Miscellaneous

No reference found.

See statute for privacy and medical record requirements.

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 act 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 & Senate Bill 272 (2022 Session), (Accessed Feb. 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 Feb. 2023).

A health care provider may not be required to document a barrier to an in10 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 House Bill 265 (2022 Session) and Sec. 08.01.085, (Accessed Feb. 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.

SOURCE: AK Admin Code. Sec. 600 & AK Dept. of Commerce, Community, and Economic Development, Occupational Licensing Centralized Regulations, Article 5. June 2021 & Division of Corporations, Business and Professional Licensing – Telemedicine Business Registry (Accessed Feb. 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 Feb. 2023).

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

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: Ariz. Code 36-3608 [repeal effective Jan. 1, 2026] (Accessed Jan. 2023).

No Reference Found

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 Feb. 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 Feb. 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 Feb. 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. 4996.23.2 & 4999.46.3, as amended by AB 1759 (2022 Session). (Accessed Feb. 2023).

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. 2023).

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

SOURCE: CO Revised Statutes 12-270-104. (Accessed Jan. 2023).

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 18-4(I)(1-4) (Accessed Jan. 2023).

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. 2023).

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. 2023).

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

SOURCE: CO Revised Statutes 12-200-103. (Accessed Jan. 2023).

Recently passed legislation authorized 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. 2023).

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. 2023).

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. 2023).

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. 2023).

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 Feb. 2023).

No Reference Found

No Reference Found.

The Florida Mental Health Act or Baker Act – Involuntary Examination

Telehealth is the delivery of an evaluation, assessment, consultation, treatment planning, or other allowable service via non-public facing live videoconference between a licensed clinician and an individual.

Telehealth be used to form the basis of a professional certificate initiating Baker Act involuntary examination. The licensed clinician must have examined the individual within the preceding 48 hours (whether in person or by telehealth) and must conclude that the individual meets criteria for examination. For the purposes of a Baker Act initiation, the licensed clinician must be a physician, clinical psychologist, psychiatric nurse, advanced practice registered nurse registered under s. 464.0123 F.S., mental health counselor, marriage and family therapist, clinical social worker, or physician assistant. The licensed clinician should have a protocol in place to address the provision of telehealth services with staff that includes obtaining/verifying the location of the individual at the beginning of each telehealth session.

Telehealth may be used by a receiving facility to conduct involuntary examinations, to form the basis of a first and second opinion supporting involuntary inpatient placement, and to form the basis of a second opinion supporting outpatient services. Telehealth may not be used to form the basis of a first opinion supporting involuntary outpatient placement.

SOURCE: FL Department of Children and Families. Telehealth and Florida’s Baker Act: FAQs. March 2021. (Accessed Jan. 2023).

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) & FL Department of Children and Families. Telehealth and Florida’s Baker Act: FAQs. March 2021. (Accessed Jan. 2023).

No Reference Found

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 Jan. 2023).

No Reference Found

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. 2023).

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 Feb. 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 Feb. 2023).

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. (Accessed Feb. 2023)

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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. 2023).

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. 2023).

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 Feb. 2023).

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 Feb. 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 Feb. 2023).

Louisiana has specific standards for its telemedicine physicians.

SOURCE: LA Statute Sec. 37:1271 (Accessed Jan. 2023).

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 Jan. 2023).

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 Jan. 2023).

Venue in any suit filed involving care rendered via telehealth pursuant to the provisions of this Part or telemedicine pursuant to the provisions of R.S. 37:1271(B) 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 or telemedicine 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, (Accessed Jan. 2023).

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 Jan. 2023).

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

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 May 2023).

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 General Laws Part I, Title  XVI, Ch. 112, Sec. 5O & Title XVI, Chapter 111, Section 1, Massachusetts General Laws (Accessed Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Jan. 2023).

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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 Mar. 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 Mar. 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 Mar. 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 Mar. 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 Mar. 2023).

Licensed Professional Counselors

“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 Mar. 2023).

Teledental Pilot

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.

In order to allow a dentist to supervise a dental assistant, certified dental assistant, or expanded functions dental assistant using telehealth technology. A supervising dentist may delegate to an expanded functions dental assistant any expanded function duties that dental assistant has a board issued permit for:

• allow a licensed dental hygienist to administer local anesthetic under the supervision of a dentist using telehealth technology.
• temporary restorations or caries arresting fluoride under the supervision of a dentist using telehealth technology subsequent to an examination and diagnosis by the supervising dentist.
• allow a licensed dental hygienist to provide scaling and polishing, root planning, and nonsurgical periodontal procedures prior to the supervising dentist performing an examination pursuant to standing orders written by the supervising dentist.

The provisions of this rule shall only apply to dental healthcare workers providing services pursuant to a pilot project created through a collaboration between ODH and the board and shall expire on August 28, 2026, in accordance with section 332.325, RSMo.

SOURCE: Emergency Rules 20 CSR 2110-2.133.  (Accessed Mar. 2023).

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.

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.

Any 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 Mar. 2023).

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, & 197.135, (Accessed Mar. 2023).

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: Montana Code Annotated 37-15-314 (Accessed Jan. 2023).

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 Mar. 2023).

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 Mar. 2023).

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: NV Revised Statutes Ch. 439.245; 439.916(h)& (m)(2); 439B.220(17); 433.314(1)(c); 433.4295(g). (Accessed Feb. 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 Feb. 2023).

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 Feb. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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New Mexico is also the home of Project ECHO.

SOURCE: University of New Mexico School of Medicine. Project ECHO. (Accessed Feb. 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 [24-25-1 NMSA 1978]. 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. 2023).

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. 2023).

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Telemedicine may be utilized for neonatal or infant echocardiograms.

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

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

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

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

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

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. 34 (Accessed Jan. 2023).

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 Jan. 2023).

“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.

SOURCE:  OH Revised Code, Section 4743.09 (Accessed Mar. 2023). 

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

SOURCE: OH Revised Code Section 4731.741 (Accessed Mar. 2023).

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 Mar. 2023).

A school psychologist licensed by the department of education under rules adopted in accordance with sections 3301.07 and 3319.22 of the Revised Code may provide telehealth services in accordance with section 4743.09 of the Revised Code.

SOURCE: OH Revised Code Section 3319.2212 (Accessed Mar. 2023).

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 Mar. 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 Mar. 2023).

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 Mar. 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 Mar. 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 Mar. 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 Mar. 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 Mar. 2023).

Occupational therapy in Oregon Schools (School-Based health services) guidance document available.

No Reference Found

a 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 Mar 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 Mar 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 Mar 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 Mar 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 Mar 2023).

The Telemedicine Committee, attached to the Department of Health, is hereby created, which shall be composed of eleven (11) persons appointed by the Secretary of Health. The Committee shall have representation of hospital institutions, insurance companies, participating physicians and the Board of Medical Examiners, among others. The Committee shall have as main function to define the services to be reimbursed through telemedicine, reimbursement methods for services rendered, the mechanisms to finance telemedicine, incentives, medical-legal aspects, and definitions of any operating standards, among other things. The Committee shall render monthly reports to the Secretary of Health and a final report after six (6) months of its constitution with its recommendations, including possible legislation to be filed.  Nothing of the herein established, shall affect the development or implementation of the Pilot Telemedicine Program of the Departments of Economic Development, Commerce and Health.

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

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 Jan. 2023).

Virtual Assessment Mechanisms for Eye Exams

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. 2023).

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 Mar. 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 Mar. 2023).

Mental Health

Reimbursable services are limited to face–to-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 Mar. 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 Mar. 2023).

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 Mar. 2023).

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.

This section expires, on December 31, 2023.

SOURCE: TX Admin. Code, Title 1, Sec. 351.823.  (Accessed Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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 Mar. 2023).

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. 133.202–205. (Accessed Mar. 2023).

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 Feb. 2023).

Utah established the Early Childhood Psychotherapeutic Telehealth Consultation Program.

SOURCE: UT Code Sec. 62A-15-1602, (Accessed Feb. 2023)

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, (Accessed Feb. 2023).

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

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:

(A) Establishing a relationship and coordinating with the patient’s Virgin Islands-licensed healthcare professional.

(B) 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.

(C) Discussing with the patient any diagnosis as well as the risks and benefits of various treatment options.

(D) Ensuring the availability for appropriate follow-up care.

(E) 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 tit. 27, § 45d (2019) (Accessed Mar 2023)

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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 Mar. 2023).

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 Mar. 2023).

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. 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 Feb. 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 Feb. 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. (Accessed Feb. 2023).

Home Health

“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). (Accessed Mar. 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.

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

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.. 2023).

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. 2023)

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, as amended by HB 4333 (2022 Session). (Accessed Feb. 2023).

No reference found.

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. 2023).

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. 2023).

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. 2023).