State medical boards continue to wrestle with telemedicine guidelines

By Jonah Comstock
07:35 am
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teladocacquisitonThe regulatory battles for telemedicine continue to play out slowly in state legislatures across the country. This week, Mississippi's medical board shelved a rule that would have put strict limits on telemedicine usage while Colorado's state medical board updated draft guidelines that will determine what doctors are and aren't allowed to do via telemedicine. And the interstate compact proposed last May by the Federation of State Medical Boards continues to build momentum as more than a fifth of states have now adopted it.

As reported by Mississippi Watchdog, the proposed Mississippi rule would have done a few things to make life more difficult for out-of-state telemedicine providers like Teladoc: It would require companies providing telemedicine services in Mississippi to establish a formal relationship with an in-state care provider and it would require video conferencing in order for any drugs to be prescribed.

"A physician may not prescribe medications based on a phone call or a questionnaire for the purpose of telemedicine," the proposed rule reads. "Videoconferencing is required as part of the teleconsult if a medication is to be prescribed. Telehealth services is not intended and therefore shall not be used for the management of chronic pain with controlled substance prescription drugs."

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The rule is being delayed while the medical board completes an economic impact statement, something which Teladoc noted was omitted from the rule in public comments the company made to the medical board.

In Colorado, meanwhile, the medical board's proposed guidelines would allow doctors to establish new relationships with patients via telemedicine, with no in-person visit, provided both parties are aware of each others' identity and consent to care via telemedicine. Healthcare Law Today, reporting on the proposed guidelines, also notes that the guidance specifically excludes medical marijuana from being prescribed via telehealth, as well as not allowing any prescriptions based solely on an internet questionnaire.

Finally, Politico reports, Illinois recently became the 11th state to adopt the interstate licensure compact that the Federation of State Medical Boards proposed last year. Alabama, Idaho, Iowa, Minnesota, Montana, Nevada, South Dakota, Utah, West Virginia, and Wyoming have all signed the compact already.

The compact would create a new option for doctors seeking out-of-state licensure, allowing them to fill out one set of paperwork to apply for licenses in any state that signed the compact. It would not prevent doctors from having to pay fees for additional licenses. In addition, there would be stricter controls on what doctors can apply for the expedited process — for instance, they must show evidence of board certification as a specialist and cannot be under investigation by their state medical board — even if the outcome of the investigation is still pending. 

A commission created by the compact will serve as a clearinghouse for applications, as well as for information about disciplinary and legal actions by the state medical boards. So if a doctor’s license is revoked in one state, it could automatically be revoked in all other states covered by the compact.

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