Noncompliance with telehealth legal requirements can result in civil, criminal, and administrative penalties from state medical boards and other regulatory bodies. It is important that you consult state medical boards and other state-specific laws for updated and accurate information on telehealth legal requirements.
Learn about the key terms in legal requirements and view a summary how they apply in your state. For more detailed state-level information, visit The Center for Connected Health Policy.
Telehealth legal requirements vary by state. Always seek individual legal advice if your practice is unsure about aspects of licensure or legal requirements. Five key legal concepts in telehealth are consent, online prescribing, cross-state licensing, licensure compacts, and professional board standards.
Many states have created specific guidelines for how physicians and other medical professionals should obtain consent for telehealth services. Most states with telehealth consent guidelines require that medical professionals obtain and document verbal or written consent, documenting it in the patient’s medical record. Physicians may also need to verify the patient's identity and location, disclose the limitations of telehealth, and obtain consent to share protected health information (PHI) with other physicians and clinicians.
There is a lot of variation between how different states have approached online prescribing of controlled substances. The most flexible states require the establishment of a patient-physician relationship for online prescribing, and that relationship can be established via telehealth. Other states require an in-person evaluation within a specific timeframe for online prescribing to take place. The most restrictive states do not allow any online prescribing of controlled substances.
Of note, Arkansas, Indiana, Iowa, Kansas, Kentucky, Montana, Oklahoma, South Carolina, South Dakota, Texas, and West Virginia have specific restrictions for online prescribing of abortion-inducing medication.
The best practice for physicians seeking to practice medicine in a different state than the one where they reside is to obtain an official medical license from the state where the patient is located. However, some states have provided more flexibility to this process but 1) not requiring physicians to be licensed in different states for infrequent telehealth treatment if they are in good-standing with their home-state medical board 2) offering special telehealth licenses or 3) participating in interstate medical licensure compacts (IMLC).