Miscellaneous

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

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

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

SOURCE: AL Code Sec. 34-24-707 (Accessed Nov. 2024).

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 Nov. 2024).

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

SOURCE: AK Statute Sec. 08.02.130, (Accessed Nov. 2024).

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

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

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

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

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

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

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

See telemedicine business registry webpage for more information on applying. [page under construction as of Feb. 2024].

SOURCE: AK Admin Code. Sec. 600, (Accessed Nov. 2024).

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

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

SOURCE: AK Admin Code 12-02.106 (Accessed Nov. 2024).

Nothing in this section prevents the use of asynchronous telemedicine.

SOURCE: AK Admin code 12-07.020 (Accessed Nov. 2024).

See telerehabilitation regulations for supervision requirements.

SOURCE: AK Admin Code Title 12, Sec. 54. 520. (Accessed Nov. 2024).

Except as otherwise provided in this section, a health care provider who 02 provides health care services to another person is not liable for civil damages resulting 03 from an act or omission in providing the health care services if the health care … services were provided …

• through telehealth under AS 08.02.130 while the health care provider was located at a clinic, facility, or site listed in (A) of this paragraph or the private office of the health care provider and the health care provider was acting within the scope of the provider’s responsibilities at the clinic, facility, or site listed in (A) of this paragraph;

SOURCE: AS 09.65.300 as amended by House Bill 126 (2024 Session, (Accessed Nov. 2024).

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

Physical Therapy

“General supervision”

• Means that the supervising physical therapist is on call and is readily available via telecommunications when the physical therapist assistant is providing treatment interventions.
• Includes supervision provided through telehealth as defined in Section 36-3601.

SOURCE: Ariz. Code 32-2001, (accessed Oct. 2024).

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 Jul. 2024).

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 Jul. 2024).

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 Jul. 2024).

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. (Accessed Jul. 2024).

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 Aug. 2024).

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

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

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

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

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

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

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

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

Statewide Electronic Registry of Advance Directives: Considerations for Telehealth

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Telehealth provider” means any health care provider licensed pursuant to title 20 and any pharmacist licensed by the Department of Consumer Protection pursuant to title 20 who is providing health care or other health services through the use of telehealth within such provider’s scope of practice and in accordance with the standard of care applicable to the profession.

See CT Cross-State Licensure category for out-of-state providers also included as part of the definition of telehealth provider, subject to in-state registration and additional requirements.

A telehealth provider shall only provide telehealth services to a patient when the telehealth provider:

• Is communicating through real-time, interactive, two-way communication technology or store and forward technologies;
• 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’s provider license number and contact information

At the time of the telehealth provider’s first telehealth interaction with a patient, the telehealth provider shall inform the patient concerning the treatment methods and limitations of treatment using a telehealth platform and, after providing the patient with such information, obtain the patient’s consent to provide telehealth services. The telehealth provider shall document such notice and consent in the patient’s health record. If a patient later revokes such consent, the telehealth provider shall document the revocation in the patient’s health record.

Each telehealth provider shall, at the time of the initial telehealth interaction, ask the patient whether the patient consents to the telehealth provider’s disclosure of records concerning the telehealth interaction to the patient’s primary care provider. If the patient consents to such disclosure, the telehealth provider shall provide records of all telehealth interactions to the patient’s primary care provider, in a timely manner, in accordance with the provisions of sections 20-7b to 20-7e, inclusive.

The provision of telehealth services and health records maintained and disclosed as part of a telehealth interaction shall comply with the provisions of the Health Insurance Portability and Accountability Act of 1996 P.L. 104-191, as amended from time to time.

Nothing in this section shall prohibit:

• 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;
• a health care provider from consulting with another health care provider concerning a patient’s care;
• orders of health care providers for hospital outpatients or inpatients; or
• the use of telehealth for a hospital inpatient, including for the purpose of ordering any medication or treatment for such patient in accordance with Ryan Haight Online Pharmacy Consumer Protection Act, 21 USC 829(e), as amended from time to time.

For purposes of this subsection, “health care provider” means a person or entity licensed or certified pursuant to chapter 370, 372, 373, 375 to 376b, inclusive, 377, 378, 379, 380, 381a, 382, 382a, 383 to 383d, inclusive, 383f, 383g, 384b, 384d, 397a, 399 or 400j, or licensed or certified pursuant to chapter 368d or 384d.

No telehealth provider or hospital shall charge a facility fee for telehealth services. Such prohibition shall apply to hospital telehealth services whether provided on campus or otherwise. For purposes of this subsection, “hospital” has the same meaning as provided in section 19a490 and “campus” has the same meaning as provided in section 19a508c.

No telehealth provider shall provide health care or health services to a patient through telehealth unless the telehealth provider:

• has determined whether the patient has health coverage for such health care or health services, and, if the patient has such health coverage, whether the patient elects to either use such health coverage to pay for such health care or health services, in whole or in part, or pay the telehealth provider directly for such health care or health services without using such coverage, and
• prior to providing such health care or health services to any patient who elects to pay the telehealth provider in part using such coverage or directly without using such coverage, discloses the cost of such health care or health services to the patient.

Notwithstanding any provision of the general statutes, a telehealth provider who agrees to provide health care or health services to a patient through telehealth 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;
• 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, unless the patient has explicitly elected to pay the provider directly without using such coverage pursuant to subparagraph (A) of subdivision (1) of this subsection, in which case the patient and provider may mutually agree to a different amount; or
• An amount mutually agreed to by the patient and 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 required to offer to the patient such financial assistance under any applicable state or federal law.

Nothing in this subsection shall be construed to prohibit a patient from paying a telehealth provider directly for health care or health services without seeking coverage from a health carrier for such health care or health services.

SOURCE: CT General Statute 19a, Sec. 906 as proposed to be amended by HB 5198 (Public Act 24-110 – 2024 Session). (Accessed Jul. 2024).

The Department of Public Health shall collect the following data regarding each telehealth provider who registers with the department pursuant to subparagraph (B)(iii) of subdivision (12) of subsection (a) of section 19a-906 of the general statutes, as amended by this act, and each out-of-state health care provider who applies to the department for a license pursuant to title 20 of the general statutes on and after the effective date of this section. Not later than January 1, 2025, and, thereafter, not later than July 1, 2025, the Commissioner of Public Health shall report, in accordance with the provisions of section 11-4a of the general statutes, to the joint standing committees of the General Assembly having cognizance of matters relating to public health regarding the following:

• The number of such telehealth providers who registered with the department on or after the effective date of this section;
• The number of such telehealth providers who applied to the department for a license pursuant to subparagraph (B)(iv) of subdivision (12) of subsection (a) of section 19a-906 of the general statutes, as amended by this act, on or after the effective date of this section;
• The number of such telehealth providers who receive a license from the department on or after the effective date of this section; and
• The number of such out-of-state health care providers who apply for a license with the department pursuant to title 20 of the general statutes on or after the effective date of this section.

SOURCE: HB 5198 (Public Act 24-110 – 2024 Session), Sec. 8. (Accessed Jul. 2024).

Family and Medical Leave Act

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

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

No Reference Found

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

SOURCE: DC Official Code Sec. 3-1204.01; B 25-0312 (2023 Session). (Accessed Jun. 2024).

“Practice of nutrition” means the application of the scientific principles derived from the study of food, nutrition, biochemistry, metabolism, physiology, and behavioral sciences for achieving and maintaining health throughout the lifespan; the provision of nutrition care services in-person or via telehealth, including medical nutrition therapy to prevent, manage, or treat diseases or medical conditions and promote wellness; the ordering of patient diets, including therapeutic diets via oral routes; the ordering of medical laboratory tests related to nutritional therapeutic treatments; and the provision of recommendations on vitamin, mineral, and other dietary supplements.”.

SOURCE: DC Code Sec. 1201.02 (6A) as amended by B 25-0545 (2024 Session). (Accessed Jun. 2024).

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

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

An advertisement of dental services provided through telehealth as defined in s. 456.47(1) must include a disclaimer that reads, in a clearly legible font and size, “An in-person examination with a dentist licensed under chapter 466, Florida Statutes, is recommended before beginning telehealth treatment in order to prevent injury or harm” for each of the following services, if advertised.

SOURCE: FL Statute Sec. 466.019, (Accessed Nov. 2024).

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

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

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

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

Malpractice Insurance

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

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

Network Adequacy

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

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

Veterinary Telemedicine

(a)  A veterinarian shall only practice veterinary telemedicine within the context of the veterinarian-client-patient relationship between medically necessary examinations of an animal patient or medically appropriate and timely visits to the premises where the animal patient is kept.

(b)  Only a veterinarian licensed in the State shall provide veterinary telemedicine to an animal patient located in the State.

(c)  When practicing veterinary telemedicine, a veterinarian shall:

• Conduct all necessary animal patient evaluations consistently with currently acceptable standards of care;
• Take appropriate precautions to safeguard the confidentiality of a client’s or animal patient’s records;
• Ensure that the client is aware of the veterinarian’s identity, location, license number, and licensure status; and
• Maintain appropriate medical records with sufficient information for continued care that are readily available upon request by the client.

     (d)  Prescribing medications via veterinary telemedicine shall require a veterinarian-client-patient relationship and shall be at the professional discretion of the veterinarian.  The indication, appropriateness, and safety considerations for each prescription issued in association with veterinary telemedicine services shall be evaluated by the veterinarian in accordance with all jurisdictional and federal laws and standards of care.

     (e)  A veterinarian may provide veterinary teleadvice or veterinary teletriage without the prior establishment of a veterinarian-client-patient relationship.  An expert with a poison control agency who is not a veterinarian may provide veterinary teletriage.

     (f)  A veterinarian may provide veterinary telesupervision for tasks that do not require direct supervision as specified by rules adopted by the board.

     (g)  Veterinary telemedicine shall constitute the practice of veterinary medicine in the State when the individual practicing veterinary telemedicine or the animal patient are in the State.  The board shall have jurisdiction over an individual practicing veterinary telemedicine within the State regardless of where the veterinarian’s physical offices are located.

SOURCE:  HI Revised Statutes Sec. 471-2.5.  (Accessed Jun. 2024).

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

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

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

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

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

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

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

Physical Therapists

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

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

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

Respiratory Therapists

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

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

Dietitian

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

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

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 Jul. 2024).

Occupational therapy may be provided via technology or telecommunication methods, also known as telehealth, however the standard of care shall be the same whether a patient or recipient is seen in person, through telehealth, or other method of electronically enabled health care.  Included in the definition of occupational therapy services are virtual interventions, including simulated, real-time, and near-time technologies, consisting of telehealth and mobile technology.

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

Hospitals & Ambulatory Care Facilities

The medical staff shall be organized in accordance with written bylaws, rules and regulations approved by the governing board.  The bylaws, rules and regulations shall specifically provide, but are not limited to:

…

establishing a procedure for granting telemedicine privileges, based upon the privileging decisions of a distant-site hospital or telemedicine entity that has a written agreement that meets Medicare requirements;

General Acute or Critical Access Hospitals without a licensed pediatric unit or board certified or board eligible pediatrician in the hospital or on call 24 hours a day, 7 days a week that provide limited inpatient or observation services to pediatric patients (neonate (less than 28 days of age) to 14 years old):

• Shall have a written agreement with a children’s hospital or hospital with a licensed pediatric unit. The agreement shall include provider-to-patient and/or provider-to-provider consultations that meet the telemedicine requirements provided in subsections (a)(2) through (a)(8) remotely via electronic communications, whether synchronous or asynchronous, and specify other information including communication frequency, equipment, education, transfers, case reviews, and critical criteria for emergency transfers;

If a hospital enters into agreement for telemedicine services with a distant-site hospital or distant-site entity, the governing body of the hospital whose patients are receiving the telemedicine services may choose, in lieu of the hospital performing the credentialing and privileging requirements, to rely upon the credentialing and privileging decisions made by the distant-site hospital when making recommendations on privileges for the individual distant-site physicians and practitioners providing the services.  The hospital’s governing body ensures, through its written agreement with the distant-site hospital, that the distant-site hospital meets the Conditions of Participation for Hospitals for credentialing and privileging of physicians and practitioners.

SOURCE:  IL Admin Code, Title 77, Chapter 1, Subch b, Part 250, Sec. 250.310.  (Accessed Jul, 2024).

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 Aug. 2024).

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 Aug. 2024).

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

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

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

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

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

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

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

SOURCE: IN Code, 25-1-9.5-7. (Accessed Mar. 2024)

Veterinarian Services

(a) As used in this section, “board” refers to the Indiana board of veterinary medicine established by IC 25-38.1-2-1.

(b) As used in this section, “license or registration certificate” means a license or registration certificate issued by the board under IC 25-38.1.

(c) As used in this section, “practitioner” means an individual who holds a license or registration certificate.

(d) After December 31, 2024, a practitioner must provide the following information when renewing the practitioner’s license or registration certificate electronically:

• The practitioner’s specialty or field of practice.
• The practitioner’s current:

1. business address or location;
2. practice setting type;
3. average hours worked per week;
4. average distance traveled between patients (if applicable); and
5. type of services provided.

• The practitioner’s educational background and training.
• The approximate outstanding balance of student loans taken out by the practitioner to finance veterinary or veterinary technician schooling.
• Whether the practitioner currently delivers veterinary services through telehealth (as defined in IC 25-1-9.5-6).

(e) After December 31, 2024, a notice of renewal sent under this chapter to a practitioner must notify the practitioner of the requirements of subsection (d).

(f) Not later than December 31 of each year, the board shall do the following:

• Compile the information collected under this section into a report.
• Post the report compiled under subdivision (1) on the board’s website.

(g) A report compiled under subsection (f) may not contain personal identifying information.

SOURCE: IN Code 25-1-2-11. (Accessed Aug. 2024).

READ LESS

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 Dec. 2024).

The department of health and human services shall review the department’s administrative rules regarding psychiatric medical institutions for children (PMICs) and shall update the rules, informed by the findings of the association of children’s residential centers” most recent nationwide survey and scan of psychiatric residential treatment facilities, and the recommendations of the coalition for family and children’s services in Iowa, to do all of the following: ..

• Allow licensed professionals, based on competencies rather than license type, to order the use of restraints or seclusions and to conduct post- restraint or seclusion assessments, including via telehealth, to increase response times and expand access to care. The department of inspections, appeals, and licensing shall adopt rules pursuant to chapter 17A to administer this subsection.

SOURCE:  Section 135H.6 & House File 2402 (2024 Session), (Accessed Dec. 2024).

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 Nov. 2024).

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 Nov. 2024).

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 Nov. 2024).

Workers’ Compensation

Nothing in KRS 211.332 to 211.338 shall be interpreted or construed to limit the authority of the Department of Workers’ Claims to promulgate administrative regulations governing the delivery of health care services via telehealth or digital health pursuant to KRS Chapter 342.

SOURCE: KY Revised Statutes 211.338. (Accessed Nov. 2024).

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 Nov. 2024).

Teledentistry

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

…

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

See rule for complete requirements.

SOURCE: Louisiana Admin Code XXXIII, Ch. 7, Sec. 701, (Accessed Nov. 2024).

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

SOURCE: LA Statute Sec. 40, Sec. 1223.5, (Accessed Nov. 2024).

Facility Admissions via Emergency Certificates

The actual examination of the person by a psychiatrist or psychiatric mental health nurse practitioner may be conducted by telehealth utilizing video conferencing technology, provided that a licensed healthcare professional who can adequately and accurately assist with obtaining any necessary information including but not limited to the information listed in Paragraph (4) of this Subsection shall be in the examination room with the patient at the time of the video conference. A patient examined in such a manner shall be medically cleared prior to admission to a mental health treatment facility. Failure to conduct an examination prior to the execution of the certificate will be evidence of gross negligence.

In the case of an emergency certificate issued pursuant to an examination conducted by telehealth pursuant to Paragraph (1) of this Subsection and Paragraph (J)(1) of this Section, the licensed healthcare professional present during the actual examination shall be responsible for obtaining, recording, and attaching to the emergency certificate the following information regarding the video conference (see statute).

In the case of an emergency certificate issued pursuant to an examination conducted by telehealth pursuant to Paragraph (B)(1) of this Section, or where the valid original is not provided to the transporter, a copy transmitted by facsimile or other electronic device shall be sufficient authority for the peace officer or ambulance worker to transport the patient to a treatment facility and for the director to accept the patient. The psychiatrist shall cause the original certificate to be deposited in the United States mail properly addressed to the director of the treatment facility by the next business day following the date of examination. The director of the treatment facility shall notify the patient’s nearest relative, if known, or designated responsible party, if any, in writing of the patient’s admission by emergency certificate as soon as reasonably possible.

Except as provided in Subparagraph (c) of this Paragraph, a coroner, who is a physician, or his deputy, who is a physician, may utilize telehealth to conduct the seventy-two-hour independent examination pursuant to this Paragraph.

Except as provided in Paragraph (7) of this Subsection, if the actual examination provided for in Paragraph (B)(1) of this Section is conducted utilizing telehealth, the seventy-two-hour independent examination by the coroner or his deputy shall be conducted in person.

See statute for additional details.

SOURCE: LA Revised Statute Sec, 28:53, (Accessed Nov. 2024).

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 Oct. 2024).

Municipal Gigabit Broadband Network Access Fund

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

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

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 Nov. 2024).

Sexual Assault Forensic Examinations Conducted Through Telehealth

Legislation effective July 1, 2024-June 30, 2025 requires the Maryland Sexual Assault Evidence Kit Policy and Funding Committee shall study and make recommendations on the feasibility of a telehealth program in the State that includes a TeleSAFE Pilot Program, which uses telehealth to support the provision of sexual assault forensic examinations. The study shall include:  (1) the framework of a TeleSAFE Pilot Program; (2) a plan for the development and implementation of the TeleSAFE Pilot Program; and (3) a process to expand the TeleSAFE Pilot Program over time.

On or before December 1, 2024, the Maryland Sexual Assault Evidence Kit Policy and Funding Committee shall report its findings and recommendations to the General Assembly, in accordance with § 2–1257 of the State Government Article.

The legislation additionally ensures a sexual assault forensic exam conducted through peer-to-peer telehealth shall be provided without charge to the individual and the provider be entitled to reimbursement by the Criminal Injuries Compensation Board upon written or electronic notification consistent with statutory requirements.

SOURCE: MD Criminal Procedure Code 11-1007 as proposed to be added by HB 1127/SB 950 (2024 Legislative Session). (Accessed Nov. 2024).

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.

Section 1, Chapter 111:  ”Health care provider”, any doctor of medicine, osteopathy, or dental science, or a registered nurse, registered pharmacist, social worker, doctor of chiropractic, or psychologist licensed under the provisions of chapter one hundred and twelve, or an intern, or a resident, fellow, or medical officer licensed under section nine of said chapter one hundred and twelve, or a hospital, clinic or nursing home licensed under the provisions of chapter one hundred and eleven and its agents and employees, or a public hospital and its agents and employees.

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

Involuntary Commitment

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

SOURCE: 104 Code of Massachusetts Regulations (CMR) 27.07, (Accessed Dec. 2024).

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 Dec. 2024).

Chemical Dependency Licensed Treatment Facilities

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

SOURCE: MN Statutes  254G.01. (Accessed Nov. 2024).

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

SOURCE: MN Senate File 2995 (2023 Session), (Accessed Nov. 2024).

Beginning October 1, 2024, to the extent space is available, a school district or charter school must provide an enrolled secondary school student with access during regular school hours, and to the extent staff is available, before or after the school day on days when students receive instruction at school, to space at the school site that a student may use to receive mental health care through telehealth from a student’s licensed mental health provider. A secondary school must develop a plan with procedures to receive requests for access to the space.

The space must provide a student privacy to receive mental health care.

A student may use a school-issued device to receive mental health care through telehealth if such use is consistent with the district or school policy governing acceptable use of the school-issued device.

A school may require a student requesting access to space under this section to submit to the school a signed and dated consent from the student’s parent or guardian, or from the student if the student is age 16 or older, authorizing the student’s licensed mental health provider to release information from the student’s health record that is requested by the school to confirm the student is currently receiving mental health care from the provider. Such a consent is valid for the school year in which it is submitted.

This section is effective for the 2024-2025 school year and later.

SOURCE: MN Sec. 121A.216 & Senate File 3567 (2024 Session), (Accessed Nov. 2024).

“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 Aug. 2024).

The provider treating a patient through a telemedicine network must maintain a complete record of the patient’s care. The provider 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 provider for the same medical condition, then the primary physician’s medical record and the telemedicine provider’s record constitute one complete patient record.

SOURCE: MS Admin. Code Title 30, Sec. 2635, Rule 5.6. (Accessed Aug. 2024).

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

SOURCE: MS Code Sec. 41-3-15. (Accessed Aug. 2024).

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

SOURCE: MS Code Sec. 41-3-15.1. (Accessed Aug. 2024).

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 Aug. 2024).

Licensed Professional Counselors

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

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

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

SOURCE: MS Code Title 30 Part 2201 Ch. 1 Rule 1.4, (Accessed Aug. 2024).

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

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

SOURCE: Title 30, Part 2201, Rule 7.5, (Accessed Aug. 2024).

Telehealth Dental Pilot Project in Medically Underserved Populations

Pursuant to the provisions of section 332.325, RSMo, the board is collaborating with the Office of Dental Health (ODH) within the Missouri Department of Health and Senior Services (DHSS) to create a pilot project designed to examine new methods of extending dental care to residents in assisted living facilities, intermediate care facilities, residential care facilities, skilled nursing facilities, and homebound special needs patients.

Specific provisions of sections 332.093 and 332.098, RSMo, and 20 CSR 2110-2.120 in order to allow a dentist to supervise a dental assistant, certified dental assistant, or expanded functions dental assistant using telehealth technology.  See regulation for additional details.

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

Utilization of telehealth by nurses

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

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

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 Sept. 2024).

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

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

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

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

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

See statute for details.

SOURCE: MT Statute Sec. 44-4-1701-1705, (Accessed Jun. 2024).

A stroke system of care task force shall recommend eligible essential health care services for acute stroke care provided through telehealth as defined in section 71-8503.

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

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

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

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

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

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

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

SOURCE: NV Revised Statutes Ch. 439.245, (Accessed Dec. 2024).

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, as defined in NRS 629.515, to patients at the hospital in the manner prescribed in 42 C.F.R. §§ 482.12, 482.22 and 485.616.

SOURCE: NV Revised Statutes Sec. 449.1925. (Accessed Dec. 2024).

Supervising Physicians

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

Direct observation of the ability of the physician assistant to take a medical history from and perform an examination of patients representative of those cared for by the physician assistant. The requirements of this paragraph are satisfied if a program includes direct observation of a physician assistant while the physician assistant uses telehealth to provide such services.

SOURCE: NV Admin Code, Sec. 630.370, (Accessed Dec. 2024).

A supervisor shall ensure that:

• A psychological trainee receives at least 1 hour of individual supervision for each 10 hours of service delivery per week. At least one-half of such individual supervision each week must be performed by the supervisor. Not more than 1 hour of such supervision each week may be performed by a psychological assistant or psychological intern in accordance with subsection 5.  As used in this paragraph, service delivery means activities that involve direct contact with a client in person or through telehealth, as defined in NRS 629.515, as amended by section 1 of Assembly Bill No. 276, chapter 19, Statutes of Nevada 2023, at page 78.

SOURCE: NV Admin Code, Sec. 641.152, (Accessed Dec. 2024).

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

SOURCE: NH Revised Statutes 329:1-f.  (Accessed Dec. 2024).

Telemedicine and Telehealth Organization Registry

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

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

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

See rule for additional requirements.

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

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

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

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

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

See NJ Department of Health website for more information.

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

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 Aug. 2024).

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

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

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

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 (Marriage & Family Therapist), 13:34-32.3 (Professional Counselors), 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); 13:35-8.23 (Hearing Aid Dispensers); 13:35-10.28 (Athletic Trainers); 13:42B-7.3 (Applied Behavior Analyst). (Accessed Aug. 2024).

Agriculture

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

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

Cattle and swine regulations allow exceptions from confinement standards in certain circumstances, including for examination, testing, individual treatment, or operation for veterinary purposes, but only if performed by or pursuant to the supervision of a licensed veterinarian, either in-person or through a telemedicine appointment.

SOURCE: NJ Administrative Code 2.8-2.4 & 2:8-7.4 as proposed by Final Rule. (Accessed Aug. 2024).

New Mexico is also the home of Project ECHO.

SOURCE: University of New Mexico School of Medicine. Project ECHO. (Accessed Nov. 2024).

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

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

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

SOURCE: OASAS Telehealth Standards for OASAS Designated Providers, p. 3. Aug. 2023. (Accessed Dec. 2024).

Telemedicine may be utilized for neonatal or infant echocardiograms.

SOURCE: 10A N.C.A.C. 43K.0102(c)(3). (Accessed Dec. 2024).

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

SOURCE: NC General Statute 130A-125(b2)(1). (Accessed Dec. 2024).

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

SOURCE: 21 NCAC 64 .1104(a)(7). (Accessed Dec. 2024).

Dentistry

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

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

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

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

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

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

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

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

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

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

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

Department of Aging – PCA Supervisor Requirements

During a state of emergency declared by the governor or a federal public health emergency, the PCA supervisor may conduct the initial visit by telephone, video conference, or in person at the individual’s home.

If the PCA supervisor conducts at least two in-person visits per year, the PCA supervisor may conduct the remainder of the subsequent visits during the same year by telephone, video conference, or in person based upon the individual’s needs. To comply, the PCA supervisor may conduct two subsequent in-person visits in the same year or the combination of an initial in-person visit and an in-person subsequent visit in the same year.

For a visit by telephone or video conference, the date of the visit, an indication of whether the visit was provided by telephone or video conference, the PCA supervisor’s name, the individual’s name, and evidence that a visit occurred by telephone or video conference (e.g., a record automatically generated by telehealth software, a record showing that the PCA supervisor’s phone called the individual’s phone, or clinical notes from the PCA supervisor).

SOURCE: OAC 173-39-02.11, (Accessed Nov. 2024).

Department of Aging – ODA Provider Certification: Homemaker

During a state of emergency declared by the governor or federal public health emergency, the supervisor may conduct the visit by telephone, video conference, or in person at the individual’s home.

Subsequent: The supervisor shall complete an evaluation of the aide’s compliance with the activities plan, the individual’s satisfaction, and job performance during a home visit with the individual at least every ninety days. The supervisor may conduct each visit with or without the presence of the aide being evaluated. The supervisor may conduct the visit by telephone, video conference, or in person.

For a visit by telephone or video conference, the date of the visit, an indication of whether the visit was provided by telephone or video conference, the supervisor’s name, the individual’s name, and evidence that a visit occurred by telephone or video conference (e.g., a record automatically generated by telehealth software, a record showing that the supervisor’s phone called the individual’s phone, or clinical notes from the supervisor).

SOURCE: OAC 173-39-02.8, (Accessed Nov. 2024).

Department of Aging – Older Americans Act: Homemaker Service

During a state of emergency declared by the governor or a federal public health emergency, the aide supervisor may conduct the visit by telephone, video conference, or in person at the consumer’s home.

During a state of emergency declared by the governor or a federal public health emergency, the aide supervisor may conduct the visit by telephone, video conference, or in person at the consumer’s home.

For a visit by telephone or video conference, the date of the visit, an indication of whether that the visit was provided by telephone or video conference, the supervisor’s name, the consumer’s name, and evidence that a visit occurred by telephone or video conference (e.g., a record automatically generated by telehealth software, a record showing that the supervisor’s phone called the consumer’s phone, or clinical notes from the supervisor).

SOURCE: OAC 173-3-06.4, (Accessed Nov. 2024).

Department of Aging – Older Americans Act: Personal Care

During a state of emergency declared by the governor or a federal public health emergency, the PCA supervisor may conduct the visit by telephone, video conference, or in person at the consumer’s home.

During a state of emergency declared by the governor or a federal public health emergency, the PCA supervisor may conduct subsequent visits by telephone or video conference, unless an emergency requires visiting the consumer in person at the consumer’s home.

For a visit by telephone or video conference, the date of the visit, an indication of whether the visit was provided by telephone or video conference, the PCA supervisor’s name, the consumer’s name, and evidence that a visit occurred by telephone or video conference (e.g., a record automatically generated by telehealth software, a record showing that the PCA supervisor’s phone called the consumer’s phone, or clinical notes from the PCA supervisor).

SOURCE: OAC 173-3-06.5, (Accessed Nov. 2024).

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 Nov. 2024).

The OK Dept. of Health established a statewide telemedicine network.

SOURCE: Oklahoma Statutes, Title 63 Sec. 1-2702, (Accessed Nov. 2024).

Oklahoma lists resources under their Office of Telehealth.

SOURCE:  Office of Telehealth. (Accessed Nov. 2024).

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

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

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

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

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

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

SOURCE: OK Statute Title 59, Ch. 7, 328.58 (Accessed Nov. 2024).

Every mental health professional who is renewing a behavioral health certification or license issued by a designated board shall report the following information: …

• Workforce practice trends, including, but not limited to: … the use of telehealth

SOURCE: OK Statute Sec. 3-335, Title 43A, & House Bill 3330 (2024 Session), (Accessed Nov. 2024).

Optometry

Telemedicine encounters shall comply with the Health Insurance Portability and Accountability Act 1996 and OAC 435:10-7-13 and ensure that all patient communication and records are secure and confidential. Doctors may not waive their obligation or require patients to waive their right to receive the standard of care. Payors may not require either doctor to perform less than the standard of care or patient to waive right to receive the standard of care. The doctor must establish and maintain fundamental elements of the doctor-patient relationship. Board approval of telemedicine: In the event a specific telemedicine program is outside the parameters of these rules, the Board reserves the right upon application of an Oklahoma licensed optometrist, to approve or reject such program or any part or parts of it, pending a formal rulemaking proceeding pursuant to the Administrative Procedure Act.

…

As indicated previously, there is no separate standard of care for telemedicine in the practice of optometry in Oklahoma. Accordingly, the optometrist who seeks to use telemedicine in his or her practice should be familiar with the requirements of the Oklahoma Board of Optometry subsections A and B of 59 O.S. § 581 and all other applicable laws and regulations, whether state or federal. By way of example and not limitation, Board Rule OAC 505:10-5-9 Oklahoma establishes the tests and measurements that require findings on the comprehensive examination of a patient for which an optometrist will sign a prescription for ophthalmic lenses or contact lenses. The optometrist should have an established and appropriate procedure for the provision of eye care to his/her patients outside of normal practice hours, and should inform patients of those procedures

Telemedicine technology must be sufficient to provide the same information to the provider as if the exam has been performed face-to-face. Telemedicine encounters must comply with HIPAA (Health Insurance Portability and Accountability Act of 1996) security measures to ensure that all patient communications and records are secure and remain confidential. Audio and video equipment must permit interactive, real-time communications, or may be a store and forward system allowing the distant site optometrist to review the results of a near site examination at a later time.

Telemedicine services are not an expansion of the scope of practice of Optometry, but an option for the delivery of certain services within that scope of practice. However, if there are technological difficulties in performing an objective, thorough medical assessment, or problems in the patient’s understanding of telemedicine, hands-on-assessment and/or in-person care must be provided for the patient. Any service delivered using telemedicine technology will be appropriate for telemedicine delivery and be of the same quality and otherwise on par with the same service delivered in person. A telemedicine encounter will maintain the confidentiality and security of protected health information in accordance with applicable state and federal law.

See rule for additional requirements.

SOURCE: OK Admin Code Sec. 505:10-5-19. (Accessed Nov 2024).

Telemonitoring Registration

Telemonitoring is 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.

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

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

SOURCE: OR Admin. Rules. 847-008-0023. (Accessed Dec. 2024).

Optometry

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

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

SOURCE: OAR 852-020-0050. (Accessed Dec. 2024).

Scope of School Psychologist

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

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

SOURCE: OAR 584-245-0200 Teacher Standards and Practices Commission, Personnel Service Licenses. (Accessed Dec. 2024).

Occupational Therapy Licensing Board Supervision

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

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

SOURCE: OAR 339-010-0005. (Accessed Dec. 2024).

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

SOURCE: OAR 339-010-0006. (Accessed Dec. 2024).

Opioid Use Disorder Medication Grant Program

Moneys awarded to grant recipients under section 83 of this 2024 Act may be used to:

Provide medication, telemedicine or any other reasonable treatment to persons in custody with an opioid use disorder.

SOURCE: House Bill 4002 (2024 Session), (Accessed Dec. 2024).

The Broadband Advisory Council: One representative must represent telehealth.

SOURCE: House Bill 4040 (2024 Session), (Accessed Dec. 2024).

Continuing Education Requirements – Naturopaths

Professional Development: limited to (2) hours of general education annually, structured program for physicians and health care professionals with course curriculum that includes at least one of the following topic areas:

• Best practices for ensuring patient confidentiality and public safety in the digital clinic environment, effective charting, records access and transparency, record management, incorporating telemedicine in primary care.

SOURCE: 850-040-0210. (Accessed Jul. 2024).

No Reference Found

The provisions of this chapter shall not apply to the practice of  telemedicine  performed by a surgeon or osteologist outside the jurisdiction due to a medical emergency. [Provided,] that the term medical emergency shall be that determined by the surgeon or osteologist, and shall be understood as the practice that occurs only once per patient and involves a maximum of ten (10) patients on an annual basis.

The provisions of this chapter shall not apply to a surgeon or osteologist who performs an irregular  telemedicine practice  without receiving compensation or remuneration of any kind, nor to occasional consultations that any surgeon or osteologist may make with a colleague outside the jurisdiction of the Commonwealth of Puerto Rico, where there is no direct relationship between the surgeon or osteologist who practices in that other jurisdiction and the patient. An irregular practice shall not be understood as one developed or exercised in accordance with any contractual relationship.

SOURCE:   20 LPRA Section 6007 (Accessed Sept. 2024).

The Telemedicine Committee is hereby created, attached to the Department of Health,   composed of eleven (11) persons, appointed by the Secretary of Health. The Committee shall have representation from hospital institutions, insurance companies, participating physicians, and the Examining Board, among others. The Committee’s main function shall be to define the services to be reimbursed through  telemedicine , the methods for reimbursement of services rendered, the financing mechanisms for  telemedicine , incentives, medical-legal aspects and definitions of any operational standards, among others. The Committee shall submit monthly reports to the Secretary of Health and a final report six (6) months after its constitution with its recommendations, including possible legislation to be presented. Nothing established in this section shall affect the development and implementation of the  Telemedicine Pilot Program  of the Departments of Economic Development and Commerce and Health.

SOURCE:   20 LPRA Section 6010 . (Accessed Sept. 2024).

The issuance of a certification to any physician or health professional covered by this chapter means that he or she is subject to the jurisdiction of Puerto Rico and the Licensing Board or the Board of Examiners or Governing Body, as the case may be, and any legislation or regulation related to these shall be applicable to him or her, and he or she shall be subject to any disciplinary sanction that may be imposed. It shall be understood that the holding of a certification pursuant to this chapter subjects such physician or health professional to the jurisdiction of the Courts of Puerto Rico. Any physician or health professional to whom a certification is issued under the provisions of this chapter is understood to agree to produce any medical record or any material or report as requested by the Licensing Board or the Boards of Examiners or Governing Body, as the case may be.

SOURCE:   20 LPRA Section 6011(g). (Accessed Sept. 2024).

Each examination board attached to the Office of Regulation and Certification of Health Professionals Health (ORCPS) of the Department of Health, within the specialties regulated by Law No. 48-2020, must adopt those standards that they consider essential for the good practice of the profession when offering services through Cybertherapy. Since the approval of the same, every applicant must meet the requirements taxes by each board to obtain certification authorized by Law No. 48-2020, including requirements for continuing education, among others. The present body of standards will not be applicable to the Social Work professionals in Puerto Rico. It recognizes the faculty of the Examination Board of Labor Professionals Social, attached to the Department of State of Puerto Rico, establish the standards that regulate this profession, including licensing, continuing education, among other requirements applicable to these professionals, under Law No. 171 of May 11, 1940, as amended.

SOURCE: Department of Health, Regulations to Regulate Cybertherapy in Puerto Rico, Number 9517 (Dec. 2023), Article 1, Section 51.5  (Accessed Sept. 2024).

The Certification issued by the Board will authorize the professional to make your queries remotely using means technological, such as: telephones, video calls, applications or any other technological tool scope. The Certification also authorizes consultations outside of the geographical limits of Puerto Rico, but within the jurisdiction of the United States, provided that the professional meets the requirements established in the state or jurisdiction in which the patient is located at the time of the consultation.

The Certification for the practice of Cybertherapy will have validity of three (3) years. All renewal requests must comply with the requirements established in Section 2.2 of this regulation/as well as with the rules or regulations established for each meeting.

Every Licensed Professional who has the Certification for the use of Telehealth in Puerto Rico, and wish to renew it, must complete a minimum of four (4) credit hours in continuing education courses accredited by the Board, during the period corresponding to each triennium of recertification. (See regulations for more detail).

SOURCE: Department of Health, Regulations to Regulate Cybertherapy in Puerto Rico, Number 9517 (Dec. 2023), Article 2, Section 2.3 & 2.5, Article 4, Section 4.1 &  Department of Health, Regulations for the Use of Telehealth in Puerto Rico, Number 9518 (Dec. 1, 2023), Article 2, Section 2.3 & 2.5, Article 4, Section 4.1.  (Accessed Sept. 2024).

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 Oct. 2024).

Virtual Assessment Mechanisms for Eye Exams

A licensee who provides health care via telehealth:

1. may only provide health care within his scope of practice;
2.  shall adhere to the same standard of care as required for in-person care and must be evaluated according to the standard of care applicable to the licensee’s area of specialty. The failure of a licensee to conform to the appropriate standard of care is considered unprofessional conduct and may be disciplined according to the licensee’s respective practice act and pursuant to Section 40-42-10(3);
3. shall generate and maintain confidentiality of a patient’s records and disclose the records to the patient consistent with state and federal laws, rules, and regulations; provided, that licensees practicing telemedicine must be held to the same standards of professionalism concerning medical records transfer and communication with the primary care provider and medical home as licensees practicing by traditional means;

A licensee or any other person involved in a telehealth encounter must:

•            be trained in the use and operation of the telehealth equipment; and
•            demonstrate competence in the use and operation of telehealth equipment.

Notwithstanding any of the provision of this section, a licensee’s respective licensing board retains all authority with respect to telehealth practice in accordance with the authorization provided to him by his respective practice act.

SOURCE: SC Code Annotated Sec. 40-42-20 as proposed to be added by H 4159 (2024 Session). (Accessed Aug. 2024).

A licensee who provides care, renders a diagnosis, or otherwise engages in the practice of medicine as defined in Section 40-47-20(36) via telemedicine as defined in Section 40-47-20(52) shall:

• adhere to the same standard of care as in-person medical care and be evaluated according to the standard of care applicable to the licensee’s area of specialty. The failure of a licensee to conform to the appropriate standard of care is considered unprofessional conduct under Section 40-47-110(B)(9);
• generate and maintain medical records for such telemedicine services in compliance with any applicable state and federal laws, rules, and regulations including this chapter, the Health Insurance Portability and Accountability Act (HIPAA), and the Health Information Technology for Economic and Clinical Health Act (HITECH). Such records timely must be made accessible to other practitioners and to the patient when lawfully requested by the patient or his lawfully designated representative;

In addition to those requirements set forth in subsection (A), a licensee who establishes and/or maintains a physician-patient relationship, provides care, renders a diagnosis, or otherwise engages in the practice of medicine as defined in Section 40-47-20(36) solely via telemedicine as defined in Section 40-47-20(53) shall:

1. adhere to current standards for practice improvement and monitoring of outcomes and provide reports containing such information upon request of the board;
2. provide an appropriate evaluation prior to diagnosing and/or treating the patient, which need not be done in person if the licensee considers that he is able to accurately diagnose and treat the patient in conformity with the applicable standard of care via telehealth; provided that evaluations in which a licensee is at a distant site, but a practitioner who is acting within his scope is able to provide various physical findings the licensee needs to complete an adequate assessment, is permitted
3. ensure the availability of appropriate follow-up care;
4. verify the identity and location of the patient and inform the patient of the licensee’s name, location, and professional credentials;
5. maintain the confidentiality of a patient’s records and disclose the records to the patient consistent with state and federal law; provided, that licensees practicing telemedicine must be held to the same standards of professionalism concerning medical records transfer and communication with the primary care provider and medical home as licensees practicing via traditional means;
6. if applicable, discuss with the patient the value of having a primary care medical home and, if the patient requests, provide assistance in identifying available options for a primary care medical home;

A licensee, practitioner, or any other person involved in a telemedicine encounter must be trained in the use of the telemedicine equipment and competent in its operation.

Notwithstanding any of the provisions of this section, the board shall retain all authority with respect to telemedicine practice as granted in Section 40-47-10(I) of this chapter.

SOURCE: SC Code Annotated Sec. 40-47-37 as amended by H 4159 (2024 Session). (Accessed Aug. 2024).

Physician assistants are authorized to perform telemedicine and telehealth in accordance with the requirements of Section 40-47-37 including, but not limited to, Section 40-47-37(C)(6) requiring board authorization prior to prescribing Schedule II and Schedule III prescriptions; Section 40-47-113, approved written scope of practice guidelines, and pursuant to all physician supervisory requirements imposed by this chapter without having to be licensed to practice medicine in this State as otherwise required in Section 40-47-37(A)(4).

SOURCE: SC Code Annotated Sec. 40-47-935 as amended by H 4159 (2024 Session). (Accessed Aug. 2024).

An APRN may perform medical acts via telemedicine and telehealth pursuant to a practice agreement as defined in Section 40-33-20(45) without having to be licensed to practice medicine in this State as otherwise required in Section 40-47-37(A)(4).

SOURCE: SC Code Annotated Sec. 40-33-34(I)(2) as amended by H 4159 (2024 Session). (Accessed Aug. 2024).

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.

A physician or physician assistant, pursuant to the physician assistant’s scope of practice guidelines, may delegate nursing tasks to unlicensed assistive personnel (UAP) under the supervision of the physician or physician assistant. Such nursing tasks include, but are not limited to performing nonclinical tasks via telemedicine. Pursuant to an advanced practice registered nurse’s practice agreement, he may delegate nonclinical tasks via telemedicine to a UAP as well.

SOURCE: SC Code Annotated Sec. 40-47-196 as proposed to be amended by H 5183 (2024 Session). (Accessed Aug. 2024).

Probate – Procedure for court appointment of a guardian; report evaluating condition of alleged incapacitated individual. For purposes of this section of law, at the discretion of the court, the “examination” must be conducted in person or virtually via telemedicine or other appropriate methods.

SOURCE: SC Code Sec. 62-5-303D(C) as proposed to be added by H 4234 (2024 Session). (Accessed Aug. 2024).

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 Jul. 2024).

Office of Adult Service and Aging

In-home services or adult day services may be provided to an individual who demonstrates a need for long-term supports and services through the assessment and meets 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 Jul. 2024).

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. 

SOURCE: SD Regulation 67:62:10:03. (Accessed Jul. 2024).

Substance Use Disorder

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

“Telehealth,” a method of delivering services, including interactive audio-visual or audio-only technology, in accordance with SDCL chapter 34-52 [included in the definition for “family counseling,” “group counseling,” and “individual counseling.”]

SOURCE: SD Regulation 67:61:01:01. (Accessed Jul. 2024).

Grants

SD allocated $5,000,000 to the Department of Health, for purposes of providing grants to assisted living centers and nursing facilities, licensed in accordance with chapter 34-12, to purchase and install technology and infrastructure for telemedicine.

SOURCE: Senate Bill 209 (2024 Session), (Accessed Jul. 2024).

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

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

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

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

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

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

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

The commission may adopt rules as necessary to:

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

Rules under this section may allow for the provision of:

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

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

Licensed Dyslexia Practitioners and Licensed Dyslexia Therapists

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

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

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

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

Occupational Therapists

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

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

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

Hospital Level of Care Designation for Maternal Care

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

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

Inmate Welfare

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

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

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

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

See statute for details.

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

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

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

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

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

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

Behavioral Analysts

Supervision of a person who performs behavior analysis services, and may include both direct and indirect supervision. A license holder may engage in direct supervision or indirect supervision in-person and on-site, through telehealth, or in another manner approved by the license holder’s certifying entity.

SOURCE: TX Admin Code Title 16, Part 4, Ch. 121, Sec. A, Sec. 121. 10 (Accessed Aug. 2024).

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

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

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

SOURCE: UT Admin. Code R432-100-34. (Accessed Nov. 2024).

Utah established the Early Childhood Psychotherapeutic Telehealth Consultation Program.

SOURCE: UT Code Sec. 26B-1-328, (Accessed Nov. 2024)

Utah established a Digital Health Services Commission.

SOURCE:  UT Code Sec. 26B-1-409, (Accessed Nov. 2024).

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

SOURCE: VT Statutes Annotated, Title 26, Ch. 56, Sec. 3052, (Accessed Nov. 2024).

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

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

• The Board of Medical Examiners shall issue a telemedicine license to authorize certain physicians, who hold a full and unrestricted license to practice medicine in another state or territory of the United States, to provide telemedicine services in the Virgin Islands. Telemedicine licenses shall be without private practice rights and without subversion of reciprocity. Any healthcare professional licensed in the Virgin Islands may practice telemedicine without restriction.
• The Board of Medical Examiners shall establish by rules and regulations the requirements for telemedicine licensure in accordance with this subchapter, provided that the rules and regulations include the following:
  1. A physician holding only a telemedicine license under this subchapter shall not open an office in the Virgin Islands, shall not meet with patients in the Virgin Islands, and shall not receive calls from patients in the Virgin Islands.
  2. The physician, when examining a patient by telemedicine, shall establish a bona fide physician-patient relationship by:

• • • Establishing a relationship and coordinating with the patient’s Virgin Islands-licensed healthcare professional.
    • Establishing a diagnosis through the use of accepted medical practices including, but not limited to, patient history, mental status and appropriate diagnostic and laboratory testing.
    • Discussing with the patient any diagnosis as well as the risks and benefits of various treatment options.
    • Ensuring the availability for appropriate follow-up care.
    • Fulfilling any other requirements as deemed appropriate and necessary by the Board of Medical Examiners.
• Any physician licensed to practice telemedicine in accordance with this subchapter, shall be subject to the provisions of this subchapter, the jurisdiction of the Board of Medical Examiners, applicable Virgin Islands law, and the jurisdiction of the courts of the Virgin Islands with respect to providing medical services to Virgin Islands residents.
• The Department of Health and the Territory’s hospitals and medical centers and Virgin Islands-licensed health care professionals are authorized to bill third-party payers for consultations and follow-up care provided by licensed providers of telemedicine services.

SOURCE: V.I. Code Title 27, § 45d (2019). (Accessed Sept. 2024).

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 Aug. 2024).

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

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

See staffing rules for telemedicine requirements for Addiction Medicine Service rules under the Department of Behavioral Health and Developmental Services.

SOURCE:  Virginia Admin Code, Title 12, 35-105-1840, (Aug. 2024).

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. (Accessed Jun. 2024).

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.

Effective June, 6, 2024, the statute has been updated by recent legislation to replace references to telemedicine to telehealth and additionally require the Collaborative to review the proposal authored by the uniform law commission for the state to implement a process for out-of-state health care providers to register with the disciplinary authority regulating their profession allowing that provider to provide services through telehealth or store and forward technology to persons located in this state. By December 1, 2024, the collaborative must submit a report to the legislature on its recommendations regarding the proposal.

SOURCE: RCW 28B.20.830 as amended by SB 5481 (2024 Legislation). (Accessed Jun. 2024).

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 Jun. 2024).

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

SOURCE: Revised Code of Washington Sec. 18.360.010 & WAC 246-827-0140 as added by Permanent Rule as amended by SB 5983 (2024 Session). (Accessed Jun. 2024).

When administering intramuscular injections for the purposes of treating a known or suspected syphilis infection in accordance with RCW 18.360.050, a medical assistant-certified or medical assistant-registered may be supervised through interactive audio or video telemedicine technology.

A medical assistant-certified may administer intramuscular injections for the purposes of treating known or suspected syphilis infection without immediate supervision if a health care practitioner is providing supervision through interactive audio or video telemedicine technology in accordance with RCW 18.360.010(11)(c)(ii). 

SOURCE: Revised Code of Washington Sec. 18.360.010 as amended by SB 5983 (2024 Legislative Session). (Accessed Jun. 2024).

Home Health and Hospice

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

SOURCE: WAC 246-335-510(8) & WAC 246-335-610. (Accessed Jun. 2024).

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

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

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

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

SOURCE: WAC 246-335-545(7-10) & WAC 246-335-645. (Accessed Jun. 2024).

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 Nov. 2024).

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

A dentist registered to provide teledentistry services shall complete continuing education as required by the State her or she is licensed in, but shall complete 3 hours of drug diversion as set forth in subdivision 3.5.4. of this rule every two years. 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 Nov. 2024)

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

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

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

HB 4110 (2024 Session) – Dietitians

Legislation authorizes the West Virginia Board of Licensed Dietitians to promulgate a legislative rule relating to telehealth practice, requirements, and definitions.

SOURCE: WV Statute 64-9-7 as amended by HB 4110 (2024 Session). (Accessed Nov. 2024).

Massage Therapy Licensure Board

The Board will not issue a license for the practice of telehealth for massage therapy due to it being an in-person and hands on profession.

SOURCE: WV Rule 194-1-5. (Accessed Nov. 2024).

Board of Acupuncture

The Board will not issue a license for the practice of telehealth due to the practice of acupuncture being an in-person office visit and hands on profession.

SOURCE: WV Rule 32-3-17. (Accessed Nov. 2024).

Medical Imaging and Radiation Therapy Technology Board of Examiners

Telehealth practice is inapplicable to the practice of a medical imaging and radiation therapy technologist.

SOURCE: WV Rule 18-1-6. (Accessed Nov. 2024).

The department of health services shall establish a pilot program to implement virtual behavioral health crisis care services for use by county or municipal law enforcement agencies in the field to connect law enforcement officers who encounter persons in crisis to behavioral healthcare services.

SOURCE:  Nonstatutory Provision, AB 573 (2023 Session), (Accessed Aug. 2024).

There is a Law Enforcement Officer Virtual Behavioral Health Crisis Care Pilot Program that may award grants to certified county crisis agencies to contract with their local law enforcement jurisdictions to provide telehealth equipment and develop virtual behavioral health care.

SOURCE:  Assembly Bill 573 (2023/2024 Session), (Accessed Aug. 2024).

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 Oct. 2024).

Connect Wyoming Program

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

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

Office of Rural Health

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

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

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

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

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

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

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