The Louisiana State Board of Medical Examiners (“Board”) recently provided guidance to Louisiana Allied Health Professionals to “facilitate the use of telehealth” and to “assure them that services provided during this emergency will not be subject to Board scrutiny merely because they were provided by telehealth.” Allied Health Professionals may provide services to clients in the state of Louisiana separated by distance from the provider by using telehealth, or appropriate information and communication technologies.
The LSBME Guidance provides:
While the Board does not currently have established telehealth rules, the following Board licensees are considered health care providers under the telehealth law: physician assistant, offshore health service provider, licensed midwife, podiatrist, occupational therapist, certified or licensed athletic trainer, medical psychologist, licensed perfusionist, licensed respiratory therapist, licensed radiologic technologist, or licensed clinical laboratory scientist.
Thus, these practitioners should comply with the following guidelines when determining the appropriateness of telehealth and when using the platform of telehealth for their respective practices:
- The above referenced allied health care providers must be licensed in Louisiana in order to provide telehealth to a patient in Louisiana.
- Patient confidentiality is required for telehealth law compliance. Presently, the Federal Government has issued temporary guidance regarding HIPAA compliance. Please see: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html.
- When practicing pursuant to your license, using telehealth, the same standard of care applies as if the healthcare services were provided in person. More plainly stated: If the treatment of the patient via telehealth satisfies the USUAL standard of practice as those in a face-to-face session, then the practitioner would comply with the current laws for telehealth and the practitioner’s respective practice act.
- In their client documentation, the health care provider using telehealth must state that the mode of treatment intervention was conducted via telehealth.
- It is recommended that the health care provider using telehealth check with the client’s insurance carrier prior to utilizing telehealth intervention/evaluation, in order to determine reimbursement. Although presently carriers may be more flexible with regard to the use of telehealth during this public health emergency, it is best to check.
- Healthcare providers as defined by the Louisiana Telehealth Act must also comply with all of the provisions of their individual practice act, including any referral requirements, which can be found on the LSBME’s website under the Laws” and “Rules” tabs. See http://www.lsbme.la.gov/content/covid-19-crisis-information.
- To be sure you are acting in compliance with the telehealth law, please review La. R.S. 40:1223.1 through 1223.5 (see Telehealth Act on first page of www.lsbme.la.gov).
Since we are at the beginning stages of this corona virus outbreak please note that we may have future updates regarding telehealth for the allied health care providers who are allowed to practice telehealth per La. R.S. 40:1223.3. Please check the LSBME website for future updates.
Risk Management Considerations:
HIPAA: While some patient privacy regulations have been relaxed by federal authorities, confidentiality in the telehealth visit must be maintained by the use of non-public facing applications such as Apple FaceTime, Facebook Messenger Video Chat, Google Hangouts video, Zoom or Skype and using any available encryption and privacy settings. Public facing applications, like Tiktok and Facebook Live should NOT be used.
Prescriptive Authority: For providers with prescriptive authority, prescriptions of controlled substances issued via telehealth should be medically appropriate, well documented and conform to the laws and rules applicable to the provider’s practice and medicine prescribed.
Documentation: The patient’s consent to the telehealth visit should be documented. Other documentation considerations include: the reason for the use of the specific telehealth application particularly if audio only technology is used; the provider’s statement that the health care services provided via telehealth met the standard of care required for an in-person visit; emergency contact information; and the accessibility of patient records. For sample documentation language and additional considerations for documentation of a telemedicine encounter, see https://www.lammico.com/article/documentation-telemedicine.