SWTRC COVID-19 UPDATES - MARCH 2021
Bringing You Up To Date Regional Information
COVID-19 FSMB Reporting on State Waivers
According to a Federation of State Medical Boards report “U.S. States and Territories Modifying Requirements for Telehealth in Response to COVID-19 (Out-of-state physicians; preexisting provider-patient relationships; audio-only requirements; etc.),” originally published February 26, 2021 and updated March 2, 2021, 41 states and 3 territories have active telehealth waivers, 1 state has a waiver but is not accepting new applications, and 6 states, 1 territory and the District of Columbia do not have active waivers or had previous waivers that have closed. The following table is a reproduction of the sections of the FSMB report for states in the Southwest Telehealth Resource Center’s region, including Arizona, Colorado, Nevada, New Mexico, and Utah.
AZ
Citations:
AZ DHS Guidance
EO 2020-15
Press Release RE: Telemedicine Coverage
EO 2020-07
AZ HB 2454
Temporary MD License
Temporary DO License
State Resource Page
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[MDs]: The Arizona Medical Board (AMB) announces the following available temporary emergency licenses for Physicians (MDs) to practice in Arizona and the extension of the time frame for renewal of MD licenses during the COVID-19 State of Emergency: MDs licensed in another state are eligible to apply for temporary licensure in the State of Arizona using the emergency temporary licensure application. All MD temporary emergency licenses expire after 90 days, or at the time the State of Emergency is declared to be over whichever shall occur first.
[DOs]: In accordance with Arizona Revised Code, individuals can apply for a temporary license with the Board to aid in the diagnosis and treatment of COVID-19 in Arizona.
RE: Telemedicine coverage - Gov. Ducey [on March 25, 2020] issued an Executive Order [EO 2020-15] requiring health care insurance companies to expand telemedicine coverage for all services that would normally be covered for an in-person visit. It remains in effect until the termination of the declared public health emergency; includes all electronic means of delivering telehealth including telephone and video calls; ensures that a patient’s home is considered an approved location to receive telemedicine services; and prohibits a regulatory board from requiring a medical professional who is authorized to write prescriptions to conduct an in-person examination of a patient prior to the issuance of a prescription.
[1/28/21 Update] – A bill currently under consideration, AZ HB 2454, would permanently allow for health care providers licensed in another jurisdiction, in good standing and not subject to current or past disciplinary actions, to practice telemedicine with Arizona patients. Licensees must act in compliance with Arizona laws including scope of practice and liability insurance, among others. The venue for any violation is that of the resident.
Status – Active until the end of the COVID-19 emergency. |
CO
Citations:
DORA Guidance
CO SB 20-212
Article RE: SB 212
State Resource Page |
Existing law allows a physician who is not currently licensed in Colorado to provide medical care in connection with an emergency so long as such services are gratuitous, that is, free of charge via § 12-240-107(3)(a), C.R.S. The Medical Practice Act also currently allows for a physician licensed and lawfully practicing medicine in another state or territory without restrictions to provide occasional services in Colorado through § 12-240-107(3)(b). This provision requires that the physician does not have a regular practice in Colorado and does maintain malpractice insurance.
Suspension of requirements that patients must be located in Colorado at time of consultation to expand treatment for traveling Colorado citizens, as currently required under § 12-240-107(1)(g), C.R.S., which defines telemedicine as the practice of medicine requiring a Colorado license to practice telemedicine on patients located in Colorado at time of consultation.
RE: permanent telehealth changes - On July 6, Colorado Governor Jared Polis signed SB 20-212, expanding access to telehealth for Colorado residents by prohibiting insurers from requiring an established in-person practitioner/patient relationship or imposing location or additional licensure requirements, as well as preventing limitations on the use of HIPAA-compliant technologies to deliver telehealth.
Status – Active, currently scheduled to expire March 17, 2021 per EO D-2021-045. |
NV
Citations:
Emergency Directive 011
[MDs]: Emergency License Application
[DOs]: Emergency License Application
State Resource Page
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Professional licensing boards regulating providers of medical services shall temporarily waive certain licensing requirements to allow the practice of currently unlicensed skilled medical professionals during the pendency of the COVID-19 crisis, including without limitation, medical doctors, physician assistants. The waiver and exemption of professional licensing requirements shall apply to qualified providers of medical services during this declared emergency who currently hold a valid license in good standing in another state, providers of medical services whose licenses currently stand suspended for licensing fee delinquencies, providers of medical services whose licenses currently stand suspended for failure to meet continuing medical education requirements, and providers of medical services who have retired from their practice in any state with their license in good standing. These waivers and exemptions shall not apply to persons whose licenses have been revoked or voluntarily surrendered as a result of disciplinary proceedings.
Status – Active until the end of the ongoing COVID-19 emergency, per ED 34. |
NM
Citations:
Emergency Declaration
NM Stat § 12-10-11
Instructions and Application for Temporary Licensure
NMMB Guidance
State Resource Page |
New Mexico’s order offers broad credentialing privileges: “The Department of Health and the Department of Homeland Security and Emergency Management shall credential out-of-state professionals who can render aid and necessary services during the pendency of this order. NMSA 1978 §§ 12-10-10.1 through 12-10-13.”
NM Stat § 12-10-11: During an emergency, a person who holds a license, certificate or other permit that is issued by a state or territory of the United States and that evidences the meeting of qualifications for professional, mechanical or other skills may be credentialed, if appropriate and approved by the department of health or the homeland security and emergency management department, to render aid involving those skills to meet an emergency, subject to limitations and conditions as the governor may prescribe by executive order or otherwise.
Use of electronic means (internet, texting, phone, email) to assess and provide responsible care during emergency will not be considered unethical or a violation of Medical Board rules.
Status – Active until gubernatorial rescission, currently scheduled for March 5, 2021 per EO 2021-004.
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UT
Citations:
UT Code annotated § 58-67-305(7)
DOPL COVID Resources
EO 2020-07
EO 2020-68
DOH Orders and Directives
State Resource Page |
Utah law provides: “An out-of-state physician may practice without a Utah license if: (1) The physician is licensed in another state, with no licensing action pending and at least 10 years of professional experience; (2) The services are rendered as a public service and for a noncommercial purpose; (3) No fee or other consideration of value is charged, expected or contemplated, beyond an amount necessary to cover the proportionate cost of malpractice insurance; (4) The physician does not otherwise engage in unlawful or unprofessional conduct.” (UT Code Annotated § 58-67-305(7)).
A medical provider that pursuant to this Order offers telehealth services that do not comply with HIPAA or HITECH, must: (1) inform the patient the telehealth service does not comply with those federal acts; (2) give the patient an opportunity to decline use of the telehealth service; and (3) take reasonable care to ensure security and privacy of the telehealth service.
[EO 2020-68] Continues the suspension of certain aspects of the Utah Telehealth Act, including allowing HIPAA exceptions (with proper notice).
Status – Active, until end of Utah State of Emergency, currently ongoing per 10/14 DOH Public Health Order. |
In addition to these state specific waivers, the Secretary of the Department of Health and Human Services (HHS) can modify or waive some Medicare, Medicaid, Children’s Health Insurance Program, and/or HIPAA requirements under section 1135 of the Social Security Act. For information on 1135 waivers, visit the Centers for Medicare & Medicaid Services “Coronavirus waivers & flexibilities” website.
Some states, including Arizona and Colorado, have made or are considering permanent expansions to telehealth by law. Professional organizations such as the American Telemedicine Association, the Alliance for Connected Care, the National Committee for Quality Assurance, the American Medical Association, the American Hospital Association, and many others are actively advocating for expanded telemedicine and telehealth access to continue even after the COVID-19 public health emergency concludes.
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