How Telemedicine Licensing Issues Arise – Compliance for Telehealth Programs
The practice of medicine is licensed and regulated at the state level. The jurisdiction of individual states over medical licensure is broadly recognized by the courts and the federal government, including CMS. The fact that every state has its own set of laws and regulations regarding licensure of healthcare providers has been a substantial impediment to the development of cross-border telemedicine programs. There has been no meaningful movement in that direction, although there has been discussion of the creation of more uniform state licensure standards, thus far.
Licensing issues are important to both initiating sites (where the patient is located) and remote sites (where the provider is located). Licensing issues impact a physician who is providing care or consultation to a patient via potential professional discipline or charges of the unlicensed practice of medicine. Both ends of the telemedicine relationship need to assure that the physician is appropriately licensed because reimbursement for services of each provider requires that the physician be appropriately licensed to provide the service under the state law of the initiating site. Failure to assure proper licensing can raise compliance risks. If services are provided by a provider through telemedicine into a state where the provider is not licensed, claims for reimbursement could be false or fraudulent. For this reason, telemedicine should be specifically included within the compliance activities of both the initiating and remote sites.