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American Telemedicine Association Cross-Border Licensure Update 2013
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American Telemedicine Association Cross-Border Licensure Update 2013

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Presentation made by Dr. Maheu on 5.7.2013 with Massachusetts Representative Daniel Winslow addressing licensure portability for telemedicine and tele health. To contact Dr. Maheu to have her speak at …

Presentation made by Dr. Maheu on 5.7.2013 with Massachusetts Representative Daniel Winslow addressing licensure portability for telemedicine and tele health. To contact Dr. Maheu to have her speak at your conference, write to info@telehealth.org

Published in: Health & Medicine

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  • 1. Noteworthy Initiatives Influencing National Licensure in Telehealth Practice AMERICAN TELEMEDICINE ASSOCIATION May 2013 Marlene M. Maheu, Ph. D.
  • 2. Functions Of Licensu re 0 Public Safety * Facilitate and centralize consumer Vg reporting * Prosecution of ’’evil agents” 0 Financial solvency of boards * (Protecting turf)
  • 3. Special Telehealth Licenses or Certificates Licenses could allow an out of state provider to render services via technology in a foreign state, or it allows a clinician to provide services via telehealth into a state if certain conditions are met (such as agreeing that they will not open an office in that state. ) http: //www. fsmb. org/ pdf/ grpo| _te| emedicine_| icen sure. pdf
  • 4. Special Telehealth Licenses or Certificates * Alabama * New Mexico ° Louisiana * Ohio 0 Minnesota ° Oregon ~ Montana ° Tennessee 0 Nevada * Texas http: //www. fsmb. org/ pdf/ grpo| _te| emedicine _| icensure. pdf
  • 5. States with Laws Mandating Private Insurance Coverage of Telemedicine
  • 6. States with Laws Mandating Private Insurance Coverage of Telemedicine States with the year of enactment: California (1996), Colorado (2001), Georgia (2006), Hawaii (1999), Kentucky (2000), Louisiana (1995), Maine (2009), Maryland (2012), Michigan (2012), Mississippi (2013), Montana (2013), New Hampshire (2009), New Mexico (2013), Oklahoma (1997), Oregon (2009), Texas (1997), Vermont (2012), Virginia (2010)
  • 7. States with Laws Mandating Private Insurance Coverage of Telemedicine States with proposed/ pending legislation: In 2013, Arizona (ENACTED)*, Connecticut, Florida, Illinois, Massachusetts, Mississippi (ENACTED), Missouri, Montana (ENACTED), New Mexico (ENACTED), New York, Pennsylvania, South Carolina, Tennessee, Washington and the District of Columbia ° *New Mexico's coverage applies to rural areas only
  • 8. U. S. Licensing Boards 1. State boards are not under a mandate to work collaboratively with other state regulators across U. S. states. 2. State laws are contradictory across states and even within states — and more so across national borders. 3. State laws have not adequately kept up with technology. Their catch-up problem is worsening with the advance of technological advancements.
  • 9. U. S. Licensing Boards 4. Most state regulators have not received formal training in the evidence base related to technology relevant to their disciplines ">. -.9,/ -y-’
  • 10. U. S. Licensing Boards 5. Turf wars occurring between states that make it difficult to get things changed. Some states refuse to compromise on some issues. — How to merge different types of credentials — Who will bear the cost and work involved in enforcement of infractions? — Who will absorb the short—fa| | when professionals licensed in several states only pay for licensure in 1 state?
  • 11. U. S. Licensing Boards 6. Worldwide health care practitioners of all types face competition from international colleagues, rogue practitioners, coaches and other groups who have poor or nonexistent regulatory systems. 7. State regulation is largely an honor system. Enforcement is lax and resources are limited for enforcement. Some states are leading while others are not yet noticeably involved. 8. Many boards are working on these issues and are joining discipline-based efforts to regulate telehealth (FSMB and ASPPB).
  • 12. Cross—Border Practice ° NOW: Most licensing boards assert that practitioners must be licensed in the location of the patient (at the time of contact) 6* Licensing Boards that may assert jurisdiction include: —The one in your state(s) of licensure —The one in the client/ patient’s state of residence/ location — Both
  • 13. Cross—Border Practice Safest approach: Decline patients where you are unlicensed —Use traditional proof of residency ° Driver's license, gov’t issued ID —Use authentication services if possible —Use opening protocol to ask and document location of patient ~ Check malpractice coverage for cross-border practice
  • 14. Telehealth Promotion Act of 2012 6 Senator Mike Thompson (CA) H. R. 6713 amended the Social Security Act to assert that telehealth must be covered in any case in which the corresponding in-person treatment would be covered. * Extends the benefits of telehealth and mHea| th to nearly 75 million Americans N»)-’ "'_": v.7xiiiv I . _ , , . ..
  • 15. Telehealth Promotion Act of 2012 ° Would increase access to telehealth within Medicare, Medicaid, the Children's Health Insurance Program (CHIP), TRICARE, federal employee health plans and the Department of Veterans Affairs. 0 Providers in all federal health plans would be licensed in the state of their physical location and be free to treat eligible patients anywhere in the nation
  • 16. Telehealth Promotion Act of 2012 Would also establish a federal reimbursement policy, whereir "no [medical] benefit covered shall be excluded solely because it is furnished via a
  • 17. Practical Implications - Verify your malpractice insurance coverage - Ask about patient’s location in your opening protocol - Inform patients of: — limits of your licensure — how you will handle their contact if they are in a state where you are unlicensed ° Visit ATA HUB for more licensing resources
  • 18. Resources ATA repository for documents: htt : hub. americante| emed. or Resources L ibra ryFo| ders[? Libra ryKey= cO886fO8-180e- 4b6f—a827—560c8063a24e