Telemedicine Requirements for Licensing, Scope of Practice, and Reimbursement

Description

One of the most significant regulatory challenges of telemedicine is licensure. For example, how does the state classify where a consult or treatment takes place? If the provider is providing a second opinion, does this fall under the same requirements? When is an in-person exam required? What are the exceptions to telemedicine licensure? Both physicians and non-physician practitioners must meet different states' requirements where they are consulting, diagnosing, or treating patients.

Further, most providers must comply with state scope-of-practice laws. Can mid-levels provide telemedicine services? If so, to what extent must they be supervised by, or collaborate with, physicians?

Reimbursement rules add another layer of complexity to telemedicine. Several restrictions limit Medicare coverage for telemedicine services. While most states' Medicaid programs cover some telemedicine services, the rules differ widely from state to state. Also, many states have telemedicine coverage and reimbursement laws that require private payers to cover telemedicine services.

Counsel for practitioners must understand what each state requires to meet the licensing, scope of practice, and reimbursement requirements. Also, counsel must be aware of myriad rules governing fee arrangements, anti-kickback and self-referral, and the corporate practice of medicine.

In an effort to expand access to care during the COVID-19 pandemic, the federal and many state governments have provided an array of waivers pertaining to many pertinent regulations. In what ways has this new regulatory flexibility affected the advice counsel should give respecting licensure, scope of practice, and reimbursement?

Listen as our authoritative panel examines regulatory requirements and challenges for healthcare providers and facilities related to licensing, the scope of practice, and reimbursement. The panel will offer best practices for overcoming these regulatory hurdles.