-call, or via telehealth, at any facility or location, or if a plan has not been adopted, the person designated to provide transportation shall take the respondent to an alternative non-hospital provider or facility-based crisis center for a first examination in conjunction with a health screening at the same location.

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.

A commitment examiner who examines a respondent by means of telehealth must be satisfied to a reasonable medical certainty that the determinations made in accordance with subsection (d) of this section would not be different if the examination had been done in the physical presence of the commitment examiner.

SOURCE: NC HB 734 (2021 Session) (Accessed Sept. 2021).

 

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North Dakota

Last updated 07/08/2021

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). (Accessed Jul. 2021).

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Ohio

Last updated 07/06/2021

A health care professional providing telemedicine services shall not charge …

A health care professional providing telemedicine services shall not charge a facility fee, an origination fee, or any fee associated with the cost of the equipment used to provide telemedicine services to a health plan issuer covering telemedicine services.

SOURCE:  OH Revised Code, Sec. 4731.2910.  (Accessed Jul. 2021).

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Oklahoma

Last updated 06/29/2021

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 Jun. 2021).

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 Jun. 2021).

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Oregon

Last updated 06/30/2021

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 Jun. 2021).

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Pennsylvania

Last updated 10/14/2021

No Reference Found

No Reference Found

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Rhode Island

Last updated 06/25/2021

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 Jun. 2021).

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South Carolina

Last updated 06/19/2021

No Reference Found

No Reference Found

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South Dakota

Last updated 09/13/2021

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 Sept. 2021).

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 Sept. 2021).

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Tennessee

Last updated 06/14/2021

Teledentistry means “the delivery of dental health care and patient …

Teledentistry means “the delivery of dental health care and patient consultation through the use of telehealth systems and technologies, including live, two-way interactions between a patient and a dentist licensed in this state using audiovisual telecommunications technology, or the secure transmission of electronic health records and medical data to a dentist licensed in this state to facilitate evaluation and treatment of the patient outside of a real-time or in-person interaction.”

Any and all services provided via teledentistry shall be consistent with the in-person provision of those services. Any and all services provided via teledentistry shall comply with this chapter and shall be provided in accordance with the rules of the board of dentistry.

SOURCE: TN Code Annotated 63-5-108, (Accessed Jun. 2021).

Worker’s Compensation Reimbursement

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

SOURCE: TN Rule Annotated, 0800-2-17-.05. (5) (Accessed Jun. 2021).

Provider-based telemedicine is subject to utilization review under the Health Care Service Utilization Review Act, compiled in chapter 6, part 7 of this title.

SOURCE:  TN Code Sec. 56-7-1002 & 1003 (Accessed Jun. 2021).

Practice of physical therapy means by in-person encounter or via telehealth, telemedicine or provider-based telemedicine.”

SOURCE: TN Code Annotated 63-13-103, as amended by House Bill 1275 & Senate Bill 1072 (2021 Session), (Accessed Jun 2021).

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Texas

Last updated 09/22/2021

An e-Health Advisory Committee was established under TX Government Code …

An e-Health Advisory Committee was established under TX Government Code Section 531.012 and is comprised of no more than 24 members, including:

  • At least one expert on telemedicine
  • At least one expert on home telemonitoring services
  • At least one representative of consumers of health services provided through telemedicine.

SOURCE: TX Admin. Code, Title 1, Sec. 351.823. (2016, amended to be effective Jan. 27, 2020). (Accessed Sept. 2021).

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 as amended by SB 40 (2021 Session), (Accessed Sept. 2021).

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, as amended by SB 40 (2021 Session), (Accessed Sept. 2021).

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Utah

Last updated 06/09/2021

If a hospital participates in telemedicine, it shall develop and …

If a hospital participates in telemedicine, it shall develop and implement policies governing the practice of telemedicine in accordance with the scope and practice of the hospital.

These policies shall address security, access and retention of telemetric data, and define the privileging of physicians and allied health professionals who participate in telemedicine.

SOURCE: UT Admin. Code R432-100-33. (Accessed Jun. 2021).

Utah established the Early Childhood Psychotherapeutic Telehealth Consultation Program.

SOURCE: UT Code Sec. 62A-15-1602, (Accessed Jun. 2021).

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Vermont

Last updated 06/02/2021

Audio-Only Telephone Requirements

Subject to the limitations of the license …

Audio-Only Telephone Requirements

Subject to the limitations of the license under which the individual is practicing and, for Medicaid patients, to the extent permitted by the Centers for Medicare and Medicaid Services, a health care provider may deliver health care services to a patient using audio-only telephone if the patient elects to receive the services in this manner and it is clinically appropriate to do so. A health care provider shall comply with any training requirements imposed by the provider’s licensing board on the appropriate use of audio-only telephone in health care delivery.

A health care provider delivering health care services using audio- only telephone shall include or document in the patient’s medical record:

  • the patient’s informed consent for receiving services using audio- only telephone in accordance with subsection (c) of this section; and
  • the reason or reasons that the provider determined that it was clinically appropriate to deliver health care services to the patient by audio- only telephone.

A health care provider shall not require a patient to receive health care services by audio-only telephone if the patient does not wish to receive services in this manner.

A health care provider shall deliver care that is timely and complies with contractual requirements and shall not delay care unnecessarily if a patient elects to receive services through an in-person visit or telemedicine instead of by audio-only telephone.

A health care provider delivering health care services by audio-only telephone shall obtain and document a patient’s oral or written informed consent for the use of audio-only telephone prior to the appointment or at the start of the appointment but prior to delivering any billable service.

Neither a health care provider nor a patient shall create or cause to be created a recording of a provider’s telephone consultation with a patient.

Audio-only telephone services shall not be used in the following circumstances:

  • for the second certification of an emergency examination determining whether an individual is a person in need of treatment pursuant to section 7508 of this title; or
  • for a psychiatrist’s examination to determine whether an individual is in need of inpatient hospitalization pursuant to 13 V.S.A. § 4815(g)(3).

SOURCE: 18 Vermont Statute Annotated Ch. 219, Sec. 9362, & Senate Bill 117 (2021 Session), (Accessed May 2021).

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Virginia

Last updated 09/20/2021

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 Sept. 2021).

By Jan. 1. 2021, Virginia requires the Board of Health to develop and implement a Statewide Telehealth plan to promote an integrated approach to the introduction and use of telehealth services and telemedicine services. The bill requires the Statewide Telehealth Plan to promote:

  • the use of remote patient monitoring services and store-and-forward technologies, including in cases involving patients with chronic illness;
  • the leveraging of telehealth and telemedicine technologies to streamline general practice and nonemergency triage services;
  • rapid patient access to emergency medicine providers through telehealth services and telemedicine services;
  • such other telehealth services and telemedicine services and technologies as the Board of Health deems appropriate

SOURCE: VA Code Annotated Sec. 32.1-122.03 (C(1), (Accessed Sept. 2021).

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Washington

Last updated 09/08/2021

Recently Passed Legislation (Now Effective)

Beginning Jan. 1, 2021, a …

Recently Passed Legislation (Now Effective)

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 Sept. 2021).

WA State requires a provider directory to be updated monthly.  For each health plan, the associated provider directory must include information about available telemedicine services and specifically described.

SOURCE: WAC 284-107-260. (Accessed Sept. 2021).

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, and 2018, and are required to issue another in 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:  SB 6163 – 2018 & SB 5385 (2020 Session).  (Accessed Sept. 2021).

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

SOURCE: HB 1196 (2021 Session), (Accessed Sept. 2021).

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 as revised by HB 1378 (2021 Session), (Accessed Sept. 2021).

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West Virginia

Last updated 09/10/2021

Emergency Rule (Effective until July 1, 2030) – Social Workers

Emergency Rule (Effective until July 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 Sept. 2021).

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Wisconsin

Last updated 09/07/2021

No Reference Found

No Reference Found

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Wyoming

Last updated 09/03/2021

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.

SOURCE:  WY Code 33-1-303(a(iv)). (Accessed Sept. 2021).

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Professional Requirements

Miscellaneous

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