Articles Posted in Telehealth

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iStock-1014086596-1000x500-2-e1661804634296-300x182Many of our healthcare and business law firm’s clients have an interest in offering more flexibility to patients.  Common flexibilities we see include offering alternative pay structures and virtual visits.  Since COVID-19, the use of telemedicine visits has increased and remains higher than pre-pandemic levels.  Complying with telemedicine rules requires analyzing federal, state, and payor requirements.  Under the federal Ryan Haight Act of 2008, a prescribing provider may prescribe controlled substances only after an in-person evaluation.  An exception to that rule is when the Secretary of the U.S. Department of Health and Human Services (“HHS”) declares a public health emergency (“PHE”).  21 C.F.R. § 1300.04(i)(4).  During the COVID-19 PHE, the in-person requirement was waived.  Although the PHE is over, the tele-prescribing flexibility for controlled substances remain.  This post discusses the reasons why the DEA continues to allow the COVID-era flexibilities and what the Third Temporary Extension (issued November 19, 2024) does.  If you have questions about tele-prescribing rules that may apply to 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 https://www.littlehealthlaw.com/.

At the outset, here is a summary of the COVID-Era Flexibilities from the DEA’s March 20, 2020 press release, which our firm discussed in a previous blog post.  DEA-registered practitioners may issue prescriptions for all schedule II-V controlled substances to patients for whom they have not conducted an in-person medical evaluation, if all the following conditions are met:

  • The prescription is issued for a legitimate medical purpose by a practitioner acting in the usual course of his/her professional practice;
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4-300x169Our 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. Continue reading ›

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woman_receiving_skin_resurfacing_treatment_657671370-e1696966883317Our healthcare and business law firm works with healthcare providers and businesses to open cosmetic medical and wellness spas.  The medical spa entity has grown drastically over the past few years.  Some states and medical boards have developed laws and rules governing medical and wellness spas.  As medical and wellness spas continue to grow, we can anticipate more laws and rules governing medical and wellness spas.  On July 19, 2023, the Alabama Board of Medical Examiners (“Medical Board”) published changes to the rules governing the “Use of Lasers and Other Modalities,” which can be found in Chapter 540-X-11 of the Rules of the Medical Board.  The rule is broken down into many different categories.  A previous post provided an overview of the rule changes that are potentially applicable to medical spa practitioners.  This post focuses on important rules that apply to Non-Laser Skin Rejuvenation procedures.  If you have a question about the Alabama Medical Board’s 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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

As mentioned in the previous blog post, the use of Lasers/Pulsed Light Devices (“LLBDs”) for cosmetic purposes is considered “the practice of medicine” in Alabama.  Level 1 and Level 2 Delegates can perform certain LLBDs only if allowed by the rules, which go fully into effect on July 17, 2024.  This post focuses on the new rules governing Non-Laser Skin Rejuvenation. Continue reading ›

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blog-2-lede-photo-e1656706286125At the beginning of COVID-19, telemedicine rules were softened on the state and federal level.  In a previous blog post, we discussed the softened Georgia rules during the COVID-19 State of Emergency in Georgia.   Unlike the federal Public Health Emergency that was recently lifted, the Georgia State of Emergency was lifted in early 2022.  But now that both the state and federal emergency-statuses are lifted, what does that mean for the telemedicine prescribing exceptions available during COVID-19?  This post intends to answer that question.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Although Georgia has clear requirements for when telemedicine is generally allowed and what the general requirements are (which must, of course, be followed if prescribing is allowed), the only restriction on prescribing via telemedicine is with pain management drugs and controlled substances. Continue reading ›

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GettyImages-1296010644-e1689271225783At the beginning of COVID-19, telemedicine rules were softened on the state and federal level.  In a previous blog post, we discussed the Medicare and Ryan Haight Act rules during the COVID-19 Public Health Emergency (“PHE”).   The PHE was lifted on May 11, 2023, and there is no final rule modifying the Ryan Haight Act, so that leaves the question:

Do we go back to the strict Pre-Covid-19 telemedicine rules? 

This post intends to answer that question.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

  • Pre-COVID-19 Federal Prescribing Rules

Under the federal Ryan Haight Act, prescribing controlled substances generally requires that the Practitioner/prescriber conduct at least one in-person medical evaluation of the patient.  21 U.S.C. Sect. 829(e) (“Controlled substances dispensed by means of the Internet”).    This is still the law on the books, but, as you’ll see below, there are still COVID-era exceptions in place as well as proposed rules to modify this law (nothing is final yet so it’s important to know the current law). Continue reading ›

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imagesOur 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 codes, and when applicable, Medicaid rules.  This post focuses specifically on Florida’s telemedicine prescribing rules.  Our firm previously posted an overview of Florida’s general telemedicine rules.  Keep in mind that this post discusses the current laws as of the date written and do not include any changes to the laws after being posted.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Florida Rules on Prescribing Based on a Telemedicine Visit

Florida is rather generous in its prescribing rules for telemedicine.  Before July 1, 2022, the law restricted prescribing all controlled substances except for certain situations.  Continue reading ›

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MM-0220-Telemedicine-iStock-e1581381176331-1024x814-1-e1631301250783Our 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 or position statements, insurance code, and when applicable, Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in Florida.  This post does not discuss telemedicine prescribing rules or Medicaid rules.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Florida Rules

The Florida telehealth rules are set out in Florida Statute 456.47, which was modified in 2022 through Senate Bill 312.  Florida allows a limited telemedicine license for those without a full medical license, but, in general, the same rules apply regardless of whether a provider has a full medical license or limited telemedicine license. Continue reading ›

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iStock-1014086596-1000x500-2-e1661804634296Our 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 when applicable, Medicaid rules.  This post focuses specifically on North Carolina’s telemedicine prescribing rules.  Our firm previously posted an overview of North Carolina’s general telemedicine rules.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

North Carolina Rules on Prescribing Based on a Telemedicine Visit

North Carolina has yet to pass any laws on telemedicine, but the North Carolina Medical Board (“Medical Board” or “NCMB”) has published telemedicine policies available on its website, here. Below is an overview of some requirements currently in North Carolina governing prescribing practices from a telemedicine visit. Continue reading ›

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4-e1647895403919Our 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 or position statements, insurance code, and when applicable, Medicaid rules.  This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in North Carolina.  This post does not discuss telemedicine prescribing rules or Medicaid rules.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

North Carolina Rules

North Carolina has yet to pass any laws on telemedicine, but the North Carolina Medical Board (“Medical Board”) has published telemedicine policies available on its website, here. Below is an overview of some requirements currently in North Carolina governing the practice of telemedicine. Continue reading ›

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Our 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 when applicable, Medicaid rules.  This post focuses specifically on Tennessee’s telemedicine prescribing rules.  Our firm previously posted an overview of Tennessee’s general telemedicine rules.  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@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.

Tennessee Rules on Prescribing Based on a Telemedicine Visit

A. General Telemedicine Prescribing Rules

Continue reading ›

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