Considerations for Health Care Providers

Telehealth can transform how care is delivered and accessed by patients. The following are key considerations for health care providers implementing or scaling telehealth services. Note: This is not an exhaustive list of all things to be considered in operationalizing a telehealth program. It is intended to be a reference for fostering conversation about certain regulatory and legal considerations governing the practice of telehealth.

Licensing

Regulations governing the provision of telehealth services vary by state.  For example, most states, including Maryland, require a provider to be licensed in the state where telehealth services are delivered; some states also require providers practicing telehealth across state lines to have a valid license in the state where the patient is located. Providers are encouraged to seek guidance from their professional licensing board regarding license-specific provisions for telehealth.

Liability

Medical malpractice policies for telehealth vary by carrier. Many carriers either include or offer an option to add coverage for telehealth. It’s a good idea to consult a carrier before engaging in telehealth. This includes knowing the carrier’s licensed coverage area if a provider intends to practice in multiple states.  See MHCC's Medical Professional Liability Insurance - Key Considerations for Telehealth Flyer for more information.

Coverage and Reimbursement

Legislation continues to expand coverage for telehealth. Insurance companies are also initiating joint telehealth ventures with third-parties providing their insured with access to approved telehealth networks. Reimbursement for telehealth varies by public and private payers. For example, Medicare’s reimbursement of telehealth services is limited to particular regions and disciplines.  Providers should continue to monitor the evolving regulatory landscape for telehealth coverage and reimbursement. 

Service Agreements

Not all telehealth arrangements and service agreements look alike. Before signing a telehealth service agreement with a provider, payor, or technology vendor, be sure to carefully review the terms and negotiate as needed.  This may include, but is not limited to, understanding business terms; intellectual property; FDA compliance; data access; scope of practice and licensure; privacy and security; fraud and abuse; and cybersecurity.  Refer to A Guide for Telemedicine Service Vendor Contracting: Applying Traditional Contracting Considerations in a New Arena for more information.

HIPAA

Telehealth does not alter covered entities or business associates obligations under the Health Information Portability and Accountability Act of 1996 (HIPAA). Health care providers are responsible for safeguarding personal health information for health care services provided in person or virtually. See the Telehealth Resource Centers HIPAA and Telehealth Flyer for more information.