Compliance with telemedicine rules are tricky these days, as many individual state medical boards regulate the practice of telemedicine within state borders. It is important to keep track of the changing laws related to telemedicine. For instance, the Texas Medical Board just approved new regulations related to telemedicine that take effect on June 3, 2015. In order to treat Texas residents through telemedicine, the physician must be licensed to practice in Texas.

The new regulations, among other changes, require physicians to see patients in person and face to face before providing health care to the patient remotely and specifically prohibit online questioning through email, texting or telephone. According to the Texas Medical Board, online or remote questioning is “inadequate to establish a defined physician-patient relationship.” The regulations require physicians to provide medical treatment and diagnosis through the use of accepted medical practices, which includes documenting and performing a patient history, mental health examination and physical examination which must be “performed as part of a face-to-face or in-person examination.” However, this requirement is not applicable to mental health treatment in Mental Health and Mental Retardation Centers and Community Centers unless there is a behavioral emergency.

The new regulations also amend the definition of an “established medical site” which excludes a patient’s home where services can be rendered, but allows residential treatment facilities, halfway houses, jails, juvenile detention centers, prisons, nursing homes, group homes, rehabilitation centers and assisted living facilities.

If you are practicing telemedicine, stay abreast of state requirements as they change frequently.