Georgia Composite Medical Board Issues New Telemedicine Rules

The Georgia Composite Medical Board enacted a new regulation governing the standards for telemedicine practice. The regulation, titled Practice Through Electronic or Other Such Means, is found under Georgia Comp. Rules and Regs. rule 360-3-.07 and is intended to establish the minimum standards of practice while providing treatment and/or consultation recommendations through the use of telemedicine.

Following two years of evaluation and discussions by the Board, the new rule went into effect May 3, 2014. Absent some minor changes, the rule is similar to the version originally contemplated by the Board. The rule offers some additional guidance on telemedicine practice in Georgia, although it does impose certain restrictions on telemedicine and telehealth in the State. Most notably, this is reflected in the rule establishing a default requirement of an in-person examination prior to a telemedicine encounter.

Highlights of the rule are as follows:

• Georgia License Required. All treatments and consultations via telemedicine must be done by Georgia-licensed providers, which includes not only physicians, but also physician assistants (PAs) and advanced practice registered nurses (APRNs).
• In-Person Examination. Prior to the telemedicine encounter, the telemedicine provider must have personally conducted an in-person examination of the patient unless one of three exceptions apply:

1. The telemedicine provider is able to examine the patient using technology and peripherals that are equal or superior to an in-person examination done by a provider within that provider’s standard of care.; or
2. The telemedicine provider is providing care (conducting the telemedicine encounter) at the request of a physician, PA or APRN licensed in Georgia who has personally seen and examined the patient; or
3. The telemedicine provider is providing care (conducting the telemedicine encounter) at the request of a Public Health Nurse, a Public School Nurse, the Department of Family and Children’s Services, law enforcement, community mental health center or through an established child advocacy center for the protection or a minor, and the provider is able to examine the patient using technology and peripherals that are equal or superior to an examination done personally by a provider within that provider’s standard of care.

• Records. The telemedicine provider must have the patient’s medical history available at the time of the consult. The provider must maintain patient records of the encounter and must document the evaluation and treatment. If there is a referring practitioner, the telemedicine provider must send a copy of this record to the referring practitioner.
• Operational. The patient must receive the telemedicine provider’s credentials and emergency contact information. The patient must also receive clear instructions on follow-up in the event the patient needs emergency care related to the telemedicine treatment.
• Annual In-Person Follow-Up Exam. The telemedicine provider must make “diligent efforts” to have the patient seen and examined in-person by a Georgia-licensed physician, PA or APRN at least once a year.
• Standard of Care. The regulations defer to the existing standard of care expectations, and do not alter existing requirements on the practice of medicine or medical malpractice.

Georgia is among the states taking the lead on telemedicine commercial insurance reimbursement, having enacted the Georgia Telemedicine Act in 2005, mandating commercial coverage of telemedicine services. The new Medical Board rule offers additional guidance on telemedicine practice standards in Georgia.