New Law Provides for Regulation of Telemedicine / Abolishment of Special Purpose License
On Apr. 12, 2022, Governor Kay Ivey signed Act No. 2022-302 providing for the regulation of the practice of telemedicine in Alabama. The Act also repeals the “special purpose license” established by Ala. Code §§ 34-24-500 through 508.
The Special Purpose License to Practice Medicine Across State Lines (SP) will be abolished as of July 11, 2022. No new SP licenses may be issued or existing SP licenses renewed after this date. Any SP license active on July 11, 2022, will continue until its current expiration date, at which time the license will not be renewable. SP licensees must obtain either a full license or a license via the Interstate Medical Licensure Compact to continue to practice medicine in Alabama.
The Board and Commission are in the process of developing administrative rules in compliance with these new laws.
Provisions of the Act
Physicians practicing medicine shall:
- Establish a diagnosis through acceptable medical practices.
- Disclose to the patient any diagnosis and the evidence for it and discuss the risks and benefits of treatment options.
- Provide a visit summary to the patient and provide information about follow-up and emergency care.
Telemedicine services are deemed to occur where the patient is located in Alabama, and they may only be provided upon the patient’s initiation or a referral by the patient’s established licensed physician.
The physician-patient relationship may be formed without a prior in-person examination.
Before providing telehealth services, the physician shall:
- Verify the identity of the patient.
- Require the patient to identify their physical location.
- Disclose to the patient the identity and credentials of the practitioner.
- Obtain the patient’s consent for the use of telehealth.
If a physician or practice group provides telehealth medical services more than four times in a 12-month period to the same patient for the same medical condition without resolution, the physician shall either:
- See the patient in person within a reasonable amount of time (no longer than 12 months); or
- Appropriately refer the patient to a physician who can provide the in-person care within a reasonable amount of time (no longer than 12 months).
The Board is authorized to provide exemptions for the in-person care provisions of the law.
If telehealth medical services are provided via video communication with a patient who is assisted in person by a licensed physician or nurse, the visit is considered to be in person.
The in-person requirement does not apply to the provision of mental health services[i].
A prescriber may prescribe a legend drug, medical supplies, or a controlled substance to a patient as a result of a telehealth medical service when authorized by applicable laws. A prescription for a controlled substance may only be issued as a result of telehealth medical services if each of the following applies:
- The telehealth visit includes synchronous audio or audio-visual communication using HIPAA compliant equipment with the prescriber responsible for the prescription.
- The prescriber has had at least one in-person encounter with the patient within the preceding 12 months.
- The prescriber has established a legitimate medical purpose for issuing the prescription within the preceding 12 months.
All telehealth medical services must use HIPAA compliant devices and technologies and take reasonable precautions to protect the privacy and security of all communications.
A physician who provides telehealth medical service shall maintain complete and accurate medical records and be able to produce the records upon demand by the patient, the Board of Medical Examiners, or
f the Medical Licensure Commission.
[i] Diagnosis of, treatment of, rehabilitation for, follow-up care of, prevention of and research into the causes of all forms of mental or emotional illness, including, but not limited to, alcoholism, drug addiction, or epilepsy in combination with mental illness or an intellectual disability.