Miscellaneous

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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 Dec. 2020) & AK Dept. of Commerce, Community, and Economic Development, Occupational Licensing Centralized Regulations, Article 5. Aug. 2020. (Accessed Feb. 2021).

Arizona explicitly prohibits the use of telemedicine to provide an abortion.

SOURCE: AZ Revised Statute Sec. 36-3604. (Accessed Feb. 2021).

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Recently Passed Legislation

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 Feb. 2021).

Recently Passed Legislation

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 Feb. 2021).

Recently Passed Legislation

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 Feb. 2021).

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 Feb. 2021).

Providers are encouraged to utilize telehealth whenever medically appropriate under the Division of Worker’s Compensation.

SOURCE: 7 CCR 1101-3, Rules 16-2. Page 3 (Accessed Feb. 2021).

Recently Passed Legislation

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 Feb. 2021).

Recently Adopted Rule

Worker’s Compensation rule encourages the utilization of telehealth wherever medically appropriate.

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 (Accessed Feb. 2021).

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HB 5001 makes appropriations to certain telehealth programs and pilots.

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

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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. 2021).

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A health care professional may engage in the practice of telehealth 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.

“Health care professional” includes 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, and mental health professionals and clinicians authorized by Illinois law to provide mental health services.

SOURCE: IL Compiled Statutes, Chapter 225, 150/5 & 15/15. (Accessed Feb. 2021).

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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 Feb. 2021). 

Recently Adopted Rule (Effective March 3, 2021)

A licensee may provide dietetic services to an individual or a group utilizing a telehealth visit if the dietetic services are provided in accordance with all the requirements of this chapter.

SOURCE:  Iowa Administrative Code Section 645.81.17. (Effective March 3, 2021). (Accessed Feb. 2021).

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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: Kentucky SB 123 (2020 Session). (Accessed Feb. 2021).

Louisiana has specific standards for its telemedicine physicians.

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

Recently Passed Legislation (Now Effective)

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

SOURCE: HB 449 (Accessed Feb. 2021).

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 Feb. 2021).

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 Feb. 2021).

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 Feb. 2021) & Title XVI, Chapter 111, Section 1, Massachusetts General Laws (Accessed Jan. 2021)

Recently Passed Legislation (Effective Now)

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 Feb. 2021). 

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A physician treating a patient through a telemedicine network must maintain a complete record of the patient’s care.

SOURCE: MS Admin. Code Title 30, Sec. 2635, Rule 5.6. (Accessed Feb. 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 Feb. 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 HB 94 (Regular Session 2020). (Accessed Feb. 2021)

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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 Feb. 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 Feb. 2021).

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

SOURCE: NH Revised Statutes 329:1-f (HB 1623 – 2020 Session).  (Accessed Feb. 2021).

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. 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 Feb. 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 Feb. 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 Feb. 2021).

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 Feb. 2021).

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 Feb. 2021).

Telehealth shall not include delivery of health care services by means of facsimile machines, or electronic messaging alone, though use of these technologies is not precluded if used in conjunction with telemedicine, store and forward technology, or remote patient monitoring.

SOURCE: NY Public Health Law Article 29 – G Section 2999-cc. & NY Senate (S 848416 2020 Session), (Accessed Feb. 2021).

Office for People with Developmental Disabilities (OPWDD)

Telehealth is an available mechanism to deliver clinical care.

SOURCE:  NY Code of Rules and Regs. Title 14, Sec. 679.1 (Accessed Feb. 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.

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

Under Public Health, originating sites are limited to:

• Licensed health facilities in Articles 28 (hospitals) and 40 (hospice);
• A facility as defined in Section 1.03, subdivision six of the Mental Hygiene Law;
• Certified and non-certified day and residential programs funded or operated by the office for people with developmental disabilities.
• Private physician’s or dentist’s offices located in New York;
• Public, private and charter elementary and secondary schools, school age childcare programs and child day care centers within the state of New York;
• Adult care facility licensed under title two of article seven of the social services law;
• Public, private and charter elementary and secondary schools, school age child care programs and child day care centers;
• The patient’s place of residence located within the state of New York or other temporary location located within or outside the state of New York.

SOURCE: NY Public Health Law Article 29 – G Section 2999-cc. (Accessed Feb. 2021).

Telemedicine may be utilized for neonatal or infant echocardiograms.

SOURCE: 10A N.C.A.C. 43K.0102(c)(3). (Accessed Feb. 2021).

Telemedicine may be used to perform the initial examination required when an individual comes into custody of law enforcement.

SOURCE: N.C. Gen. Stat. § 122C-263(c). (Accessed Feb. 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 Feb. 2021).

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

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

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 Feb. 2021).

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 Feb. 2021).

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 Feb. 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 Feb. 2021).

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.”

Requirements:

• The facility where the surgery is performed must be a licensed hospital or ambulatory surgical center;
• The facility must grant medical staff membership and/or clinical privileges to the monitoring physician;
• The facility must request the Board grant Telemonitoring active status to the monitoring physician.

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 Feb. 2021).

Telehealth is considered to meet the definition of “face-to-face” in Assertive Community Treatment when there is live streaming audio and video.

SOURCE: OR Admin. Rules 309-019-0225, Health Systems Division: Behavioral Health Services, Outpatient Behavioral Health Services, Assertive Community Treatment Definitions (Accessed Feb. 2021).

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See Department of Health Policy for Department of Health Telemedicine Guidelines for other requirements on RI providers.

SOURCE: RI Department of Health. Telemedicine. (Accessed Feb. 2021).

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 Apr. 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 Apr. 2021).

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 & SB 1214. (Accessed Feb. 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 Feb. 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 & HB 8002 (2020 Session). (Accessed Feb. 2021).

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 Feb. 2021).

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 all health professionals who participate in telemedicine.

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

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Telemedicine Guidance from VA Medical Board

• Prescribing via telemedicine is at the discretion of the prescribing practitioner.
• Informed consent must be obtained and maintained.
• See guidance for additional requirements.

SOURCE: VA Board of Medicine. Telemedicine Guidance Document: 85-12. p. 3-4 (Oct. 2018). (Accessed Feb. 2021).

See rules for the practice of teledentistry specifically.

SOURCE: VA Statute 54.1-2711 (SB 122 – 2020 Session).  (Accessed Feb. 2021).

Virginia requires the Commonwealth Broadband Chief Advisor to advocate for and facilitate the development and deployment of applications, programs, and services, including but not limited to telework, telemedicine, and e-learning, that will bolster the usage of and demand for broadband level telecommunications, among other things.

SOURCE: VA SB 877 (2020 Session) (Accessed Feb. 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)) (HB 1332) (Accessed Feb. 2021).

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 Feb. 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 Feb. 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 Feb. 2021).

Recently Passed Legislation (Now Effective)

WV Statute requires each health care board to propose a rule for legislative approval to regulate telehealth practice that includes certain elements (see statute).

SOURCE: WV Statute Sec. 30-1-25 (HB 4003 – 2020 session). (Accessed  Feb. 2021).

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Boards have power to adopt telehealth/telemedicine definitions applicable to their regulated profession and standards for the practice of telemedicine/telehealth.

SOURCE:  WY Code 33-1-303(a(iv)) (HB 164 – 2017). (Accessed Feb. 2021).