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Telehealth in Response to Covid-19 Requirements
The Federation of State Medical Boards (FSMB) recently updated its list of U.S. State and Territories modifying requirements for telehealth in response to COVID-19, such as out-of-state physicians; preexisting provider-patient relationships; audio-only requirements, and more. FSMB's listing of modified requirements for telehealth for Arizona, Colorado, Nevada, and New Mexico are repeated below.
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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 AZ DHS Guidance 3 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.
- [5/5/21 Update] – Re: interstate telemedicine - On June 5, 2021, AZ HB 2454 was signed, which permanently allows 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 register with the 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 – Inactive, on May 5, 2022, former Gov. Doug Ducey issued EO 2021-13, rescinding prior telemedicine-related executive orders, and referencing the comprehensive HB 2454. However, Arizona offers interstate telemedicine via Registration system, see above.
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- 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 does require that the physician not have a regular practice in Colorado and 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. DORA Guidance Article re: Telehealth changes CO SB 20-212 Article re: SB 212 5
- Re: permanent telehealth changes - On July 6, 2022 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 HIPAAcompliant technologies to deliver telehealth.
- Status – Inactive, Colorado’s State of Emergency was rescinded on July 8, 2021, per 7/8 announcement
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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.
- [6/22/21 Update] re: audio-only telemedicine/establishing patient-physician relationship – SB 5, which was signed into law on June 4, 2021, allows the delivery of telehealth services through audio-only interactions and allows providers to establish a patient relationship through telehealth, among other actions.
- [9/8/21 Update] re: Special licensure – Nevada statute provides for Special Purpose Medical Licenses that “can be issued to a physician who is licensed in another state to perform any of the acts described in subsections 1 and 2 of NRS 630.020 by using [telemedicine] if the physician: i) Holds a full and unrestricted license to practice medicine in that state; ii) Has not had any disciplinary or other action taken against him or her by any state or other jurisdiction; and iii) Is certified by a specialty board of the American Board of Medical Specialties or its successor. (NRS 630.261).
- [5/13/22 Update] re: End of State of Emergency – On May 6, 2022, Nevada Gov. Steve Sisolak announced that he will end Nevada’s state of emergency on May 20, 2022. (Article).
- Status – Inactive, Nevada’s state of emergency was rescinded May 20, 2022, per Gov. Sisolak’s 5/6 announcement (see above). (Article re: ending emergency).
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- 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.
- [6/29/21 Update] re: permanent interstate telemedicine – On April 6, 2021, Gov. Lujan Grisham signed SB 279 into law, which, among other things, states “The [Medical] board shall issue a licensed physician a telemedicine license to allow the practice of medicine across state lines to an applicant who holds a full and unrestricted license to practice medicine in another state or territory of the United States.
- Status – Inactive, Temporary licenses issued in June 2020 were active until July 1, 2021 per Federal Emergency Licensure FAQs. However, SB 279 creates a process that allows physicians licensed in other jurisdictions to provide services via telemedicine to New Mexico residents, please see above for more information.
- Further, the Board of Osteopathic medicine offers a limited telemedicine license that allows an osteopathic physician located outside New Mexico to practice osteopathic medicine on patients located in New Mexico. The annual fee is $100. (NMAC 16.17.2.7 & .8.)
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The Southwest Telehealth Resource Center serves Arizona, Colorado, Nevada, New Mexico and the Four Corners Region.
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