On Tuesday, we began to discuss the AMA’s new guidelines for telemedicine. These guidelines indicate the growth and increased comfort level of telemedicine’s use in day-to-day practice. The AMA’s report does not approve or disapprove of any specific technology, but does make the following recommendations for the delivery of health care services via telemedicine:

• Telemedicine services should be based on a valid patient-physician relationship established prior to the use of telemedicine services. This relationship can be established through methods such as a face-to-face examination, or a consultation with another physician who has an ongoing physician-patient relationship.

• Patients seeking care via telemedicine must be offered a choice of provider and should have access to documentation of the licensure and board certifications of their health care practitioners in advance of their visits.

• The patient’s medical history must be collected as part of the provision of any telemedicine service, the services provided must be properly documented, and a visit summary must be provided to the patient.

• Providers must establish protocols for emergency referrals.

• Delivery of telemedicine services must abide by laws addressing the privacy and security of patients’ medical information.

In July of 2013, Kentucky issued final rules expanding the coverage of telemedicine services for Medicaid beneficiaries. Although providers are still limited to using only interactive video-conferencing to qualify for reimbursement under Kentucky’s new rules, Medicaid beneficiaries now have access to a broader list of providers and telemedicine services.