The foundation for operating a successful telemedicine practice while minimizing risk is as simple as a junior high school geography test — know your states.
“Different states have different rules and regulations regarding the delivery of telemedicine, which can make it difficult for providers to offer services across state lines,” said Judy Klein, risk management manager at Coverys, a medical malpractice insurance provider. “Many special exceptions made during the pandemic through waivers are now expiring. The licensure requirements of multiple states may be needed and state law may also dictate whether physician assistants and nurse practitioners can practice telemedicine across state lines.”
What is considered telemedicine, telehealth and everything in between varies state by state, and in-depth research, outreach and strategy are needed to stay in full compliance and out of the courtroom. Doctors need to make sure that their telemedicine professional liability insurance covers each state that they are providing services for patients, and that the liability insurance carrier has a representative that has a high level of expertise in each state’s laws, legislation and regulations.
“Along with state licensing requirements, some states have specific laws that govern the use of telemedicine,” Klein said. “Some states require that patients have an established relationship with a physician before receiving care via telemedicine. Some states also have laws that govern how telemedicine services may be billed and what type of insurance coverage is required.”
With 2022 being a mid-term year and heavy turnover expected in many state legislatures, this attention to detail is not a luxury — it is a requirement.
When providing healthcare care across state lines physicians and their administrative and legal staff have to know in detail each state’s laws and regulations in providing care, technology, effects of technology downtime and continuity of care. Offices should also emphasize the importance of documenting exactly when the patient relationship begins with the doctor.
Along with different state regulations, telemedicine providers have to be cognizant of operating in states that have patient compensation funds specifically for malpractice suits. Currently, the states that have the largest patient compensation funds are: Connecticut, Indiana, Kansas Louisiana, Nebraska, New Mexico, Pennsylvania, Virginia and Wisconsin.
If you are operating in any of these states make sure your telemedicine professional liability insurance provider has an expert available to talk to you at a moment’s notice for clarification of current laws and updates to new legislation and regulation regarding the state’s patient compensation fund.
“As telemedicine becomes more common, it is vital for providers to be aware of the laws in their state to ensure that they are providing care in compliance with the law,” Klein said. “Consultation with an attorney is essential.”
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