via Lockton Compliance Services
After four years of wrangling with telemedicine providers, the Texas Medical Board formally adopted rules that limit the use of telemedicine. Employers offering (or considering offering) telemedicine benefits to Texas employees will want to work with their telemedicine providers to determine how the new restrictions, which are effective June 1, 2015, will affect their benefits.
Prior to the recent ruling, Texas required a physician-patient relationship before a physician could diagnose or treat a condition; however, it was unclear how this relationship could be established through telemedicine.
The new rules provide that a remote physician is able to create the required physician-patient relationship with respect to a new patient or condition only if the patient is at an established medical site and is in the presence of another licensed medical professional acting on behalf of the remote physician. The rules make clear that the required relationship cannot be based solely on common telemedicine practices like “an online questionnaire or questions and answers exchanged through email, electronic text, or chat or telephonic evaluation of or consultation with a patient.”
The appointment must take place at an established medical site, which generally does not include the patient’s home. In-home visits are permissible if certain requirements are met, including real-time audio and video, and all necessary equipment is present to evaluate the patient.
Once the physician-patient relationship is established with respect to a particular condition, the remote physician may treat the patient without the patient being in the presence of another licensed practitioner. Presumably this follow-up appointment can occur at the patient’s home without the additional practitioner; however, the rules are vague on this point.
The Board did provide more flexibility for mental health. Specifically, mental health services may be provided at the patient’s house and do not require the assistance of another licensed practitioner.
While this ruling is limited to Texas, it serves as a good reminder that states have the authority to regulate the practice of medicine. Further, many states are yet to provide clear rules around the provision of telemedicine, and it is likely that those states will at least consider the approach taken by the Longhorn State.
For those interested, the American Telemedicine Association has a dearth of resources discussing how each state regulates telemedicine benefits.
Scott Behrens, J.D., Compliance Services
Not Legal Advice: Nothing in this Alert should be construed as legal advice. Lockton may not be considered your legal counsel and communications with Lockton’s Compliance Services group are not privileged under the attorney-client privilege.