Interstate Telehealth: Rules and Helpful Tips

By Harrison Tyner

In my last blog post I discussed the cause-effect relationship telehealth is having on interstate treatment and multi-state licensure trends. Today I will go into more detail surrounding the nuances of interstate telehealth laws and how best to coordinate your transition online within the parameters of your state board.

I first want to start by acknowledging the fact that interstate treatment is an issue for providers and there currently is no federal or compact license provision that alleviates this problem. This is a post that does not delve into why that is, but rather, expounds on how to navigate the current regulatory environment.

The principal rule to remember here is that in the majority of cases the provider must be registered in the state in which the patient resides. This is the case not necessarily because that state doesn’t think your license in another state is adequate; they simply want to be aware of who and in what manner their resident is receiving treatment. If you are a provider and want to treat a patient in another state, you should approach that state’s board and asks permission to treat the patient. Often, permission is granted and you will be allowed to register in that state. It is important to do your own homework on each state’s policy before delivering treatment because each one is different. For instance, Massachusetts openly allows out of state providers to treat its citizens, where as, California requires providers to be licensed in C.A. and the patient’s state. Note that even if your state board does not have an official policy regarding telehealth, you may be subject to the state’s telemedicine policy. It is important to check with medical boards to see if this is the case, and again, get their response in writing!

When talking to state boards it is important to understand that the representatives you speak to may not be trained or informed on interstate telehealth issues. In fact, depending on who you speak to you could get completely different answers. The best things to do is CYAWP (Cover You’re A** With Paper). That is, ask them to verify whatever they say in writing, this way you at least have some level of protection.

To summarize, here is a list of helpful things to know when considering interstate treatment:

• There is no law requiring state boards to communicate with one another, so its up to you to be proactive and know each states policy.

• The state board where your patient resides is the one you need to talk to, even above your own.

• State board representatives are often untrained on interstate telehealth issues and may mis-inform you. You should get everything they say in writing.

• If your state board has no rules concerning telehealth, they could default to the states tele-medicine policy (there is a difference!)

• Your relationship with you state board legally supersedes that of your patient and should not be overlooked.

• State boards aren’t out to get you, they just want to be informed.

• State regulation is largely an honor system, not an investigatory system (but you should work with them and not around them!)

Telehealth has grown leaps and bounds in just a few short years. It is constantly becoming easier to conduct treatment online as regulation continues to catch up with the industry. Starting an online practice is easy, and following these simple measures will make the process worry and hassle free!

Before getting started I encourage providers to learn more about telehealth in general and HIPAA compliant telehealth solutions. You can keep up on the most recent telehealth news by following our blog. Good luck!