Articles Posted in Telehealth

tixeo-virtual-openspace-300x202Our 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 Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Georgia.  There are specific rules governing prescribing via telemedicine, which are not covered by this post.  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, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Georgia Insurance Code’s Definition of Telemedicine

The Georgia Composite Medical Board (“Medical Board”) generally requires an in-person exam, but the Medical Board Rules allow telemedicine in certain situations.  The relevant definition of “telemedicine” is found in Georgia’s insurance code and defines “telemedicine” as:

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MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783Given the increased use of telehealth during the Public Health Emergency (“PHE”), the Centers for Medicare and Medicaid Services (CMS) passed a final rule modifying the rules around when Medicare will reimburse for mental health visits.  A previous blog post analyzed Federal laws and rules governing telehealth visits, including the general Medicare rules applicable during the PHE.  This post analyzes the changes to the Medicare telehealth reimbursement rules for mental health treatment that begin the day after the PHE ends.  Note, there are different rules when treatment includes for substance abuse disorders.  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, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Essential Requirements Under Medicare’s New Rule

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4-e1647895403919Many of our healthcare and business law firm’s clients have an interest in offering a practice that offers more flexibility to patients when it comes to in-person versus virtual visits.  Deciding to offer telemedicine visits to your patients not only requires acquiring a video product that satisfies HIPAA and other privacy requirements but requires compliance with numerous laws at the state and federal level.  This post analyzes potentially relevant federal laws and rules that currently apply during the Public Health Emergency (“PHE”).  A subsequent post will provide an overview of state law considerations.  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, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

State laws provide the majority of laws and regulations governing telemedicine visits.  There are, however, two potentially relevant federal rules that a medical practice should consider before offering telemedicine: Medicare rules and the Ryan Haight Act. Continue reading ›

csm_FlatDesign-Telework_c532b56131-e1645230859515Previous blog posts provided an overview of the Centers for Medicare and Medicaid Services’s (“CMS”) Vaccine Mandate and addressed whether boosters are required. To continue supporting our healthcare and business law firm’s clients, herein we have tackled more specific questions about CMS’s Vaccine Mandate.   This blog post outlines CMS’s current stance on whether remote workers and executives are required to be vaccinated if the practice falls under CMS’s vaccine mandate. As always, the analysis herein is current as of the date this blog is posted and subject to change as agencies and courts release new decisions.

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image_4-e1631547014743Last week, our blog post discussed the general rules permitting telemedicine in Georgia.  Often, our healthcare and business law firm’s provider clients who conduct telemedicine also need to understand the requirements around prescribing controlled substances based on telemedicine visits.  This post intends to outline some of the relevant prescribing rules in Georgia and the exceptions due to the Public Health Emergency (PHE) created by COVID-19.  This post intends to outline some relevant Georgia rules and regulations relating to telemedicine.  If you have questions about telemedicine or prescribing 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, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

Georgia Rules on Prescribing Controlled Substances via Telemedicine

As discussed in our prior blog post on the general telemedicine rules, we look to the Medical Board’s rules on Unprofessional Conduct, among other rules, to decipher what is allowed in Georgia.  Rule 360-3-.02 defines Unprofessional Conduct to include subsection (5), which provides that Unprofessional Conduct could include: “Prescribing controlled substances . . . and/or dangerous drugs . . . for a patient based solely on a consultation via electronic means with the patient, patient’s guardian or patient’s agent.”  As such, the general rule prohibits prescribing controlled substances via a telemedicine consult.  However, the rule does “not prohibit a licensee from prescribing a dangerous drug for a patient pursuant to a valid physician patient relationship in accordance with O.C.G.A. § 33-24-56.4 or a licensee who is on-call or covering for another licensee from prescribing up to a 30-day supply of medications for a patient of such other licensee nor shall it prohibit a licensee from prescribing medications when documented emergency circumstances exist.”  Rule 360-3-.02(5).  There are other exceptions related to specific Schedule II controlled substances.

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MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783Our healthcare and business law firm frequently receives questions asking about telemedicine rules in Georgia.  This post intends to outline some relevant Georgia rules and regulations relating to telemedicine.  Our next post will consider the rules around prescribing based on a telemedicine consult and how COVID-19’s Public Health Emergency impacts those rules.  If you have questions about telemedicine rules and regulations 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, info@hamillittle.com. You may also learn more about our law firm by visiting www.hamillittle.com.

General Telemedicine Rules and Definitions

The Georgia Composite Medical Board (“Medical Board”) generally requires an in-person exam, but the Medical Board Rules allow telemedicine in certain situations.  To begin, the relevant definition of “telemedicine” is found in Georgia’s insurance code and defines “telemedicine” as:

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As a healthcare and business law firm, we work with may healthcare providers and employers who wish to integrate telehealth into their business models and, understandably, have questions.  4-300x169What is telehealth versus telemedicine?  What laws and rules govern the practice of telemedicine?  Has COVID-19 impacted telemedicine?  Etc.  This post intends to outline some of the rules and laws relevant to practitioners, including the impact of HB 307 on telehealth in Georgia.  If you have questions regarding this blog post or telehealth, you may contact us at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@hamillittle.com.

As an initial matter, telehealth and telemedicine are distinct terms.  Telemedicine is a subset of telehealth.  The definitions of both are found within Georgia’s insurance code.   Telehealth is defined as “the use of information and communications technologies, including, but not limited to, telephones, remote patient monitoring devices or other electronic means which support clinical health care, provider consultation, patient and professional health related education, public health, and health administration.”  O.C.G.A. § 33-24-56.4(b)(6).  “Telemedicine” is defined as:

[A] form of telehealth which is the delivery of clinical health care services by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology to provide or support health care delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care by a health care provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in this state, while such patient is at an originating site and the health care provider is at a distant site.

Telemedicine has new and profound importance due to the COVID-19 crisis.  “Virtual” healthcare preserves patient protective equipment that would otherwiimage_4-e1587393250939se be used and allows physicians to manage chronic illnesses remotely, without the in-person interaction that exposes provider and patient to the risk of spread. This increased reliance on telemedicine has prompted state and federal legislative bodies to pass new rules and guidelines to promote access to telehealth services by reducing costs, increasing availability, and promoting relationships between healthcare providers and their patients.   Our Georgia-based business and healthcare law firm follows regulatory developments that impact healthcare providers.  As of the date of this post, seven states (Arizona, Florida, Kansas, Maine, New Jersey, Oregon, and Utah) have waived restrictions on telehealth. More relaxation of telehealth rules may be expected.

 New Regulations: an Overview

Virtual medicine is expected to aid in slowing the spread of coronavirus by limiting contact between individuals.  New telemedicine regulations encourage video and audio conversations between providers and their patients.  Telemedicine platforms can serve a variety of functions, some assist with managing patient triage, while others provide alerts to providers and patients in regard to medication management.  Other platforms allow for effective monitoring of chronic illnesses for patients, even with the strict social distancing guidelines that are currently in place. Thus, as part of an effort to allow healthcare providers to better support each other and their patients, the federal government has reduced the regulatory hoops that have previously limited access to Telehealth services. The CMS Fact Sheet discusses in depth the changes that have been made to provide virtual services.

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