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 October:
- Telehealth disciplinary guidelines
- Behavioral health
- Medicaid state plan waivers
- Telehealth flexibilities
A CLOSER LOOK
Proposed Legislation and Rulemaking:
- A proposed law in Wisconsin (Senate Bill (SB) 214) passed the first chamber and would establish a pathway and registration requirements for out-of-state healthcare providers to offer telehealth services in Wisconsin.
- The Alaska State Medical Board proposed regulatory changes relating to the standards of practice for the use of buprenorphine to treat opioid-use disorder via telemedicine.
- In North Dakota, a proposed rule would establish veterinary medicine telemedicine guidelines.
- In Florida, the boards of Podiatric Medicine, Orthotists and Prosthetists, Acupuncture, and Athletic Training proposed updates to their respective disciplinary guidelines regarding patient overpayments and refunds to include telehealth registrants.
- In New Mexico, the Physical Therapy Board proposed a rule to clarify the scope of supervision required when services are administered via telehealth. Under this rule, a healthcare provider must render telehealth services under the same level of supervision required for in-person practice.
- In California, a proposed rule clarifies standards of practice for telehealth psychology services and underscores the board’s authority to regulate all psychological services provided by individuals under its jurisdiction, whether delivered in person or via telehealth.
- In Pennsylvania, a proposed rule would codify requirements for mobile crisis team services, including that a crisis intervention service medical professional or a crisis intervention service licensed behavioral health professional may participate in the mobile crisis team by means of tele-behavioral health.
- In Connecticut, the commissioner of the Department of Social Services (DSS) published a Notice of Intent to submit three applications to the Centers for Medicare and Medicaid Services, each to be effective April 1, 2026:
- Renewal of the Employment and Day Supports Medicaid Waiver
- Amendment of the Comprehensive Supports Medicaid Waiver
- Amendment of the Individual and Family Supports Medicaid Waiver
Each waiver program is operated by the Department of Developmental Services (DDS). DSS and DDS are proposing to add a new waiver service titled “Virtual Health Consultation” to each program. This service is tailored to meet the unique needs of individuals supported by DDS by providing timely, specialized telehealth assessments when a participant’s primary care physician is unavailable or unable to determine the most appropriate clinical course of action. The service ensures greater access to both routine and specialized medical care that might otherwise be challenging to obtain through traditional means and helps reduce unnecessary emergency room visits while also promoting efficient and accessible care.
- In the District of Columbia, the director of the Department of Health Care Finance (DHCF) applied for an amendment to the district’s Home and Community-Based Services for People with Intellectual and Developmental Disabilities (IDD) Waiver program. Specifically, the district is seeking approval to update the following services to include telehealth as a modality option
- Assistive technology assessment
- Behavioral support services
- Creative arts therapies
- Family training services
- Occupational therapy services
- Parenting support services
- Speech, hearing, and language services
- Wellness services, including bereavement counseling, fitness training, nutrition evaluation and counseling, and sexuality education
Additionally, the district is proposing to add a new telehealth service option called “Health Assessment and Coordination.” This standalone urgent-care telehealth service will provide specific medical advice on when waiver participants should seek additional or in-person medical treatment via virtual platforms. It also allows the provision of urgent care telehealth services to people residing in host homes, supported living, and residential habilitation settings.
Finalized Legislation and Rulemaking Activity:
- California Governor Gavin Newson signed several pieces of legislation into law relating to telehealth in the month of October:
- Assembly Bill (AB) 1503 prohibits any person from furnishing or dispensing any dangerous drug or device on the internet for delivery to any person in California without a prescription issued pursuant to an “appropriate prior examination.” California changed the terminology from “good faith prior examination” to “appropriate prior examination” in its laws governing the furnishing or dispensing of dangerous drugs or devices via the internet to better align with modern standards of care and regulatory clarity.
- AB 1502 makes technical amendments to statutes currently referencing the scope of practice, recordkeeping, and supervision requirements for veterinarians using telemedicine.
- SB 338 establishes the Virtual Health Hub for Rural Communities Pilot Program and requires the California Department of Health Care Services to administer the program to expand access to health services for farmworkers in rural communities. The bill would require the department, among other things, to deploy mobile units in rural counties based on farmworker population and access to healthcare, which would include, at a minimum, computers, Wi-Fi, cubicles for virtual visits, and exam rooms for telemedicine.
- SB 530 reinforces patient choice by requiring managed care plans to offer in-person services – even when telehealth meets access standards – if the patient prefers face-to-face care.
- AB 688 mandates the California Department of Health Care Services to utilize Medi-Cal and other data sources to generate and publicly publish Medi-Cal telehealth utilization reports starting in 2028 and biennially afterward.
- SB 669 requires the California Department of Public Health to establish a pilot project to allow critical access and individual and small-system rural hospitals to establish standby perinatal medical service. Hospitals selected for the pilot program must comply with various requirements, including having policies regarding telemedicine services for real-time perinatal and neonatal consultation.
- The Department of Veterans Affairs (VA) adopted a rule to amend its medical regulations that govern the VA’s healthcare professionals who practice healthcare via telehealth to enable the VA to maximize healthcare resource utilization and provide safe and convenient national healthcare to veterans using telehealth.
- In Michigan, an adopted rule clarifies rules for midwives who practice via telehealth.
- In New Hampshire, an adopted rule codifies requirements for providers under the Therapeutic Cannabis Program, and provides that telemedicine shall be allowed for providers for follow-up visits related to cannabis certification and treatment and for recertifications and extensions completed by the same certifying provider.
- In Utah, an adopted rule modifies the Mobile Crisis Outreach Teams (MCOT) Certification Standards to provide that in cases where a mental health therapist is not a deploying member of the team, each MCOT shall ensure a mental health therapist is available through telehealth.
- In Massachusetts, an adopted rule sets forth the requirements for programs of assertive community treatment (PACT) providers to enroll as MassHealth providers. PACT services may be provided by telehealth, as appropriate.
- The Texas Board of Physical Therapy Examiners adopted an amendment to the Texas Administrative Code relating to standardized formats for, and retention of, records related to a patient’s consent to treatment, data collection, and data sharing when providing physical therapy services via telehealth.
- Lastly, as described in more detail in the firm’s article, the pandemic-era Medicare telehealth flexibilities expired on September 30, 2025, during the pendency of the government shutdown that began on October 1, 2025. During that time, the pre-pandemic telehealth limits were reinstated.
Why it matters:
- Telehealth regulation is maturing. States are developing detailed, profession-specific rules to clarify licensure, supervision, and standards of care for telehealth across medical, behavioral health, and allied health professions.
- Access and equity are key drivers. States are expanding telehealth availability for underserved groups (such as individuals with developmental disabilities, rural communities, and behavioral health patients) while ensuring patient safety and provider accountability.
- Data, oversight, and patient choice are gaining prominence. States are formalizing data-sharing, reporting, and patient-consent requirements to balance innovation with transparency and consumer protection.
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.
