Our healthcare and business law firm previously published a blog post on the federal telemedicine rules. Both Federal and State rules govern the provision of telemedicine. Each state’s rules governing telemedicine are different, but the applicable laws and rules are generally found in the state medical board’s rules or position statements, insurance code, and when applicable, Medicaid rules. This post focuses specifically on the telemedicine rules applicable to the practice of telemedicine in North Carolina. This post does not discuss telemedicine prescribing rules or Medicaid rules. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, firstname.lastname@example.org. You may also learn more about our law firm by visiting www.hamillittle.com.
North Carolina Rules
North Carolina has yet to pass any laws on telemedicine, but the North Carolina Medical Board (“Medical Board”) has published telemedicine policies available on its website, here. Below is an overview of some requirements currently in North Carolina governing the practice of telemedicine.
Like with other states, a physician who regularly treats patients in North Carolina need to be licensed in North Carolina. Position Statement 5.1.4: Telemedicine, NCMB.
- Patient Evaluation
The Medical Board’s position statement makes clear that a patient evaluation need not be in person. The NCMB provides the following clear and useful guidance:
Licensees using telemedicine technologies to provide care to patients located in North Carolina must provide, or rely upon, an appropriate evaluation prior to diagnosing and/or treating the patient. This evaluation need not be in-person if the licensee employs technology sufficient to accurately diagnose and treat the patient in conformity with the applicable standard of care. A diagnosis should be established using accepted medical practices, i.e., a patient history, mental status evaluation, physical examination, and appropriate diagnostic and laboratory testing.
Evaluations may also be considered appropriate if a licensed health care professional is able to facilitate aspects of the patient assessment needed to render reasonable diagnostic possibilities and care plans. On the other hand, a simple questionnaire without an appropriate evaluation may be a violation of law and/or subject the licensee to discipline by the Board.
- Verification of Patient Identity
The NCMB “stresses the importance of proper patient identification prior to any telemedicine encounter.” Position Statement 5.1.4: Telemedicine, NCMB. The Board provides: “Failure to verify the patient’s identity may lead to fraudulent activity or the improper disclosure of confidential patient information. The licensee using telemedicine should verify the identity and location of the patient. Furthermore, the licensee’s name, location, and professional credentials should be provided to the patient.” Id.
- Informed Consent
The North Carolina Medical Board states: “HIPAA and related privacy and security documents should be present and signed where appropriate. Appropriate informed consent documents acknowledging the risks, limitations, alternatives, and benefits of the telemedicine encounter should be included.” Position Statement 5.1.4: Telemedicine, NCMB.
- Medical Records and Follow-Up Care
When providing care via telemedicine, the physician must maintain complete records of the care, coordinate with a primary care physician, if available, and ensure the availability of follow-up care.
As is clear from the above, medical practices must be thoughtful before offering telemedicine services. If you have questions about telemedicine rules or would like to discuss this blog post, you may contact our healthcare and business law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, email@example.com. You may also learn more about our law firm by visiting www.hamillittle.com.
*Disclaimer: Thoughts shared here do not constitute legal advice.