John Durso, Esq. Nixon Peabody LLP

What are your thoughts on the rising attention given to telemedicine? Are we more at risk, using clinicians miles away and viewing resident conditions and records off-site? What precautions or pre-conditions to adopting it should we take?

The use of telemedicine is rapidly on the rise across the country and across different providers. There are special rules in every state as to how they allow and regulate telemedicine, setting forth what you are required to do under the state laws to participate in telemedicine.  

This would be true of the state in which the provider is located, as well as the state in which the telemedicine provider may be located. 

You are at greater risk under telemedicine if you do not follow the rules and regulations set forth in the state laws and regulations specifically relating to telemedicine. The risk of using physicians or other healthcare professionals who are offsite may raise “standard of care” issues because they do not see the resident in person. Of course, if the physicians are specialists who are consulting with a local treating physician who is seeing the patient in person, your exposure would decrease.

There also are issues with respect to Medicare and telemedicine because Medicare billing does not ordinarily cover or pay for telemedicine. Medicaid payments depend on the state law in which the facility is located and may pay for telemedicine services. 

Telemedicine will continue to grow as healthcare providers and purchasers of healthcare continue to search for ways to reduce costs of care.

You should get legal advice from an expert in telemedicine in the states involved before you set up your policies and procedures and before you participate in such a program.