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Telehealth Contract Review: How to Vet a Telehealth Opportunity

by admin on October 12, 2017 No comments

telemedicine contractBy: Susan St. John

So you’ve been approached by a telehealth company to provide telehealth services to patients. What do you do next about this telehealth contract opportunity? Providing these services can be an opportunity to assist patients who cannot make it to a physician’s or practitioner’s office, and it’s an opportunity for a potential source of income. However, before you sign on the telehealth contract’s dotted line, you need to do a little background checking, a little investigation, to ensure the telehealth company you sign with is compliant with state and federal laws for providing telehealth services. In other words, perform due diligence in determining if this is the telehealth company for you.

So what should you look for in a telehealth company as a physician or practitioner presented with a telehealth contract?

  1. Role. Know what your role will be and how patients will be presented to you.
    • Will there be a “live transfer” from a person performing intake on behalf of the telehealth company, or will appointments be set in advance?
  2. Platform. Ask what kind of interactive communications system or equipment it has.
    • Will it provide audio as well as video capability for providing telehealth services? Federal law, e.g., Medicare, requires an interactive communications system that includes audio and video capabilities – a telephone communication is not enough.
    • Additionally, except in very limited circumstances, federal law prohibits “store and forward” communications, i.e., an audio and/or video of the patient recorded and sent to the physician or practitioner at a later point in time.
  3. License Issues. Keep in mind your state of licensure’s laws. Make sure before you jump on board with a telehealth company that the state you are licensed in allows you, that is your profession, to provide telehealth services. Many states follow federal law requirements regarding the provision of telehealth services, but some states may be more or less restrictive.
    • Also, if a telehealth company asks you to provide telehealth services in more than the state you are licensed in, find out whether other states you might provide services in allows for practitioners licensed in other states to provide services to folks located within its geographic boundaries. Many states do not allow a physician or practitioner to furnish telehealth services to patients within its geographic boundaries without being licensed in that state.
  4. Legal Issues. You will also need to consider whether an originating site other than a patient’s home is required by federal or state law. For Medicare, an originating site is specifically limited and must be within certain geographic locations. It’s important to note – an originating site under Medicare is not the patient’s home. State law may also require an originating site be separate from the patient’s home.
  5. Equipment. Make sure the telehealth company’s communication equipment and maintenance of patient records must be HIPAA compliant.
    • Determine what access you will have to patient records once the telehealth service has been completed or when your contract with the telehealth company comes to an end. Will your access ability comport with the state law you are licensed in? Will you have access to patient records should you undergo an audit, review or investigation? Undoubtedly the patient records will belong to the telehealth company, but you may need access either for follow-up care or to respond to inquiries from insurers, state or federal agencies. Know what access you will have throughout the duration of your contract and should you need access after your contract terminates.
  6. Services. Does the telehealth company understand the scope of practice for your profession or will the telehealth company perform live transfers or schedule appointments for patients needing a service that you cannot provide?
    • What policies, procedures and protocols does the telehealth company have in place to ensure that you are not asked to provide telehealth services beyond what you are legally allowed to provide pursuant to your license.
  7. Deeper Due Diligence. Finally, ask the telehealth company for references and check with other physicians or practitioners that are or have been associated with the telehealth company.
    • Find out how long the telehealth company has been in business.
    • Request copies of the telehealth company’s policies, procedures and protocols for the provision of telehealth services and find out if the telehealth company has an opinion from an attorney that its policies, procedures and protocols are compliant with applicable laws regarding telehealth services.
    • Consider asking your health law attorney to review the telehealth company’s policies, procedures and protocols to make sure you are protecting yourself before entering into any agreement with a telehealth company.

Providing telehealth services can be a worthy compliment to your practice; however, caution should be exercised before entering into a contractual relationship with a telehealth company. Keep in mind, when a telehealth company touts itself as “HIPAA compliant,” this is only one area where it must maintain compliance. It must also be complaint with federal and/or state laws for furnishing telehealth services.

 

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