State licensing issues affecting telemedicine practice among several states

Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.

Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.

Historically, state licensing boards and organizations require health care professionals to become independently licensed by each state in which they chose to practice medicine.[i] Surely, there are metropolitan areas in our nation where several states make up a metropolitan area, particularly on the East Coast. The Chicago metropolitan area spans across state lines to include residents of Wisconsin, Illinois and Indiana, and notably, Michigan is not too far from the Chicago area and many people keep weekend lake homes there. Consider an oncologist who manages care and treatment of cancer patients, who has a lake house in New Buffalo, Michigan and a practice based in Chicago. What happens when telemedicine allows the doctor to use technology to monitor Chicago patients from his lake house in Michigan?

As technology and telemedicine offer health care professionals new options, there are new questions arising in professional licensing among the states.

Telemedicine is the use of mobile technology to perform certain routine health care services. Common applications of telemedicine include a physician with rural patients who require services that could be performed through the use of mobile technology, saving the patients the time and expense of travel to the doctor’s main office. Telemedicine also reduces the use of the office space and staff when patients are seeing the doctor from home.

Latoya Thomas, director of the State Policy Resource Center for the American Telemedicine Association commented in a recent article about the increased frequency in which states and organizations are addressing the concerns raised about the practice of telemedicine and developing appropriate laws and policies. Thomas stated, “It is something I think hospitals across the country are becoming familiar with if they haven’t already,” Thomas says, “and trying to figure out how they can comply with current standards but also prepare themselves for any new policies that might come down the pike in 2016.”

There are some “safe harbor” rules for telemedicine and states adopting policies and procedures for mobile healthcare practice.

In another scenario, an out of state patient who sees a physician in Illinois, for example, can conduct a surgical follow-up visit online; Indiana, Illinois and Ohio permit online physician follow-up with established patients[ii]. Another instance of allowed interstate telemedical practice not requiring the physician be licensed in the outlying state is the safe harbor rule of infrequent patient treatment. Minnesota has a telemedicine statute stating, “An out-of-state physician who holds a valid license to practice medicine in another state need not possess a Minnesota license-nor even register with the Minnesota Board-if she provides telemedicine services on an “irregular or infrequent basis,” which is defined as less than once per month or to fewer than ten patients annually.[iii]

There is not a uniform law directing the standard of interstate telemedical practice yet. There are Telemedicine Practice Guidelines, however, offered by the American Telemedicine Association. Some states do allow physicians in neighboring or other states to practice medicine in their state without being independently licensed, but where the out of state physician practices with the same standard of care required in the individual state.

Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.

Michael V. Favia and his associates and colleagues in health care law and litigation actively follow updates in mobile health care technology and the delivery of health care services. Favia works with clients not only with matters involving the practice of medicine directly, but also with the state licensing and regulation of health care professionals. When considering telemedicine, it is important to consult with the malpractice insurance provider and find out what policies control the location of the delivery of health care services.

Michael V. Favia & Associates are available to assist nurses and healthcare professionals with professional licensing matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. For more about Michael V. Favia & Associates’ professional licensing work, please visit and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter.

[i] Healthcare Dive, State licensure issues challenging telemedicine borders, by Heather Caspi, Oct. 29, 2015

[ii] The National Law Review, The Out-of-State Practice of Telemedicine: Licensure Challenges and Opportunities, Oct. 21, 2015

[iii] See HNi above


1 thought on “State licensing issues affecting telemedicine practice among several states

  1. arth

    Good Day to You,

    I found your blog by researching “professional licensing” in the Reader of my Dashboard.

    I am a recently retired Maine State Employee, developing a project called “Professional Licensing Helper”.

    Indexed Resource Link Pages will be added to the site over time (a painstaking and time consuming process). The pages are being offered as a “tool”, to help potential and current professionals connect with Administrative Agency Resources, by providing direct links to the appropriate resource webpages.

    I have published some pages, but want to improve on them, before creating more, because the indexing process has been refined with improvements, compared to the existing pages.

    The main menu has a link to the “Maine Professional Licensing” resource page, listing all the professions regulated in my home state of Maine.

    A new menu called “Professions” has been started, alphabetically connecting to the individual “Professions” pages. The “Professions” pages will contain a similar format of indexed resource links to Administrative Agency Resources. The current pages will be updated with improvements as well, before adding new professions.

    The difference between the “Maine Professional Licensing” page and the “Professions” pages, is that the “Professions” pages contain listings for each U.S. State and Territory having a regulating authority for that profession.

    This project is a “work in progress”. I’m still learning and developing my WordPress site, following the guidelines outlined in the Blogging 101 class at Blogging University.

    The current tool will be getting updated with a much larger list of resources, that will greatly increase the available resources listed.

    I invite information and resource requests, have not established a set of products or services yet, and encourage visitors to ask for help, at no charge, until I can better judge what the needs of my “target audience” are. Clients are encouraged to recommend a fee, based on their perception of the value of any product or service, I provide, that can be re-purposed to offer for a fee.

    My experience has shown me that professionals often need to know how to incorporate a business, find tax information, education, and much more.

    I was the sole full time customer service representative for the Uniform Commercial Code (UCC) section, attached to the Bureau of Corporations for 20+ years of my 30 years of state employment, and know my way around government websites.

    I believe there is a need for this niche, to help bring together all the fragmented information presented by the overwhelming task of having to go from agency to agency to piece together all the fragments that each specialized agency can offer.

    I’m sure you are well aware of this problem.

    This post is a good example of another ever increasing need for finding these resources on an inter-state level. This post is a wonderful resource for the professionals in the Chicago area.

    We see very little inter-agency cross-training, resulting in the customer being passed from one agency to another. My goal is to offer empowerment, by providing links to the agency resources and information, using the Indexed Resource Link Pages, as a tool to “centralize” the resources.

    I have developed some Blogrolls, and intend to create more, as another way to add quality to the site, gain trust through quality content, and connect to valuable resources.

    A Blogroll being considered with the posible title “Of Interest”, This post in particular, and others on your site would be a good fit for this kind of Blogroll.

    I’m interested in your response to this idea.

    Many of your posts have a great deal of relevance in “professional licensing”. They are very knowledgeable and provide much needed advice for professionals. I am happy to follow you.

    I look forward to the valuable insights you share in your posts.

    My Best to You


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