Little Health Law Blog
Our healthcare and business law firm works with many physicians and other providers with their medical practices, including integrating telemedicine services into their practice and/or creating a full telemedicine practice. The telemedicine laws and rules have gone through major changes since the COVID-19 Pandemic, and the laws and rules continue to be in a state of flux. The federal rules govern prescribing controlled substances, but the majority of telemedicine rules are governed by state law. Generally, before a provider can prescribe any drug, the provider must have an established patient-provider relationship. An open question in many states we’ve researched is-Can you create a patient-provider relationship through telemedicine? This post dives into this question, with a focus on Georgia rules. If you need assistance integrating telemedicine into your practice 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
Each state is going to answer this question differently. Let’s dive into the rules in Georgia as an example of how to think through this question.
First, it’s important to understand what telehealth modalities are permitted in a given state. In Georgia, for instance, the definition of telemedicine is found within the insurance code. Georgia Code Section 33-24-56.4 (“Ga. Telehealth Act”) defines telemedicine 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 . . . .”
Second, it’s also important to understand if a given state’s Medical Practice Act dictates when telehealth is permitted. Among many other requirements, the baseline standard for when a provider can provide care through telehealth in Georgia is that the provider “is able to examine the patient using technology or peripherals that are equal or superior to an examination done personally by a provider within that provider’s standard of care.” Rule 360-3-.07(a)(3.d.)
Third, just because a modality is permitted does not mean it can be used to establish a patient-provider relationship. A state’s medical practice laws and/or medical board may provide specific guidance on how to create a patient-provider relationship through telemedicine. Often times, however, the rules permit provider discretion. As an example, in Georgia, it’s unclear whether a video call and/or whether store and forward technologies can create a patient provider relationship. Here is a question to and answer from the Georgia medical board within the last year:
Question: “As a practical matter, what does a doctor’s office need to do in order to establish a provider-patient relationship via telehealth?” For example, can the doctor’s office establish the relationship using an online questionnaire? Or is a real-time audio-visual (e.g. Zoom call) experience required?
Answer: After discussion, the Board would like to refer to the existing rules concerning this matter (Rule 360-3-.07). Specifically, subsection (a)(3) addresses four scenarios for how a Georgia licensed physician, physician assistant, or advanced practice registered nurse would practice through electronic or other such means. https://rules.sos.state.ga.us/GAC/360-3-.07.
As you can see, the Board did not answer “yes” or “no.” My interpretation is that the Georgia Medical Board is leaving it up to the provider to determine what is required with a particular patient to establish a patient-provider relationship. What may be required in a given situation is very fact dependent. Our firm has worked with many different medical practices to provide guidance with the provider’s input on how to properly integrate telemedicine into their practice.
If you need assistance integrating telemedicine into your practice 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.