AHLA Telehealth Law Handbook (Non-Members)

Preface
Recent Titles from the American Health Law Association
About the Editor
About the Authors
Acknowledgements
About the American Health Law Association

Chapter 1  Telehealth Models
1.1  Introduction And The Impact of Covid-19
1.2  Telehealth Communication Platforms
1.2.1  Synchronous Communication
1.2.2  Asynchronous Communication
1.2.3  Participant-Type Communication Models
1.2.3.1  The Provider-To-Provider Model
1.2.3.2  The Provider-To-Provider Extender Model
1.2.3.3  Direct-To-Consumer Communication
1.3  Remote Patient Monitoring
1.4  Conclusion

Chapter 2 Telehealth Regulatory Requirements
2.1  Introduction
2.2  Telehealth Practice Requirements 2.2.1  Provider-Patient Relationship
2.2.2  Provider And Patient Validation
2.2.3  Consent
2.2.4  Follow-Up Care Requirements
2.2.5  Patient And Provider Type And Location Requirements
2.2.6  Technology Requirements
2.2.7  Medical Records And Privacy
2.3  Remote Prescribing
2.3.1  The Ryan Haight Act
2.3.2  The Support Act
2.3.3  State Requirements
2.4  Corporate Practice of Medicine And Fee Splitting

Chapter 3 Licensing Issues For Physicians
3.1  Introduction And Impact of Covid-19
3.2  State Telehealth Licensing Requirements For Physicians
3.2.1  States With Full Licensure Requirements
3.2.2  States With Special License Or Registration Requirements
3.2.3  States With Bordering State Exceptions
3.2.4  Interstate Medical Licensure Compact
3.2.5  Physician-To-Physician And Infrequent Consultation Exceptions
3.2.5.1  Physician-To-Physician Consultations
3.2.5.2  Infrequent Consultation Exceptions
3.2.6  Supervision of Allied Health Professionals

Chapter 4  Considerations For Non-Physician Telehealth Providers
4.1  Allied Health Professionals And Telehealth
4.1.1  Types of Allied Health Professionals
4.2  Telehealth Practice Standards For Allied Health Professionals
4.3  Telenursing
4.4  Telebehavioral Health
4.5  Telephysical Therapy
4.6  Supervision of Allied Health Professionals
4.7  Licensure Issues For Health Coaches

Chapter 5  Payment And Reimbursement
5.1  Introduction
5.2  Medicare Coverage of Telehealth Services
5.2.1  Qualifying Rural Geographic Area
5.2.2  Qualifying Originating Site
5.2.3  Eligible Distant Site Practitioners
5.2.4  Eligible Telecommunications Technology
5.2.5  Eligible CPT/HCPCS Codes
5.3  Medicare Coverage of Telehealth During The Covid-19 PHE And Immediately Post-PHE
5.4  Medicare Billing, Coding, And Payment For Telehealth Services
5.5  Medicare Coverage of Other Remote Practitioner Services
5.6  Medicare Advantage Flexibility to Provide Additional Telehealth Services
5.7  Medicaid Coverage of Telehealth Services
5.8  Commercial Insurance Coverage of Telehealth
5.8.1  Telehealth Commercial Coverage And Parity Laws
Table 5.1:  States With Telehealth Commercial Insurance Coverage Parity Laws
Table 5.2:  States Without Telehealth Commercial Insurance Coverage Parity Laws
5.8.2  Telehealth Payment Parity Laws
Table 5.3:  States With Telehealth Commercial Insurance Payment Parity Laws
Table 5.4:  States Without Telehealth Commercial Insurance Payment Parity Laws
5.8.3  Interaction Between Telehealth Coverage And Payment Parity
5.8.4  How Differences in Telehealth Insurance Laws Affect Patients And The Marketplace

Chapter 6  Fraud And Abuse
6.1  Introduction
6.2  Legal Authorities
6.2.1  Federal Anti-Kickback Statute
6.2.2  Beneficiary Inducements—Civil Monetary Penalties Law
6.2.3  Federal Physician Self-Referral Law
6.2.4  Federal False Claims Act And Civil Monetary Penalties Law
6.2.5  State Fraud And Abuse Laws
6.3  Enforcement
6.3.1  U.S. Department of Justice
6.3.2  Office of Inspector General
6.3.3  State Medical Boards
6.4  Fraud And Abuse in The Broader Telehealth Policy Debate

Chapter 7  Privacy And Security Issues in Telehealth
7.1  HIPAA
7.2  State Law
7.3  Requirements of The Federal Trade Commission And The Food And Drug Administration
7.4  Covid-19 Rules
7.5  The European Union's General Data Protection Regulation

Chapter 8  Liability Issues
8.1  The Provider-Patient Relationship
8.1.1  Formation of The Relationship
8.1.2  Prescribing
8.2  Professional Liability
8.2.1  Duty
8.2.2  Breach
8.2.3  Agency
8.2.4  Informed Consent
8.2.4.1  Consent of Those Under Disabilities
8.2.5  Causation
8.2.6  Locus of Care
8.2.7  Risk Management
8.2.8  Insurance
8.2.9  Other Considerations
8.3  Product Liability
8.4  Conclusion

Chapter 9  Mobile Health Technology
9.1  FDA Regulation of Mobile Health Technology
9.1.1  What Is Mobile Health Technology?
9.1.2  What Is A Medical Device?
9.1.3  How The FDA Approaches Regulation of mHealth Technology
9.1.4  FDA Policy Changes Resulting From Section 3060 of The 21st Century Cures Act
9.1.5  General Wellness mHealth Devices
9.1.6  Mobile Medical Applications
9.1.7  Clinical Decision Support Software
9.2  Other Federal Agency Regulation
9.3  Conclusion

Appendix A  50-State Survey: Telehealth Medicaid Coverage Laws
Appendix B  50-State Survey: Telehealth Commercial Insurance Coverage Laws
Appendix C  Sample Policy: Telehealth Policy And Procedures
Appendix C-1  Sample Operational Workflow And Tips For Effective Telehealth Encounters Using Videoconferencing Technology
Appendix C-2  Consent to Participate in A Telehealth Consultation
Appendix D  Sample Agreement: Employer-Provider Telemedicine Services Agreement
Index