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Navigating regulations and risks in the expanding world of telehealth
By Jayme Matchinski on April 2, 2019 at 9:30 AM

Image of a cellphone showing an app for calling a doctor, with the words "Health Care Today Series: The Telehealth Landscape"The expansion of telehealth is changing the landscape of health care. This is the first in a four-part series exploring what providers should know about this growing area.

Health care providers and patients are relying more heavily on telehealth for the provision of health care. The rise of telehealth is changing the landscape of how health care is provided due to advances in technology and health care delivery systems, and it is improving patient access to health care and the quality of patient care. As the use of telehealth continues to expand, health care providers and third-party payors need to ensure regulatory compliance and navigate the related risks in implementing telemedicine practices and programs. 

Currently, there are no uniform telehealth regulations other than Medicare and Medicaid coverage guidelines and regulations, which we will cover later in this series. No federal telehealth statutes or regulations have been set forth. Most telehealth regulations have been enforced on a state level due to scope of licensure and reimbursement.

Telehealth laws and regulations

Proposed laws and rules related to telehealth will continue to expand coverage, and many national insurance companies have implemented online medicine by adding access to approved telehealth networks for their insureds. The provision of online medicine and related telehealth services by health care providers for the most part is subject to the same regulatory and liability issues as “brick and mortar” providers. Issues regarding across state line care, HIPAA violations, kickbacks, and inappropriate prescribing for drugs, medical devices and durable medical equipment (DME) are all key considerations for health care providers who decide to provide telehealth services.

Health care providers entering into agreement for the provision of online health care should be aware of the regulatory and liability risks associated with telehealth to address the patient consent, fraud and abuse, licensing and HIPAA hurdles. 

State telehealth regulations

Telehealth regulations vary from state to state. Many states have updated or adopted new state law to require private insurers to cover services provided through telemedicine if the same services provided in person are covered and reimbursed by the insurance companies. Generally, these “parity” state laws require health insurers to cover and provide reimbursement for services provided via telehealth in a comparable manner to how the payor would for the same services provided in person.

Each state must regulate telehealth issues related to: establishing the physician/patient relationship, patient consent and disclosures, scope of practice, licensure, recordkeeping and information access, clinical standards, payment practices, coordination of care, and prescription standards.

Next in our telehealth series: Medicare Coverage for Telehealth

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