Effective June 17, 2016, physicians engaging in the practice of telemedicine in the state of Louisiana need not have a physical practice location in the state, nor are they required to enter into an arrangement with a physician who does have a Louisiana practice location to provide for referrals and follow-up care. The new telemedicine law, which also allows physicians to utilize interactive audio without video in certain circumstances, was proposed in reaction to regulations issued by the State Board of Medicine in 2015, which created the physical practice requirement.
In-state practice location
In November 2014, the American Telemedicine Association (ATA) issued comments to the Board, stating that its then-proposal to require physicians to maintain a physical practice location or enter into arrangements with in-state physicians “would be the most anti-telemedicine in the nation, especially for patients needing medical experts outside the borders of Louisiana or in an [sic] natural disaster,” and went on to opine that the proposal “reflect[ed] more of a concern of protecting economic markets rather than having anything to do with providing health services to the residents of Louisiana.”
The new law eliminates the physical practice requirement but retains the Board rules stating that physicians need not conduct an in-person physical examination or patient history prior to providing telemedicine services as long as they hold unrestricted licenses to practice medicine in the state and have access to patient records with consent. However, it adds requirements for doctors to create a medical record for each patient and make it available to the Board upon request and, when necessary, to provide a referral to an in-state physician or otherwise arrange for in-state follow-up care.
The 2015 Board rules also required physicians to provide telemedicine services via simultaneous two-way video and audio communications. The new law, however, allows doctors to utilize interactive audio communications without video communication, provided that they first access and review a patient’s records and determine that they can meet the same standard of care as if they were providing face-to-face services.
The new law did not affect existing Board rules prohibiting physicians from prescribing controlled substances via telemedicine services unless the physician has had at least one in-person, in-state medical visit at a practice location within the past year, the prescription is entered for a legitimate medical purpose, it conforms with the in-person standard of care, and is otherwise permitted by state and federal laws and regulations.