Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate the delivery of virtual care.

Trending in the past week:

• Expanding Telehealth
• Telehealth Practice Requirements

A CLOSER LOOK

Finalized Legislation and Rulemaking:

• Indiana enacted SB 132, which removes the requirement that out-of-state providers licensed in Indiana and their employer/contractor file a certification to be subject to Indiana jurisdiction and laws with the Indiana Professional Licensing Agency before providing telehealth services in Indiana. Providers would still be subject to Indiana jurisdiction and substantive and procedural law.
• In Indiana, SB 104 was also enacted, which requires veterinarians and veterinary technicians to disclose certain information when renewing a license or registration certificate including whether services are provided via telehealth.
• New Hampshire adopted a final rule, which includes amendments to describe the initial application process, qualifications, renewals and audits for psychologists. It also clarifies requirements for a tele-pass license for psychologists.
• Utah enacted HB 44, which enters Utah into the Social Work Licensure Compact.
• Utah enacted HB 145, which permits veterinarians to supervise veterinary technicians via telehealth. Previously, veterinarians were only permitted to supervise state-certified veterinarian technicians via telehealth.

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

• In Maryland, HB 1078 passed the first chamber. The bill would require the state Medicaid program to provide ultrasound procedures and remote fetal nonstress tests in certain circumstances.
• In Wisconsin, SB 823 passed the first chamber. This bill would require out-of-state practitioners to register with the Department of Safety and Professional Services or an applicable Wisconsin credentialing board to provide telehealth services in Wisconsin.
• In Kentucky, HB 829 passed the first chamber. This bill, among other things, would require a patient or designated caregiver to complete a consultation with an authorized pharmacist prior to purchasing medical cannabis and would require the patient to complete the consultation annually. The bill includes an exception to the consultation requirement for visiting qualified patients presenting a valid out-of-state registry identification card and proof of diagnosis of a qualifying condition. It provides that the consultation may be completed via telehealth and establishes a process for pharmacists to become authorized to provide medical cannabis consultations.
• In Michigan, a proposed rule would require chiropractors to obtain consent from patients before providing telehealth services, maintain proof of consent in patient’s medical record and require chiropractors to exercise the same standard of care applicable to in-person service when providing service via telehealth.
• In Nevada, a proposed rule would establish provisions related to teledentistry, including requiring dentists to collect a digital form of written consent for a patient, specify recording keeping requirements for teledentistry and establish standards for collaborations with other providers.
• In Texas, a proposed rule would permit physical therapists providing services to students with disabilities in the educational setting to perform certain examinations via telehealth by removing the onsite examination requirement.
• In Wisconsin, a proposed rule would require optometrists to be licensed in Wisconsin or to obtain a temporary credential from the Optometry Examining Board in order to provide optometry services via telehealth to patients located in Wisconsin.

Why it matters:

• States continue to amend and clarify professional practice requirements for telehealth. With the increase in the delivery of care through virtual modalities, legislatures are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices. States continue to expand the kinds of services that may be provided via telehealth modalities, but these expansions often come with new requirements that providers must comply with to provide telehealth services.