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Arkansas PT/OT Telehealth

September 7, 2020

Physical Therapy

Proposed Physical Therapy Telehealth Rule

Occupational Therapy - Telemedicine Act

Definitions

"Distant site" means the location of the healthcare professional delivering services through telemedicine at the time the services are provided;

"Healthcare professional" means a person who is licensed, certified, or otherwise authorized by the laws of this state to administer health care in the ordinary course of the practice of his or her profession;

"Originating site" means a site at which a patient is located at the time healthcare services are provided to him or her by means of telemedicine;

"Professional relationship" means at minimum a relationship established between a healthcare professional and a patient when:

    • The healthcare professional has previously conducted an in-person examination and is available to provide appropriate follow-up care, when necessary, at medically necessary intervals;
    • The healthcare professional personally knows the patient and the patient's relevant health status through an ongoing personal or professional relationship and is available to provide appropriate follow-up care, when necessary, at medically necessary intervals;
    • The treatment is provided by a healthcare professional in consultation with, or upon referral by, another healthcare professional who has an ongoing relationship with the patient and who has agreed to supervise the patient's treatment, including follow-up care;
    • An on-call or cross-coverage arrangement exists with the patient's regular treating healthcare professional or another healthcare professional who has established a professional relationship with the patient;
    • A relationship exists in other circumstances as defined by rule of the Arkansas State Medical Board for healthcare professionals under its jurisdiction and their patients; or
    • A relationship exists in other circumstances as defined by rule of a licensing or certification board for other healthcare professionals under the jurisdiction of the appropriate board and their patients if the rules are no less restrictive than the rules of the Arkansas State Medical Board;

"Remote patient monitoring" means the use of synchronous or asynchronous electronic information and communication technology to collect personal health information and medical data from a patient at an originating site that is transmitted to a healthcare professional at a distant site for use in the treatment and management of medical conditions that require frequent monitoring;

"Store-and-forward technology" means the asynchronous transmission of a patient's medical information from a healthcare professional at an originating site to a healthcare professional at a distant site; and

"Telemedicine" means the use of electronic information and communication technology to deliver healthcare services, including without limitation the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient.

"Telemedicine" includes store-and-forward technology and remote patient monitoring.

Establishment of Professional Relationship

A healthcare professional at a distant site shall not utilize telemedicine with respect to a patient located in Arkansas unless a professional relationship exists between the healthcare professional and the patient or the healthcare professional otherwise meets the requirements of a professional relationship as defined above.

The existence of a professional relationship is not required in the following circumstances:

    • Emergency situations where the life or health of the patient is in danger or imminent danger; or
    • Simply providing information of a generic nature, not meant to be specific to an individual patient.

If the establishment of the professional relationship is permitted via telemedicine under § 17-80-402(4)(E) or § 17-80-402(4)(F), telemedicine may be used to establish the professional relationship only for situations in which the standard of care does not require an in-person encounter.

"Professional relationship" does not include a relationship between a healthcare professional and a patient established only by the following:

    • An internet questionnaire;
    • An email message;
    • Patient-generated medical history;
    • Audio-only communication, including without limitation interactive audio;
    • Text messaging;
    • A facsimile machine; or
    • Any combination thereof.

Appropriate Use of Telemedicine

A professional relationship shall be established to provide healthcare services through telemedicine.

Once a professional relationship is established, a healthcare professional may provide healthcare services through telemedicine, including interactive audio, if the healthcare services are within the scope of practice for which the healthcare professional is licensed or certified and the healthcare services otherwise meet the requirements of this subchapter.

A licensing or certification board shall not permit the use of telemedicine in a manner that is less restrictive than the use of telemedicine authorized by the Arkansas State Medical Board.

Regardless of whether the healthcare professional is compensated for the healthcare services, if a healthcare professional seeks to provide healthcare services to a minor through telemedicine in a school setting and the minor is enrolled in the Arkansas Medicaid Program, the healthcare professional shall:

    • Be the designated primary care provider of the minor;
    • Have a cross-coverage arrangement with the designated primary care provider of the minor; or
    • Have authorization from the designated primary care provider of the minor.
      • If the minor does not have a designated primary care provider, this section does not apply.
      • If a minor is enrolled in a health benefit plan as defined in § 23-79-1601 that is not part of the Arkansas Medicaid Program, the terms and conditions of the health benefit plan shall control.
      • The designation of a primary care provider for a minor remains the right of a parent or legal guardian in accordance with § 20-9-601 et seq.

Healthcare services provided by telemedicine, including without limitation a prescription through telemedicine, shall be held to the same standard of care as healthcare services provided in person.

A healthcare professional who is treating patients in Arkansas through telemedicine shall be fully licensed or certified to practice in Arkansas and is subject to the rules of the appropriate state licensing or certification board.

    •  This requirement does not apply to the acts of a healthcare professional located in another jurisdiction who provides only episodic consultation services.

A healthcare professional shall follow applicable state and federal law, rules, and regulations for:

    • Informed consent;
    • Privacy of individually identifiable health information;
    • Medical recordkeeping and confidentiality; and
    • Fraud and abuse.

Reference

AR Code § 17-80-402

AR Code § 17-80-403

AR Code § 17-80-404

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