Have you heard? In a bit of a stunning move, Alabama has repealed its telemedicine license program in 2022. This sets an extremely negative precedent for the rest of the country.
I have been providing you with important updates on telemedicine laws around the country, and up until this point, I've been espousing the belief that most states will gradually lower barriers for out-of-state practices practicing in their state. It turns out that we may be moving in the opposite direction, which is definitely not a good sign.
Despite Alabama’s reputation as being a bit behind on some things, for a long time they were actually ahead of the curve regarding telemedicine licenses. They’ve actually had a special purpose telemedicine license on the books since 1997. This was way before most states even considered something like this, and many states still don’t even have a program like this. For the record, this program didn’t allow those who were part of it to actually treat patients or open a practice in Alabama, it was just used to verify that one was in good standing in their home state. From there, the practitioner was able to go through the process of registering to treat patients in Alabama without needing to get a full license there as well.
In April, the governor of Alabama signed into legislation an act that repeals that whole program, making it much more difficult for out-of-state practitioners to be able to practice in Alabama. The rationale for the change is defensible since it makes sense that each state would want control of who is and isn’t allowed to practice medicine. Losing Alabama alone isn’t that major of a loss by itself, since there are still 15-20 other states that have this same type of program.
But what do you do if you want to practice in a state that doesn’t have one of these programs? There are other loopholes, like peer-to-peer consultations. If you qualify for infrequent/episodic care, you can see up to ten patients a year without getting a license as well. Alabama is also a member of the Interstate Medical Licensure Compact, which does provide an expedited way for you to be able to get licensed in different states. Practicing using permission gained through the special program is still allowed until it expires, which may be after the law goes into effect, so there is definitely time to adjust to these new rules.
Although there are ways around the removal of the special program, Alabama has made some other changes that make practicing telemedicine much more difficult. Alabama added another provision that’s fairly unique and it definitely hampers telemedicine innovation. While they did retain the right that the patient-physician relationship can be established via telemedicine if the standard of care is met, they did make some important changes regarding in-person consultation. The change was that they now require that if a physician or group provides telehealth medical services to the same patient for the same medical condition more than four times in a 12-month period without resolution, they have to be seen in person. Now, they don't have to be seen in person by you, but they do have to be seen in person by somebody, whether that's you or their primary care physician. This change is concerning because not a lot of states have an in-person requirement anymore, so long as the standard of care is being met.
Requirements like this seem to me to be a reaction from special interest groups to the progress that has been made regarding telehealth, and they mostly seem to be trying to protect their power and money at the expense of not allowing residents of their state to have as many options.
We're not trying to scare you, but if you don't stay up to date on these laws, you could be in danger of fines or losing your license. Medical laws vary greatly on a state-by-state basis, so be sure to do your homework. Talk to an attorney, or follow me at FunctionalLawyer.com, and we'll try to get your telemedicine practice up and running so that you can focus on healing your patients without worrying about breaking any rules.
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