Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules, insurance code, and, when applicable, Medicaid rules. This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Alabama. This post does not discuss telemedicine prescribing rules. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
Alabama Rules Prior to July 11, 2022
Telemedicine authority in Alabama is new. In fact, the law discussed herein (Act No. 2022-302) does not go into effect until July 11, 2022. Prior to the enactment of Act No. 2022-302, there was little to no authority regulating telemedicine versus traditional in-person medical practice, and physicians were held to the same standard of care, regardless of treatment modality, regarding such matters as the establishment of a physician-patient relationship and the prescribing of controlled substances and other medications. Prior to the enactment of Act No. 2022-302, physicians treating Alabama citizens via telemedicine had to have the medical license and controlled license of an Alabama physician and were held to the same standards as in-person treatment. See, e.g., Ala. Admin § 540-X-9-.11. Regarding prescribing controlled substances, telemedicine physicians were required to adhere to all federal and state statutes, and federal regulations currently require a previous in-person examination before prescribing controlled substances via telemedicine, except in a declared health emergency. Id.
New Alabama Statute
On Apr. 12, 2022, Alabama Governor Kay Ivey signed Act No. 2022-302, the provisions of which become effective on July 11, 2022, which governs the practice of telehealth/telemedicine in Alabama. See Act No, 2022-302; see also https://www.albme.gov/resources/licensees/telemedicine/ The Act establishes Ala. Code Section 34-24-700 et seq. and repeals Ala. Code Section 34-24-500 et seq. as of July 11, 2022.
The new Alabama telemedicine rules create many requirements, including:
Except in cases of irregular or infrequent treatment (i.e., services occurring less than 10 days in a calendar year or involving fewer than 10 patients in a calendar year) or treatment provided in consultation with a physician licensed to practice in Alabama, any physician engaging in telemedicine with a patient physically-located in Alabama must possess a full and active license to practice medicine or osteopathy issued by the Alabama Medical Licensure Commission. Ala. Code § 34-24-702. As licensees of the Alabama Medical Licensure Commission, physicians providing telemedicine services to Alabama residents are still subject to all regulations issued by the Alabama State Board of Medical Examiners and the Alabama Medical Licensure Commission, including their regulations regarding maintaining patient medical records and the confidentiality thereof, and all other relevant state and federal laws, such as the requirement to obtain and renew on an annual basis (on or before December 31 of each year) an Alabama Controlled Substance Registration Certificate, which requires maintenance of an active DEA registration. See Ala. Code § 20-2-51; Ala. Admin. § 540-X-4-.01.
Physicians engaging in telemedicine “owe to the patient the same duty to exercise reasonable care, diligence, and skill as would be applicable if the service or procedure were provided in person.”
iii. Establishing Physician Patient Relationship
The new laws explicitly provide that a telehealth/telemedicine physician-patient relationship “may be formed without a prior in-person relationship.” Ala. Code § 34-24-703. There are additional requirements the physician must do in Ala. Code § 34-24-703.
If a physician provides telemedicine services to the same patient more than four (4) times in a twelve (12) month period for the same medical condition, the physician must either: (a) see the patient in person within a reasonable amount of time (which shall not exceed twelve (12) months); or (b) refer the patient to a physician who can provide in-person care within a reasonable amount of time (which shall not exceed twelve (12) months). Ala. Code § 34-24-703.
As is clear from the above, medical practices must be thoughtful before offering telemedicine services. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.