State licensing issues affecting telemedicine practice among several states

Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.
Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.

Historically, state licensing boards and organizations require health care professionals to become independently licensed by each state in which they chose to practice medicine.[i] Surely, there are metropolitan areas in our nation where several states make up a metropolitan area, particularly on the East Coast. The Chicago metropolitan area spans across state lines to include residents of Wisconsin, Illinois and Indiana, and notably, Michigan is not too far from the Chicago area and many people keep weekend lake homes there. Consider an oncologist who manages care and treatment of cancer patients, who has a lake house in New Buffalo, Michigan and a practice based in Chicago. What happens when telemedicine allows the doctor to use technology to monitor Chicago patients from his lake house in Michigan?

As technology and telemedicine offer health care professionals new options, there are new questions arising in professional licensing among the states.

Telemedicine is the use of mobile technology to perform certain routine health care services. Common applications of telemedicine include a physician with rural patients who require services that could be performed through the use of mobile technology, saving the patients the time and expense of travel to the doctor’s main office. Telemedicine also reduces the use of the office space and staff when patients are seeing the doctor from home.

Latoya Thomas, director of the State Policy Resource Center for the American Telemedicine Association commented in a recent article about the increased frequency in which states and organizations are addressing the concerns raised about the practice of telemedicine and developing appropriate laws and policies. Thomas stated, “It is something I think hospitals across the country are becoming familiar with if they haven’t already,” Thomas says, “and trying to figure out how they can comply with current standards but also prepare themselves for any new policies that might come down the pike in 2016.”

There are some “safe harbor” rules for telemedicine and states adopting policies and procedures for mobile healthcare practice.

In another scenario, an out of state patient who sees a physician in Illinois, for example, can conduct a surgical follow-up visit online; Indiana, Illinois and Ohio permit online physician follow-up with established patients[ii]. Another instance of allowed interstate telemedical practice not requiring the physician be licensed in the outlying state is the safe harbor rule of infrequent patient treatment. Minnesota has a telemedicine statute stating, “An out-of-state physician who holds a valid license to practice medicine in another state need not possess a Minnesota license-nor even register with the Minnesota Board-if she provides telemedicine services on an “irregular or infrequent basis,” which is defined as less than once per month or to fewer than ten patients annually.[iii]

There is not a uniform law directing the standard of interstate telemedical practice yet. There are Telemedicine Practice Guidelines, however, offered by the American Telemedicine Association. Some states do allow physicians in neighboring or other states to practice medicine in their state without being independently licensed, but where the out of state physician practices with the same standard of care required in the individual state.

Before engaging in telemedicine, it is important to seek advice and counsel to avoid unauthorized practice of medicine liability.

Michael V. Favia and his associates and colleagues in health care law and litigation actively follow updates in mobile health care technology and the delivery of health care services. Favia works with clients not only with matters involving the practice of medicine directly, but also with the state licensing and regulation of health care professionals. When considering telemedicine, it is important to consult with the malpractice insurance provider and find out what policies control the location of the delivery of health care services.

Michael V. Favia & Associates are available to assist nurses and healthcare professionals with professional licensing matters. With offices conveniently located in the Chicago Loop, Northwest side and suburban meeting locations, you can schedule a discrete meeting with an attorney at your convenience and discretion. For more about Michael V. Favia & Associates’ professional licensing work, please visit and feel free to “Like” the firm on Facebook and “Follow” the firm on Twitter.

[i] Healthcare Dive, State licensure issues challenging telemedicine borders, by Heather Caspi, Oct. 29, 2015

[ii] The National Law Review, The Out-of-State Practice of Telemedicine: Licensure Challenges and Opportunities, Oct. 21, 2015

[iii] See HNi above