Technology has created opportunities for physicians, 牙医, and other healthcare practitioners to extend the reach of their professional practice beyond the physical limitations of their practice settings. 通过使用远程保健技术, 提供者可以评估, 诊断, 并在其他地区治疗患者, 哪些可以增加访问, 方便, 在护理方面的选择.

Yet, despite bridging a gap in distance, telehealth does not transcend the boundaries of state laws. Each state has its own statutes and regulations associated with clinical practice and the delivery of healthcare. 正因为如此, licensing is recognized as a significant barrier for telehealth, and it represents a key area of risk for telehealth providers because of legal and regulatory variations by state. 例如，各州可以:

• Require full licensure for telehealth practice
• Offer an abbreviated telehealth licensing process
• Allow licensed out-of-state providers to provide telehealth services within the state without obtaining a state-specific license (often with limitations)
• 参与州际契约(1).e., the Nurse Licensure Compact or the Interstate Medical Licensure Compact) that allows providers to have one license that is viable in participating states or sets forth an expedited licensure process in participating states

Because of the complexity associated with telehealth licensing, healthcare providers must be cognizant of the laws and regulations in their states and the states in which their patients are receiving services. 进一步, the American Society for Healthcare Risk Management notes that “Organizations that provide telemedicine services in multiple states must . . . navigate and meet multiple, potentially disparate requirements.”¹

使事情更复杂的是, some states have specific nuances to their telehealth laws and regulations. 例如, some states allow for patients’ homes to serve as originating sites, 但只针对特定的专业或服务, 比如心理健康治疗. The types of telehealth technology permitted — e.g., live video, store-and-forward imaging, remote patient monitoring, etc. — also can vary by service or specialty across states. 另外, some states might restrict the types of providers that can be reimbursed for providing telehealth services.²

Another layer of complexity is introduced when healthcare providers and organizations venture into international telehealth services. 在这些情况下，美国和欧洲都是如此.S. laws and the laws of the other country must be understood and implemented as part of the telehealth program. 正如ECRI解释的那样, “Facilities considering international telemedicine must ensure that their programs comply with both the selected country's regulations and U.S. 法规，以及全球最佳实践.”³

虽然繁琐又费时, understanding state-specific — and international, if applicable — telehealth laws and regulations, 实践行为, and standards of care is vital for healthcare providers and organizations participating in telehealth programs. Failure to do so could have legal and disciplinary implications.

To learn more about laws and regulations in the state(s) in which you practice, visit the 互联健康政策中心 网站, which breaks down current laws and policies for all 50 states and the District of Columbia and provides information about pending legislation and regulations. 另外, healthcare providers can contact state medical, 整骨疗法的, 牙科, or nursing boards for information related to telehealth regulations.

尾注

¹ 罗素,D.布瓦维尔，S., & Borg, J. D. (Eds.). (2018). 远程医疗风险管理方面的考虑. The American Society for Healthcare Risk Management. 芝加哥，伊利诺伊州:ASHRM.

² 互联健康政策中心. (2021). State telehealth laws and Medicaid program policies executive summary: A comprehensive scan of 50 states and D.C. 发现 & 突出了. 从检索 www.cchpca.org/resources/state-telehealth-laws-and-reimbursement-policies-report-fall-2021/

³ ECRI. (2022年2月18日). Regulatory and liability considerations for telehealth. 卫生系统风险管理. 从检索 www.ecri.org

This document does not constitute legal or medical advice and should not be construed as rules or establishing a standard of care. Because the facts applicable to your situation may vary, or the laws applicable in your jurisdiction may differ, please contact your attorney or other professional advisors if you have any questions related to your legal or medical obligations or rights, 州或联邦法律, 合同的解释, 或者其他法律问题.

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