Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate the delivery of virtual care.
Trending in June:
- Telehealth reimbursement and payment parity
- Licensure and cross-state practice
- Telehealth practice-specific standards and documentation requirements
- Expansion of telehealth across specialties and e-prescribing
A CLOSER LOOK
Proposed legislation and rulemaking:
- Iowa’s Board of Optometry proposed rule 481-762.9. If adopted, it would establish the standard of care requirements for teleoptometry, clarify when an optometrist-patient relationship is established through telehealth, and prohibit the use of telemedicine if, consistent with the standard of care, an in-person examination would be required to produce an informed diagnosis.
- West Virginia’s Board of Medicine proposed rule 8537 seeking to establish the regulatory framework for the licensure and regulation of genetic counselors in West Virginia, including telehealth practice standards. The rule would define the telemedicine modalities that a genetic counselor may use to establish a patient relationship and would establish the same standard of care for telemedicine services as required for in-person services.
- Vermont’s Office of Professional Regulation proposed rule 26P013, which would govern the licensing and registration of out-of-state healthcare professionals providing telehealth-only services to Vermont patients. Currently, healthcare providers who are not licensed in Vermont are not required to pay fees, but this rule would establish an application and renewal fee requirement in order to provide telehealth services to Vermont patients.
- Texas’s Board of Pharmacy proposed rule 49743, which would establish documentation and record retention requirements for telehealth services provided by a pharmacist in Texas.
- California AB 225 passed one chamber and aims to prevent billing for or collection of facility fees for preventive care telehealth services. The bill would impose notification requirements regarding facility fees and penalties for violations, and would prohibit health insurers from passing facility fees on to enrollees.
Finalized legislation and rulemaking:
- Rhode Island enacted SB 3180, expanding veterinary telemedicine authority by allowing veterinarians in Rhode Island to establish provider-patient relationships using . Previously, telehealth was limited to animals with an existing provider-patient relationship. In-person examinations are required to renew a prescription that was previously renewed twice based only on virtual examinations. Controlled substances may not be prescribed without an in-person examination.
- Florida final rule 52933 was published, establishing requirements for clinical social work, marriage and family therapy, and mental health counseling intern supervision, including hour thresholds, the use of in-person versus electronic methods, telehealth protocols, and the distinction between individual and group supervision. Face-to-face psychotherapy is defined to include electronic methods as long as certain requirements are met, including that the provider maintains a written telehealth protocol and safety plan.
- Alaska’s second chamber passed HB 14, which would require a healthcare insurer to reimburse a provider for healthcare services, including behavioral health services, provided through telehealth on the same basis and at least at the same rate as for comparable healthcare services provided in person. The bill allows insurers to implement a geographic pay differential to reimburse out-of-state providers.
- Both chambers of the Illinois legislature passed SB 3211, establishing protocols for diagnosis and care delivery using telehealth systems by licensed dentists and requiring certain dental services to be provided in person. A synchronous exam is required prior to the processing of x-rays as ordered by a supervising dentist, and local anesthetics may not be used during certain procedures provided in a teledentistry service by a dental hygienist.
- West Virginia enacted HB 5458, which allows a genetic counselor to provide telehealth services and gives the West Virginia Board of Medicine authority to establish the standard of care for the provision of genetic counseling via telehealth
Why it matters:
- States are establishing more detailed telehealth practice and compliance requirements. Legislative and regulatory activity reflects a growing focus on informed consent, documentation, supervision, and the standards governing the formation of provider-patient relationships in virtual care settings.
- Telehealth expansion is increasingly paired with specialty-specific standards of care. States are expanding telehealth authority across a broader range of professions while imposing requirements related to clinical appropriateness, prescribing, modality use, and circumstances that continue to require in-person services.
- Reimbursement and cross-state practice remain significant areas of policy development. Lawmakers and regulators continue to evaluate payment parity, patient cost protection, and licensure frameworks for out-of-state providers, reflecting efforts to expand access to care while maintaining regulatory oversight and accountability.
Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott Will & Schulte digital health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care, and mitigate enforcement risk through proactive compliance.
