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Louisiana Joins its Peers in Removing In-State Barriers to Telemedicine

Last week, Louisiana legislators approved the removal of certain restrictions on the delivery of telemedicine services to residents of Louisiana to encourage the provision of telemedicine services in the state.  H.B. No. 570 was signed by the President of the Senate on June 5, 2016 and sent to Governor John Bel Edwards on June 6, 2016.

Notably, the Bill modifies the telemedicine requirements under La. Stat. Ann. § 37:1271, and R.S. 40:1223.3(5) and 1223.4(A) as follows:

  • A physician practicing telemedicine in the state who does not maintain a physical practice location within the state of Louisiana (but who is licensed in the state and has access to the patient’s medical records) is no longer required to first conduct an in-person patient history or physical examination of the patient before engaging in a telemedicine encounter.
  • In sum, La. Stat. Ann. § 37:1271 now requires that telemedicine providers hold an unrestricted license to practice medicine in Louisiana; obtain access to the patient’s medical records upon consent of the patient; create a medical record on each patient and make it available to the Louisiana State Board of Medical Examiners upon request; and, if necessary, provide a referral to a physician or arrange follow-up care in the state, as indicated.
  • The definition of “synchronous interaction” found in S. 40:1223.3(5) is now broadened to allow providers to use audio (without video) for telemedicine encounters if the same standard of care as in-person encounters is maintained.
  • This means that patients will be able to use a phone for telemedicine purposes, which is especially useful for patients who may not have: access to video-based technology, the know-how to connect with a provider using video-based technology, or an appropriate data plan/wireless connection for the simultaneous transmission of video.
  • Each state agency and each professional or occupational licensing board or commission authorized to adopt rules and regulations specific to the practice of telemedicine pursuant to S. 1223.4(A) is now prohibited from adopting any rules or regulations that are more restrictive than the provisions of the present law.

Like Alaska’s recent modifications to its telemedicine requirements, the Louisiana Bill broadens the base of available health care providers through the removal of the in-state restriction, which helps to increase the supply of physicians and competition from lower-cost providers, reduces transportation costs and improves access to quality care.  In addition, this Bill expands the types of technologies that may be used to deliver telemedicine services, which will better accommodate the significant portion of health care consumers who prefer phone consultations to access care.




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FTC Weighs-in on Telehealth: Providing Comments Regarding Alaska’s Proposed Licensure and Standard of Care Requirements

In March 2016, the US Federal Trade Commission (“FTC”) staff submitted public comments regarding the telehealth provisions of a proposed state bill in Alaska demonstrating the FTC’s continued focus on health care competition and general discouragement of anti competitive conduct in health care markets, with a renewed interest and focus on telehealth.

(more…)




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Developing and Implementing an Effective Telemedicine Informed Consent Form

The search by consumers, payers and providers for more efficient, effective and convenient care delivery models has led to an explosion of technological innovation in the health care sector. This explosion has supported the increased use of telemedicine by providers to reach patients who were previously out of reach, and to provide more timely and cost-effective care.

With the use of telemedicine technologies comes a responsibility on the part of providers to educate and inform patients on the benefits, and more importantly, on the risks associated with receiving care via telemedicine. Like any other care setting, compliance with this responsibility serves the dual purpose of providing consumers with the information needed to make an informed decision about their care, but also mitigates the provider’s potential liability exposure from medical malpractice claims. (more…)




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New Year, New Telehealth Opportunities

As we reflect upon how the health care industry has changed in 2015 and what we expect to see in 2016, there is one area that stands out as having great promise for continued growth—telehealth.

  • There were more than 200 telehealth-related bills introduced in 42 states in 2015, many of which helped to encourage the growth and expansion of telehealth. More than half of the states now have laws that mandate some degree of coverage of telemedicine programs by private payers. In addition, nearly a quarter of the states have joined the Interstate Medical Licensure Compact, which provides a more streamlined licensure process for physicians who are located in a “Compact state” and who provide telemedicine services to residents of another “Compact state.” In 2016, we expect even more states will adopt laws to require health insurance coverage for telemedicine services and ease the licensure requirements for health care professionals who are engaged in multi-state telemedicine programs. See our article, “States Begin 2016 with the Expansion of Telehealth Services,” for additional details.
  • There has been a marked increase in consumer investment in personal health and wellness, partly as a cost reduction strategy in light of high-deductible health plans, over the past few years. Consumers are particularly excited about the possibilities of telehealth, which has spurred the expansion of direct-to-consumer telehealth programs. In 2016, we anticipate an increase in the number of consumers who use telehealth services, as well as an increase in the types of telehealth technologies used.
  • An increasing number of employers—ranging from big to small—offered telemedicine as a benefit to employees in 2015 in an effort to reduce health care costs and as a means of improving employee health. Given the broad breadth of coverage included in the cost of employer-sponsored coverages, and the desire for employers to improve employee health to increase productivity and satisfaction levels, we anticipate that even more employers will turn to telemedicine as a solution in 2016.
  • The telehealth programs of accountable care organizations (ACOs) and clinically integrated networks (CINs) proved to improve patient access to care (particularly in the area of behavioral health) and deliver quality care at a lower cost—a critical imperative in the post-Accountable Care Act era of value-based purchasing. The realization of these benefits in 2015 will likely contribute to an increase in the number of ACOs and CINs using telemedicine as a tool in 2016.
  • There was a marked rise in 2015 in the number of partnerships between U.S. health care providers and international institutions for U.S. physicians (particularly in certain orthopedic and oncology sub-specialty areas) to provide consultations to international physicians about their patient cases, as well as “second opinion” programs where U.S. physicians review the medical records and diagnostic tests of patients located abroad, and then render a second opinion to that patient. We anticipate that these international telemedicine arrangements will continue throughout 2016 as U.S. providers search for ways to expand their patient base and grow their brands internationally.

If these telehealth trends [...]

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Telehealth: Implementation Challenges in an Evolving Dynamic

As part of its four-part Digital Health webinar series, on April 14, 2015, McDermott Will & Emery presented “Telehealth: Implementation Challenges in an Evolving Dynamic.”

Telehealth (also known as telemedicine) generally refers to the use of technology to support the remote delivery of health care.  For example:

  • A health care provider in one place is connected to a patient in another place by video conference
  • A patient uses a mobile device or wearable that enables a doctor to monitor his or her vital signs and symptoms
  • A specialist is able to rapidly share information with a geographically remote provider treating a patient

While the benefits of telehealth are clear – for example, making health care available to those in underserved areas and for patients who cannot regularly visit their providers but need ongoing monitoring — implementing telehealth requires providers and patients, as well as payers, to adapt to a dynamic new health care, data sharing and reimbursement delivery framework.  The webinar explored these areas and more.

We are pleased to offer our readers access to the archived webinar and the slide presentation.  If you have questions or would like to learn more, please contact Dale Van Demark.




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