Navigating Telemedicine Requirements for Licensing, Scope of Practice and Reimbursement
Partner Nate Lacktman spoke at a Strafford Publishing Web conference titled, “Navigating Telemedicine Requirements for Licensing, Scope of Practice and Reimbursement.”
When evaluating or establishing a multi-state telemedicine line of business, one of the initial regulatory challenges is licensure. Both physicians and non-physician practitioners must meet the differing requirements of each state in which they are consulting, diagnosing or treating patients. Obtaining the appropriate licenses is a costly and burdensome process.
Further, most states have scope of practice laws that require compliance. 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?
Reimbursement rules add another layer of complexity to telemedicine. Medicare is expanding its coverage for telemedicine services and regions that will be reimbursed. While most states’ Medicaid programs reimburse some telemedicine services, the rules differ from state to state. Also, some states have reimbursement laws that impact private payers.
Counsel for practitioners must understand what each state calls for to meet licensing, scope of practice and reimbursement requirements. In addition, they must also be aware of the myriad of rules governing fee arrangements, anti-kickback and self-referral, and the corporate practice of medicine.
The presentation provided guidance for counsel to health care facilities and practitioners on the requirements and exceptions for telemedicine licensing. The panel offered best practices for overcoming licensing challenges and discussed what providers should do to comply with the requirements.
The presentation reviewed these and other key questions:
- What are the regulatory challenges with meeting licensing requirements in multiple states?
- What are the exceptions of telemedicine licensure?
- What telemedicine services are covered by Medicare? by Medicaid?
- What are the regulatory hurdles relating to anti-kickback and self-referral?
For more information, please visit the Strafford Publishing Web site.
