U.S. States and Territories Modifying Requirements for Telehealth in

U.S. States and Territories Modifying Requirements for Telehealth in Response to COVID-19

(Out-of-state physicians; preexisting provider-patient relationships; audio-only requirements; etc.)

Last Updated: May 24, 2023

States with Waivers: 2

States with Waivers, not allowing new applications: 1

States without Waivers (or closed waivers): 47 + DC

States with long-term or permanent interstate telemedicine: 21 + GU + CNMI + PR + USVI

On April 10, 2023, President Biden signed a resolution formally ending the coronavirus national emergency that began in

March 2020. However, the COVID Public Health Emergency (PHE), will continue until May 11, 2023, as was previously

announced by the administration.

On April 10, 2023, President Biden signed a resolution formally ending the coronavirus national emergency that began in

March 2020. However, the COVID Public Health Emergency (PHE), will continue until May 11, 2023, as was previously

announced by the administration.

Following the conclusion of the federal PHE on May 11, many other states followed suit, including Colorado,

Connecticut, Delaware, Massachusetts, Oregon and Washington. As of May 24, only two states – New York and Texas –

have active states of emergency related to the pandemic.

State

Note

Citation

Alabama

• The Medical Licensure Commission of Alabama hereby finds that the need for qualified

physicians to provide medical services in Alabama warrants the emergency adoption of this

rule to provide for the issuance of an emergency license to physicians licensed in other states

who may assist with this health emergency. The intent of this rule is to provide for the

expedited issuance of medical licenses to qualified physicians who desire to provide health

care to citizens of Alabama suffering from and affected by the 2019 novel coronavirus known

as COVID-19. The Medical Licensure Commission hereby finds that physicians who obtain an

emergency certificate of qualification by endorsement from the State Board of Medical

Examiners are eligible for an emergency medical license… An emergency license issued under

this rule shall expire 120 days after the effective date of this rule, or when the Governor of

Alabama proclaims the termination of the state’s public health emergency, whichever is

sooner. An emergency license shall not be renewed. Applicants for an emergency license

shall not be required to pay a fee.

• Re: Alabama Medicaid - The extension of telemedicine services is effective March 16, 2020.

This extension allows clinicians to provide medically necessary services that can be

appropriately delivered via telecommunication services including telephone consultations…

These actions will be effective for one month, expiring on dates of service April 16, 2020. It

will be reevaluated for a continuance as needed.

• Re: controlled substances - If you have a current DEA registration in any jurisdiction, upon

issuance of the Temporary Emergency Medical License, you will receive an Alabama

Controlled Substances Certificate for the sole purpose of treating patients suffering from and

affected by COVID-19. The Alabama Controlled Substances Certificate will specifically

prohibit the prescribing of controlled substances via telemedicine.

• [6/8/21 Update] - It is not the case that a physician may practice telemedicine in any state as

long as there is a license in at least one other state. To practice telemedicine in Alabama,

the physician must hold one of the Alabama medical licenses that are available (Alabama

full traditional license, a license via the Interstate Medical Licensure Compact, or special

purpose license to practice medicine across state lines).

ALBME Emergency

Rule Statement

ALBME Telemedicine

Guidance

Initial Emergency

License Instructions

2 
 
•  Re: Special purpose [interstate] license – However, the Alabama Board of Medical Examiners 
does issue a license “limited solely to the practice of medicine or osteopathy across state 
lines  via  telecommunications.  These  licensees  are  not  authorized  to  provide  in-person 
treatment in Alabama.” 
•  [5/18/22 Update] re: Special purpose licenses abolished - On Apr. 12, 2022,  Governor Kay 
Ivey signed Act  No. 2022-302 effectively abolishing  the  SPL  which allowed the  practice of 
medicine and osteopathy across state lines via telemedicine. No new SPL applications will be 
accepted after May  26, 2022.  Currently active  Special Purpose licenses will  remain  active 
until their natural expiration date. No Special Purpose licenses will be renewed. 
•  Physicians desiring to continue to practice telemedicine in Alabama will be required to 
obtain  a full  license or  a  license  through  the Interstate  Medical  Licensure  Compact. 
(ALBME Guidance). 
•  [7/12/22  Update]  re:  infrequent  interstate  telemedicine  –  However,  as  part  of  that 
legislation, there is an exception for physicians “who provide [telemedicine] services on 
an  irregular  or  infrequent  basis  (defined  as  fewer  than  10  days  or  10  patients  per 
calendar  year),  or  when  the  services  are  provided  in  consultation  with  a  physician 
licensed in the state. The bill also explicitly allows a physician-patient relationship to be 
established  without  an  in-person  exam,  and  prescribing  can  include  controlled 
substances under certain circumstances. 
•  Status – Inactive, waivers currently rescinded - On July 20, 2020, the Board and Commission 
extended the expiration of existing and new emergency licenses to November 17, 2020. All 
temporary emergency licensees that wish to continue practicing in Alabama after November 
17,  2020,  should  apply  now  for  permanent  licensure  through the  Board (typically  2-3 
months) or the Interstate Medical Licensure Compact (within 30 days). It is anticipated that 
licenses should be issued within 48 hours of receipt of application. 
 
 
Temporary License 
Application 
 
 
 
 
 
 
 
Guidance re: AL 
Medicaid 
 
 
 
 
 
 
 
State Resource Page 
Alaska 
•  On April 10, 2021,  Gov. Dunleavy signed SB 241, which says, in part, "... during the public 
health disaster emergency declared by the governor… on March 11, 2020… [Alaska Statutes] 
do not apply to a health care provider who is providing treatment; rendering a diagnosis; or 
prescribing, dispensing, or administering a  prescription, excluding a controlled substance… 
through an audio-visual, real-time, two-way interactive communication system, without first 
conducting an  in-person  physical  examination,  if  (1)  the  health  care  provider  is  licensed, 
permitted, or certified to provide health care services in another jurisdiction and is in good 
standing in the jurisdiction…” 
•  For as long as the Secretary’s designation of a public health  emergency remains in effect, 
DEA-registered practitioners may issue prescriptions for controlled substances to patients for 
whom  they  have  not  conducted  an  in-person  medical  evaluation,  provided  all  of  the 
following conditions are met: 1) The prescription is issued for a legitimate medical purpose 
by a practitioner acting in the usual course of his/her professional practice 2) Is conducted 
using  an  audio-visual,  real-time,  two-way  interactive  communication  system.  3)  The 
practitioner is acting in accordance with applicable federal and state law. 
•  Re: opioid use disorder treatment - On May 7, 2020,  the State Medical Board adopted, as 
emergency  regulations,  changes  in  12  AAC  40,  to  allow  a  physician  or  PA  to  examine, 
diagnose and treat a patient for an opioid use disorder without a healthcare provider present 
with the patient, during a public health emergency disaster declared by the governor. 
•  [2/16/21 Update] Re: expiration of state of emergency - Alaska on [February 14] became one 
of  two  states  in  the  United  States  without  a  formal  COVID-19  public  health  disaster 
declaration and the only state without any disaster-related provisions, at least right now. 
•  [2/19/21 Update] Re:  waivers  -  While  certain  authorities  under  the  DD  have  expired,  the 
Department of Health and Social Services (DHSS) is making every effort to minimize potential 
disruption to interactions between Alaskans and DHSS as we transition out of the DD. DHSS 
will continue to operate its COVID-19 response under the same guidance and direction that 
had previously been provided, which includes all prior waived or suspended statutes and 
regulations. 
•  [6/30/21 Update] re: Interstate telemedicine – Alaska offers Emergency Courtesy Licenses 
for  physicians  licensed  in  other  jurisdictions,  which  are  valid  for  6  months,  and  can  be 
renewed  for  6  months  “if  the  board  has  determined  the  urgent  situation  still  exists.” 
(Article). (State Medical Board guidance). 
•  [1/7/22 Update] re: Interstate telemedicine – The practice of telehealth/telemedicine on a 
patient located in Alaska requires an Alaska license. (Telehealth & Licensing During COVID-
19). 
•  [11/3/22  Update]  re:  Interstate  telemedicine  –  Although  treating  a  patient  in  Alaska  via 
telemedicine  requires  an  Alaska  license,  HB  265  (2022)  includes  a  provision  that  allows 
Alaskans  with  suspected  or  diagnosed  life-threatening  conditions,  such  as  cancer,  to  be 
 
 
AK SB 241 
 
 
 
Courtesy License 
Application 
 
 
 
Emergency 
Regulation 
 
 
 
Telehealth & 
Licensing During 
COVID-19 
 
 
 
Bulletin 20-07 re: 
Telehealth Coverage 
 
 
 
Article re: Waiver 
expiration 
 
 
 
DHSS Guidance re: 
Waivers 
 
 
 
AK HB 76 

treated by an out-of-state physician as long as they:

o Have a referral from their Alaska-licensed physician.

o Have an existing patient-physician relationship with the out-of-state physician.

o And the out-of-state physician has previously conducted an in-person visit with the

patient.

• Status – Inactive. AK HB 76, which was signed April 30, formally ended Alaska’s state of

emergency. (Article). According to the 4/30 Public Health Order, no interstate licensing

waivers are included.

o However, SB 241 allows a licensed health care provider in good standing in another

jurisdiction to provide services via telemedicine to Alaska patients, with the exception

of prescribing controlled substances (see above) during a declared state of

emergency.

4/30 PHO

State Resource Page

Arizona

• [MDs]: The Arizona Medical Board (AMB) announces the following available temporary

emergency licenses for Physicians (MDs) to practice in Arizona and the extension of the time

frame for renewal of MD licenses during the COVID-19 State of Emergency: MDs licensed in

another state are eligible to apply for temporary licensure in the State of Arizona using the

emergency temporary licensure application… All MD temporary emergency licenses expire

after 90 days, or at the time the State of Emergency is declared to be over whichever shall

occur first.

• [DOs]: In accordance with Arizona Revised Code, individuals can apply for a temporary

license with the Board to aid in the diagnosis and treatment of COVID-19 in Arizona.

• Re: Telemedicine coverage - Gov. Ducey [on March 25, 2020] issued an Executive Order [EO

2020-15] requiring health care insurance companies to expand telemedicine coverage for all

services that would normally be covered for an in-person visit… It remains in effect until the

termination of the declared public health emergency… Includes all electronic means of

delivering telehealth including telephone and video calls; Ensures that a patient’s home is

considered an approved location to receive telemedicine services; … And prohibits a

regulatory board from requiring a medical professional who is authorized to write

prescriptions to conduct an in-person examination of a patient prior to the issuance of a

prescription.

• [5/5/21 Update] – Re: interstate telemedicine - On June 5, 2021, AZ HB 2454 was signed,

which permanently allows health care providers licensed in another jurisdiction, in good

standing and not subject to current or past disciplinary actions; to practice telemedicine

with Arizona patients. Licensees must register with the act in compliance with Arizona laws

including scope of practice and liability insurance, among others. The venue for any violation

is that of the resident.

• Status – Inactive, on May 5, Gov. Ducey issued EO 2021-13, rescinding prior telemedicine-

related executive orders, and referencing the comprehensive HB 2454. However, Arizona

offers interstate telemedicine via Registration system, see above.

AZ DHS Guidance

EO 2020-15

Press Release re:

Telemedicine

Coverage

EO 2020-07

AZ HB 2454

Temporary MD

License

Temporary DO

License

Status of AHCCCS

Emergency Authority

Requests

Universal License

Application

State Resource Page

Arkansas

• In response to the current health crisis and Gov. Hutchinson’s Executive Order 20-16, the

ASMB voted to grant a Border State Emergency Temporary License to physicians that are

currently practicing in any of the six bordering states [Texas, Oklahoma, Missouri, Tennessee,

Mississippi, Louisiana] and also holds an active and unrestricted medical license in that state

with the understanding that this is for telemedicine only for already established Arkansas

patients.

• Re: establishing patient/physician relationship - Gov. Hutchinson is waiving the requirement

for in-person/face-to-face meetings to establish relationships. “Physicians licensed in

Arkansas who have access to a patient’s personal health record maintained by a physician

may establish a professional relationship with a patient using any technology deemed

appropriate by a provider, including the telephone… to diagnose, treat, and if clinically

appropriate, prescribe.”

• Re: controlled substances – The Arkansas State Medical Board voted to allow prescribers to

see patients and prescribe controlled substance medications via telemedicine for a six-month

period during the public health emergency, so long as the prescription is a refill only and not

a change to the current medication.

• [5/21/21 Update] – Re: Recission of State of Emergency - Gov. Asa Hutchinson on [5/20/21]

said he won’t seek another extension of the emergency he declared because of the

coronavirus pandemic, allowing it to expire at the end of the month. Hutchinson said the

declaration that he first issued March 11, 2020, because of the pandemic will expire May 30.

• [8/3/21 Update] re: New State of Emergency Declaration - Hutchinson said the declaration

will allow the Arkansas Department of Emergency Management to seek staffing assistance

from health workers outside the state. It also eases the process for retired health workers to

re-enter the workforce and for medical students to become licensed. (Article).

Border State

Emergency License

Instructions &

Application

Executive Order 20-

• EO 21-14: The Arkansas Division of Emergency Management is hereby ordered to seek

necessary staffing assistance… through available avenues to include the Emergency

Management Assistance Compact… the Arkansas Dept. of Health is ordered to identify any

regulatory statutes, orders, or rules related to licensure of healthcare professionals that may

be preventing, hindering, or delaying necessary action for coping with this emergency…

o The Emergency Management Assistance Compact (EMAC) is a congressionally ratified

interstate mutual aid mechanism (Public Law 104-321) that is supported through

legislation enacted by all 50 States, the District of Columbia, Puerto Rico, and the U.S.

Virgin Islands. It provides a general framework (and legal basis) for interstate coordination

and mutual aid during Governor-declared emergencies or disasters… including Licensure

and permit waivers for medical and other professionals

• [9/29/21 Update] re: Emergency declaration recission - Arkansas Gov. Asa Hutchinson on

[9/28/21] said he'd allowed the state's public health emergency for the coronavirus

pandemic to end, saying he didn't need any additional powers to respond to it. (Article).

• [1/7/22 Update] re: interstate telemedicine - Healthcare providers must be fully licensed or

certified in Arkansas to provide services in the state unless the out-of-state provider is only

providing episodic consultation services. (AR Code 17-80-404(d)).

• Status – Inactive, the state’s emergency declaration expired September 27, 2021 (see

above).

ASMB Telemedicine

Guidance

Article re: SoE

recission

State Resource Page

California

• (Broad provision in Executive Order) - Any out-of-state personnel, including, but not limited

to, medical personnel, entering California to assist in preparing for, responding, to, mitigating

the effects of, and recovering from COVID-19 shall be permitted to provide services in the

same manner as prescribed in Government Code section 179.5, with respect to licensing and

certification. Permission for any such individual rendering service is subject to the approval

of the Director of the Emergency Medical Services Authority for medical personnel and the

Director of the Office of Emergency Services for nonmedical personnel and shall be in effect

for a period of time not to exceed the duration of this emergency.

• [EMSA Guidance] - A medical facility, telehealth agency or staffing agency which desires to

utilize medical professionals with out-of-state certifications or licenses during the COVID-19

State of Emergency shall submit the following to the EMS Authority prior to receiving

approval: (A) A complete and signed “Request for Temporary Recognition of Out-Of-State

Medical Personnel During a State of Emergency” form. (B) Email the temporary recognition

form and supporting documents to the EMS Authority. (C) The California EMS Authority shall

review and make a written determination... (D)The duration of the approval shall continue

until the termination of the State of Emergency or the end date on the temporary

recognition form, whichever comes first.

• On April 4, Gov. Newsom signed Executive Order N-43-20 expanding protections to medical

providers as they amplify the use of video chats and similar applications to provide routine

and non-emergency medical appointments in an effort to minimize patient exposure to

COVID-19. The order relaxes certain state privacy and security laws for medical providers, so

they can provide telehealth services without the risk of being penalized.

• The requirements related to the responsibility of a health care provider to obtain verbal or

written consent before the use of telehealth services and to document that consent, as well

as any implementing regulations, are suspended.

o [10/5/21 Update] - California Governor Gavin Newsom has extended an Executive

Order enabling physicians to conduct routine and non-emergency telehealth services

without risk of being penalized for the inadvertent release of patient data. (Executive

Order N-16-21).

• [8/10/21 Update] re: Continuing telehealth flexibilities - The main telehealth update came

with the Governor’s signing of AB 133 on July 27th, which extends California’s temporary

COVID-19 telehealth flexibilities until the end of 2022. The extension ensures payment parity

for all telehealth modalities, including audio-only, and all providers, including federally

qualified health centers (FQHCs) and rural health clinics (RHCs).

• [1/7/22 Update] re: interstate telemedicine - Physicians using telehealth technologies to

provide care to patients located in California must be licensed in California. Physicians are

held to the same standard of care, and retain the same responsibilities of providing informed

consent, ensuring the privacy of medical information, and any other duties associated with

practicing medicine regardless of whether they are practicing via telehealth or face-to-face,

in-person visits. (Medical Board of California Telehealth Resources).

• [10/18/22 Update] re: State of Emergency recission – On October 17, 2022, Gov. Newsom

announced that California’s emergency declaration will end on February 28, 2023. (Article).

• Status – Inactive, California’s state of emergency expired February 28, 2023 (see above).

Emergency

Declaration

EMSA Guidance

Temporary License

Application

EO N-43-20

CA AB 133 Fact Sheet

(CCHP)

State Resource Page

Colorado

• Existing law allows a physician who is not currently licensed in Colorado to provide medical

5 
 
care in connection with an emergency so long as such services are “gratuitous,” that is, free 
of charge via § 12-240-107(3)(a), C.R.S. The Medical Practice Act also currently allows for a 
physician  licensed  and  lawfully  practicing  medicine  in  another  state  or  territory  without 
restrictions  to  provide  occasional  services  in  Colorado  through  §  12-240-107(3)(b).  This 
provision  does  require  that  the  physician  not  have  a  regular  practice  in  Colorado  and 
maintain malpractice insurance. 
•  Suspension  of  requirements  that  patients  must  be  located  in  Colorado  at  time  of 
consultation to expand treatment for traveling Colorado citizens, as currently required under 
§ 12-240-107(1)(g), C.R.S., which defines telemedicine as the practice of medicine requiring a 
Colorado  license  to  practice  telemedicine  on  patients  located  in  Colorado  at  time  of 
consultation. 
•  Re: permanent telehealth changes - On July 6, Colorado Governor Jared Polis signed SB 20-
212,  expanding  access  to  telehealth for  Colorado  residents  by  prohibiting  insurers  from 
requiring an established in-person practitioner/patient relationship or imposing location or 
additional  licensure  requirements,  as  well  as  preventing  limitations  on  the  use  of  HIPAA-
compliant technologies to deliver telehealth. 
•  Status –  Inactive,  Colorado’s  State  of  Emergency  was  rescinded  on July 8,  2021,  per  7/8 
announcement. 
 
DORA Guidance 
 
 
Article re: Telehealth 
changes 
 
 
CO SB 20-212 
 
 
Article re: SB 212 
 
 
State Resource Page 
Connecticut 
•  [EO 7G] - Suspends the licensure/certification/registration requirements in § 19a-906(a)(12) 
–  which  establishes  who  may  qualify  as  a  “telehealth  provider”  in  Connecticut  –  for 
telehealth providers enrolled in Medicaid or in-network in fully-insured commercial plans, in 
accordance  with  orders  issued  by  the  Commissioner  of  the  Department  of  Public  Health 
(DPH). 
o Section 5(b) of Executive Order 7G allows a clinician licensed in another state to treat 
someone in CT through telehealth without getting a license in CT. [CT.gov] 
•  Re: licensure by endorsement - Existing Connecticut law provides that “Department of Public 
Health may  establish a process of  accepting an  applicant’s license from another state and 
may issue that applicant a license to practice medicine in the state without examination, if 
certain conditions are met” (Conn. Gen. Stat. § 20-12) 
•  Re:  originating  sites  -  Waiving  the  homebound  requirements    for  all  otherwise  coverable 
medical  telemedicine  services;  Addition  of  specified  “New  Patient”  Evaluation  and 
Management (E&M) Services; and Waiving the originating site requirements for psychiatric 
diagnostic evaluations. 
•  [EO  7G]  Re:  telemedicine  modality  -  The  order  expands  Medicaid  and  commercial  health 
insurance telehealth coverage to audio-only telephone. 
•  Re: State of Emergency extension – On July 14, 2020, Gov. Lamont signed Executive Order 
7HHH, which extends the suspension of the requirements of licensure for physicians and PAs 
for six months [January 14, 2021] unless earlier modified or terminated. 
•  Re: telemedicine waiver extensions - CT HB 6001, which was signed into law July 31, 2020, 
extends  Gov.  Lamont’s  emergency  orders  regarding  telemedicine  until  March  15,  2021, 
including expanding the type of healthcare professionals that can provide telehealth services 
to  dentists,  genetic  counselors,  and  occupational  or  physical  therapist  assistants,  among 
others; allowing audio-only telemedicine modalities, and prohibiting insurers from reducing 
reimbursement for telemedicine services. 
•  [3/16/21  Update]  re:  telemedicine  waiver  extensions  –  On  March  14,  2021,  Gov.  Lamont 
issued Executive Order No. 10C that extends the act's expiration date to April 20, 2021. 
•  [5/14/21 Update] re: two-year waiver extension – On May 10, 2021, Gov. Lamont signed CT 
HB 5596, which, among other things, allows for physicians licensed out-of-state to provide 
services via telemedicine to Connecticut residents for two years. Requires any Connecticut 
entity, institution, or provider who contracting with  an  out-of-state  provider  to  verify the 
provider’s  credentials  and  confirm  they  have  professional  liability  insurance.  Bill  allows 
audio-only modalities when appropriate, also limited to a two-year time frame. (Article). 
•  [7/27/21 Update] re: status of waivers - The executive order that allowed a physician or PA 
licensed in another state to practice in Connecticut without a Connecticut license expired on 
July 20, 2021. The order did not distinguish between in-person and telehealth. Public Act 
21-9 (HB 5596) authorizes the Commissioner of Public Health to issue an order allowing an 
out of state licensed physician or PA to provide services via telehealth without obtaining a 
Connecticut license through June 30, 2023.  However, there is no such order in place at this 
time. 
•  [12/23/21  Update]  re:  new  waivers  -  As  COVID-19  cases  and  hospitalizations  rise,  the 
Connecticut Department  of  Public Health is  waiving state license  requirements  for certain 
out-of-state health care workers looking to  practice in Connecticut in an effort to combat 
staffing  shortages…  This  order  will  suspend  for  60  days  the  state's  requirements  for 
 
 
 
 
 
Article re: 
Telemedicine 
 
 
 
 
Executive Order 7G 
 
 
 
 
Conn. Gen. Stat. § 
20-12) 
 
 
 
 
CMAP Telemedicine 
Guidance 
 
 
 
 
CT HB 6001 
 
 
 
 
Article re: 2
nd
 
Telemedicine 
Extension 
 
 
 
 
CT HB 5596 
 
 
 
 

licensure, certification or registration requirements for health care workers who have the

appropriate credentials in another U.S. state or territory. It will not extend past February 15

if the state's public health emergency is not extended… Applies to: physicians, PAs, APRNs…

(Article).

• [4/15/22 Update] re: recission of waiver – “In accord with Special Act 22-1, Executive Order

14 D will expire on April 15, 2022, ending the modification of various provisions of the

General Statutes governing the licensure, permitting of health care professionals and

supervision of various health care professionals. The following statutory requirements

modified by the Executive Order shall no longer be modified and will be in full effect on April

15, 2022.” (DPH Guidance).

• [3/1/23 Update] re: out-of-state mental and behavioral health care providers – “I hereby

authorize the following health care providers appropriately licensed, certified or registered in

another state or territory of the United States or the District of Columbia to deliver mental

health and behavioral health care and services via telehealth… psychologists, marital and

family therapists, marital and family therapy associates, clinical social workers… [APRNs]…

certified as a Psychiatric-Mental Health Nurse Practitioner… [PAs]… with a Certificate of

Added Qualifications in Psychiatry…” OOS providers must register with CT DPH, follow CT

law, and submit an application within 30 days of enrolling. (DPH Commissioner’s Order

11/2/22).

• Status – Inactive, the out-of-state waiver expired April 15, 2022, “The Connecticut

Department of Public Health (DPH) has further extended its temporary waiver of the state’s

license requirements for certain out-of-state health care professionals looking to practice in

Connecticut to April 15. (DPH Guidance).

• However, OOS mental and behavioral health care providers that are registered with the

state’s Department of Public Health may practice via telemedicine until September 30, 2023

per DPH Commissioner’s Order 11/2/22.

Executive Order

7HHH

DPH Commissioner’s

Order 11/2/22

DPH Commissioner’s

Orders

State Resource Page

Delaware

• Nurses, doctors, mental health care providers, pharmacists and other health care

professionals who have active licenses or certificates of good standing in any U.S. jurisdiction

are authorized to provide in-person health care services in Delaware throughout the

emergency, as well as telemedicine services.

• All out of state mental health providers with an active license in good standing in any United

States jurisdiction… are hereby authorized to provide in-person and telemedicine mental

health services in Delaware.

• Any in-person requirement prior to telemedicine services under Title 24 is waived.

Regulation 19 on Telemedicine, including audio-visual requirements are suspended.

• DE HB 348, signed into law July 16, eliminated authorization for out-of-state practitioners to

practice telemedicine and telehealth in Delaware with the exception of mental health care

providers. It retains the suspension of certain regulations which limit the practice of

telemedicine (e.g., audio-only telemedicine, no pre-existing patient provider relationship

necessary, prescribing opioids) that had been instituted with executive order waivers, until

July 1, 2021.

• [6/25/21 Update] On June 23, 2021, Delaware Governor John Carney signed the Telehealth

Access Preservation and Modernization Act of 2021 into law. This legislation allows the first-

time encounter to establish the physician/patient relationship to occur via telehealth and

allows for audio-only telehealth visits. The law will also bring Delaware into the Interstate

Medical Licensure Compact, which makes it easier for physicians to practice in multiple

states. (Article).

• [10/26/22 Update] re: interstate telemedicine – On October 15, HB 334 was signed into law,

which “Allows practitioners licensed outside of Delaware to render services to Delaware

patients by telemedicine so long as their license in good standing in all jurisdictions in which

they are licensed, not under investigation or subject to an administrative complaint, and they

first obtain an interstate telehealth registration from the Division of Professional Regulation.

Delaware retains jurisdictional authority for medicine practiced in the state, and "may report

any discipline to the National Practitioner Database, as well as to every jurisdiction in which

the health-care provider holds a license."

• Status – Inactive, out-of-state telemedicine waivers rescinded, with the exception of mental

health care providers, per HB 348. In October, 2022, HB 334 provides an opportunity for OOS

providers to render services in the state. See above for more details.

Gov.’s Press Release

DEMA/DPH Order

Med Board Reg. 19

Out of State Medical

Personnel Form

DE HB 348

DE HB 334

State Resource Page

Florida

• On March 16, 2020, Florida’s Surgeon General issued an Emergency Order that allows certain

out-of-state health care professionals to temporarily provide telehealth services to persons

in Florida in order to prepare for, respond to, or mitigate the effects of COVID-19. The Order

also allows certain Florida licensed physicians to use telehealth services instead of in-person

examinations in limited circumstances.

Article re:

Telemedicine

• For purposes of preparing for, responding to, and mitigating any effect of COVID-19, health

care professionals not licensed in this state may provide health care services to a patient in

this state using telehealth… for a period not to exceed 30 days unless extended by order of

the State Surgeon General. In addition to the allowed professions under Department of

Health Emergency Order 20-002, this exemption shall apply to the following out of state

health care professionals holding a valid, clear, and unrestricted license in another state or

territory in the United States who are not currently under investigation or prosecution in any

disciplinary proceeding in any of the states in which they hold a license… physicians,

osteopathic physicians, PAs, and APRNs licensed in Florida… designated… as a controlled

substance prescribing practitioner… may issue a renewal prescription for a controlled

substance listed as Schedule II, Schedule III, or Schedule IV… only for an existing patient for

the purpose of treating chronic nonmalignant pain without the need to conduct a physical

examination of the patient. These practitioners may only substitute telehealth services for

the physical examination.

• During the 2019 legislative session, Florida passed a law authorizing out-of-state health care

practitioners to perform telehealth services for patients in Florida. Signed by the Governor

on June 25, 2019, this law became effective on July 1, 2019.

• [6/29/21 Update] re: Recission of waivers - But after Gov. Ron DeSantis let an executive

order declaring a public-health emergency expire [6/26/21], many regulatory flexibilities that

health-care providers received during the pandemic, including flexibilities related to

telehealth, also expired. As of 6/26, telephones no longer are an acceptable platform for

delivering telehealth services to non-Medicare patients in Florida. Physicians also cannot

use telehealth to prescribe controlled substances to existing patients for treating chronic

non-malignant pain. Also, physicians cannot use telehealth to recertify medical-marijuana

patients. (Article).

• [7/1/21 Update] re: waiver recission - Out-of-state health care practitioners are no longer

authorized to perform telehealth services for patients in Florida unless they become licensed

or registered in Florida.

o Qualified physicians are required to conduct an in-person physical examination to issue a

physician certification for any patient.

o Controlled substance prescribers are required to conduct an in-person physical

examination to issue a renewal prescription for a controlled substance. (FBOM

Guidance).

• Florida Law § 2019-137: (a) A health care professional not licensed in this state may provide

health care services to a patient located in this state using telehealth if the health care

professional registers with the applicable board, or the department if there is no board, and

provides health care services within the applicable scope of practice established by Florida

law or rule.

• Status – Florida’s temporary waivers are inactive, because Florida’s State of Emergency

expired June 26, 2021 (EO 21-94). However, out-of-state professionals can provide

telemedicine services to Florida residents if they are registered with the Medical Board per

Florida Law § 2019-137.

DOH EO 20-002

DOH EO 20-003

DOH EO No. 20-004

FL DOH Guidance

Article re:

Telemedicine

Waivers Rescinded

§ 2019-137 re:

Permanent OOS

Telemedicine

Additional FL OOS

Telemedicine FAQs

State Resource Page

Georgia

• Medical Board Emergency Practice Permits for Telemedicine: On March 5, 2020, the Georgia

Composite Medical Board announced that it would issue emergency practice permits to

previously unlicensed physicians, physician assistants, advance practice registered nurses,

and respiratory care professionals who wish to practice medicine during the COVID-19

emergency response with the Board’s approval of the application; valid for 90 days or when

the governor lifts the statement of emergency.

• Re: permanent out-of-state telemedicine - Existing Georgia law provides that “The [Medical]

Board is authorized to issue telemedicine licenses to physicians who are licensed in other

states but not licensed in Georgia if… (1) Hold a full and unrestricted license to practice

medicine in another state; (2) Not have had any disciplinary or other action taken against

him or her by any other state or jurisdiction; and (3) Meet such other requirements

established by the board pursuant to subsection (c) of this Code section as deemed

necessary by the board to ensure patient safety. (GA Code § 43-34-31.1).

• The Board issued Ga. R & Regs. § 360-3-0.10-.08 allowing for electronic prescribing during

the emergency. This modification allows DEA registered practitioners to issue prescriptions

for controlled substances for patients for whom they have not conducted an in-person

medical evaluation.

• [6/25/21 Update] re: establishing patient-physician relationship and prescribing - In May,

2021, Governor Kemp enacted legislation to prevent insurance companies from mandating a

patient receive an in-person consultation before seeing a health care provider virtually. The

law also says insurers can’t place additional restrictions on prescribing medications through

Article re:

Telemedicine

GA Code § 43-34-

31.1

Emergency Practice

Application

telehealth visits. (Article).

• [8/10/21 Update] re: license flexibility – “…Georgia Composite Medical Board is authorized

to grant temporary licenses to physicians who apply for a temporary medical license and are

currently licensed as a physician in good standing by equivalent boards in other states to

assist with the needs of the State of Emergency for Continued COVID-19 Economic Recovery”

per EO 7.22.21.02.

• Status – Inactive, licensing waivers expired on April 15, 2022, with the expiration of

Georgia’s State of Emergency. However, Georgia issues telemedicine licenses for OOS

physicians, see above for more information.

GA Executive Orders

State Resource Page

Guam

• Existing Guam Code allows physicians that are licensed somewhere in the United States to

practice telemedicine (10 GCA § 12202(b)).

10 GCA § 12202(b)

Territory Resource

Page

Hawaii

• [EO 20-02] - The suspension of the following laws:… Section 453-1.3, HRS, practice of

telehealth, to the extent necessary to allow individuals currently and actively licensed… to

engage in telehealth without an in-person consultation or a prior existing physician-patient

relationship; and to the extent necessary to enable out-of-state physicians, osteopathic

physicians, and physician assistants with a current and active license, or those who were

previously licensed… but who are no longer current and active, to engage in telehealth in

Hawai‘i without a license, in person consultation, or prior existing physician-patient

relationship, provided that they have never had their license revoked or suspended and are

hired by a state or county agency or facility or by a hospital, including related clinics and

rehabilitation hospitals, nursing home, hospice, pharmacy, or clinical laboratory.

• [6/22/21 Update] re: Establishing patient-physician relationship - SB 970, which was signed

into law on June 10, authorizes the establishment of a physician-patient relationships via a

telehealth interaction if the physician is licensed to practice in the state.

• Status – Inactive, Hawaii’s public health emergency expired on March 25, 2022. (Article).

Executive Order 20-

HI SB 970

State Resource Page

Idaho

• Pursuant to the Board’s Proclamation, issued March 18, 2020, out-of-state physicians, and

physician assistants with a license in good standing in another state will not need an Idaho

license to provide telehealth to patients located in Idaho during the response to COVID-19.

Prescribing controlled substances via telehealth must always comply with Federal law and

HHS guidance related to COVID-19.

• Temporary Suspension of rules: 57 - Idaho Telehealth Access Act 54-5705 [preexisting

provider-patient relationship not required before initiating telemedicine services]; 54-5707

[prescribing prescription drugs via telemedicine is allowable - but not controlled substances].

• [Article re: Changes] - Idaho Gov. Little [on June 22] signed an executive order [EO 20-13]

[proposing] making permanent more than 150 emergency rules enacted since March to

address the coronavirus pandemic.… such as allowing the use of Zoom, Facetime and other

applications and making it easier for providers to offer telehealth services… allowing out-of-

state providers with valid licenses to treat Idaho residents through telehealth…

• [EO 20-13] - If a state agency determines that the regulation is required by law to remain in

place or that permanently suspending the regulation would be deleterious to public health

or safety, the agency head shall submit a signed letter to the administrator of DFM no later

than July 24, 2020 outlining the law that compels the specific regulation, or the substantiated

consumer health and safety issues that arose from suspending the rule during the declared

emergency, and any other information that justifies the continuation of the original

regulation…

• The BOM’s Summer [2021] Newsletter states: “When Governor Little lifts the Emergency

Declaration, all out-of-state practitioners (MDs, DOs, PAs, and RTs) must be fully licensed in

Idaho to continue practicing in person or via telemedicine. For those out-of-state

practitioners who plan to discontinue their Idaho practice, please timely transition your

patients to an Idaho-licensed provider to ensure continuity of care. Any practitioner who is

practicing in Idaho or providing telemedicine services to Idaho residents without an active

Idaho license after the Emergency Declaration is lifted may be disciplined by the Board. The

Board is no longer issuing new temporary licenses to retired and inactive practitioners for

COVID-19 purposes.”

• [3/9/22 Update] re: license reciprocity - Where permitted by law, an applicant, in good

standing with no restrictions upon or actions taken against their license to practice in a state,

territory or district of the United States or Canada is eligible for licensure by endorsement to

practice medicine in Idaho. (IDAPA 24 - General Provisions of the Board of Medicine).

• [9/27/22 Update] re: waivers open: The BOM’s Summer 2022 newsletter states “The state of

Idaho is under a federal emergency declaration… Any healthcare professional may provide

telehealth services in or into Idaho, so long as the healthcare professional is licensed or

registered and in good standing with another U.S. state or jurisdiction and acting in good

Board of Med Proc.

Gov’s Proc. (4/3)

Idaho Telehealth

Access Act

Article re: Changes

EO 20-13

Gov’s Proc. (6/11)

Idaho Admin. Rules

(Board of Medicine)

BOM Summer '21

Newsletter re:

Rescinding Waivers

BOM Summer ’22

Newsletter re:

Reopening waivers

Temp Licensure App.

ID Executive Orders

faith… with no active or pending disciplinary action… must possess the necessary education,

training, and experience for the services being provided… the Division enforcement

discretion is in place until January 1, 2023, unless extended by DOPL announcement. To

ensure continuity of patient care after the waiver ends, healthcare professionals providing

telehealth services should pursue Idaho licensure or prepare a transition plan for patient

care.”

• Status – Inactive, the state’s waiver expired January 1, 2023 (see above).

State Resource Page

Illinois

• The IDFPR interprets Executive Order 2020-9 to permit an out-of-state health care provider

not licensed in Illinois to continue to provide health care services to an Illinois patient via

telehealth where there is a previously established provider/patient relationship. The

Department deems such a provider to be "authorized to practice in the State of Illinois"

pursuant to Section 5 of the Executive Order without further need to obtain licensure in

Illinois.

• “Telehealth Services” are expanded to include all health care, psychiatry, mental health

treatment, substance use disorder treatment, and related services provided to a patient

regardless of the patient’s location via electronic or telephonic methods including, for

example, FaceTime, Facebook Messenger, Google Hangouts, or Skype.

• Re: Origination sites - Under the amended rules, any site that allows for the patient to use a

communication or technology system as defined above may be an originating site, including

a patient’s place of residence located within the state of Illinois or other temporary location

within or outside the state of Illinois.

• Re: insurers - Health insurers (“Insurers”) may not impose: Utilization review requirements…

Prior authorization requirements for in-network providers providing Telehealth Services

related to COVID-19… Cost-sharing obligations for Telehealth Services provided by in-

network providers. Insurers must cover the costs of Telehealth Services rendered by in-

network providers for medically necessary covered services… May establish reasonable

requirements and parameters for Telehealth Services.

• [1/4/22 Update] - Re: interstate telemedicine - Must have an IL medical license. An out-of-

state person providing a service to a patient in IL through telemedicine submits himself or

herself to the jurisdiction of the courts of IL. IL Compiled Statutes, Chapter 225, 60/49.5(e).

• Status – Inactive, according to the 1/10/22 IDFPR Guidance, the out-of-state telehealth

waiver, for established patients only, expired May 31, 2022.

IDFPR Clarification

EO 2020-09

Article re: Telehealth

Article re: Origination

Site

IL Executive Orders

State Resource Page

Indiana

• (Broad provision in Executive Order 20-05) - Suspension of the requirement that a healthcare

provider hold an Indiana license if he or she: (1) has an equivalent license from another

State, and (2) is not suspended or barred from practice in that State or any State.

• The Initial Telemedicine Provider Certification Request must be completed and filed with the

Indiana Professional Licensing Agency before the provider may establish a provider-patient

relationship or issue a prescription under IC 25-1-9.5-8 for an individual located in Indiana.

Note however, that a provider that practices predominantly in Indiana is not required to file

this certification.

• Re: Mental health - Pursuant to Executive Order 20-05, all licensed mental health

professionals in the State of Indiana are permitted to conduct their work via telehealth. All

statutes and rules that are applicable during remote practice must still be observed; however

the requirement that the patient be physically present with the professional is suspended

until the end of the public health crisis.

• Re: chronic pain, controlled substances and telemedicine guidelines - The directive also

waives the prohibition against audio-only telemedicine services and allows for physical,

speech and occupational therapists to provide telemedicine services, but only when using

secure videoconferencing, interactive store and forward technology or remote patient

monitoring technology. In addition, those DEA-registered providers who have not conducted

an in-person medical evaluation of a patient may issue a prescription to that patient for any

schedule II-V controlled substance as long as the prescription is issued for a legitimate

medical purpose, the telemedicine communication is conducted using an audio-visual, real-

time, two-way interactive communication system and all other applicable state and federal

laws are followed.

• [EO 20-45] - As provided by Executive Orders 20-13… any individual… who received an initial

and/ or subsequent 90-day temporary authorization to provide health care in the State of

Indiana in response to this public health emergency because he or she was not currently

licensed to practice in the state, either because their Indiana license is no longer active or

they are licensed by another state, is granted an additional 90-day authorization to continue

to provide health care services during this public health emergency. All application

procedures for reinstatement or approval will be reinstituted and must be followed upon

expiration of these temporary licenses or the lifting of the COVID-19 public health

Executive Order 20-

PLA Guidance

Initial Telemedicine

Provider Certification

Request

IC § 25-1-9.5-8

Article re: Chronic

pain, controlled

substances and

telemedicine

guidelines

Executive Order 20-

emergency.

• Re: out-of-state registry - According to the IPLA, “The State of Indiana has created a registry

of individuals who do not hold a valid license to practice in Indiana but can be mobilized to

help fight COVID-19 by issuing temporary permits to practice. Any individual who utilizes the

registry may work initially for 90 days (extendable in 30-day increments) or until the public

health emergency is over. Once the emergency is over, their license will expire, and all

existing application procedures must be followed such as taking the appropriate licensure

exam and passing a criminal background check. This registry will be open to: Out-of-state

healthcare practitioners; retired healthcare professionals; and recent graduates of

accredited medical, registered nursing, pharmacy, physician assistant, and respiratory care

programs.”

• [1/6/22 Update] re: interstate telemedicine – Indiana code provides for out-of-state

physicians to provide care for Indiana patients – “A practitioner who is physically located

outside Indiana is engaged in the provision of health care services in Indiana when the

practitioner: (1) establishes a provider-patient relationship under this chapter with; or (2)

determines whether to issue a prescription under this chapter for an individual who is

located in Indiana. (b) A practitioner described in subsection (a) may not establish a provider-

patient relationship… [unless they] have certified in writing to the Indiana professional

licensing agency, in a manner specified by the Indiana professional licensing agency, that the

practitioner and the practitioner's employer or practitioner's contractor agree to be subject

to: (1) the jurisdiction of the courts of law of Indiana; and (2) Indiana substantive and

procedural laws… (IC 25-1-9.5-9).

• [3/31/22 Update] re: Emergency License Registry – On March 21, 2022, Indiana’s

Professional Licensing Agency (PLA) issued a bulletin clarifying that the recently signed HB

1003 extends the [out-of-state] healthcare registry through the duration of the COVID-19

public health emergency declared by the U.S. Department of Health and Human Services.”

• Status – Inactive, the state’s healthcare registry ended with the conclusion of the national

PHE, which expired on May 11, 2023 (see above).

Executive Order 20-

IC 25-1-9.5-9 (re:

interstate

telemedicine)

IN PLA Telemedicine

Registry

IN Executive Orders

IPLA Bulletin re:

Registry Extension

State Resource Page

Iowa

• A physician may practice medicine/telemedicine in Iowa without an Iowa medical license on

a temporary basis to aid in the emergency, if a physician holds at least one active medical

license in another United State jurisdiction, and all medical licenses held by a physician in

other United States jurisdictions are in good standing, without restrictions or conditions. All

rules which establish preconditions, limitations, or restrictions on the provision of telehealth

or telemedicine services in Iowa are temporarily suspended…

• [Covid-19 Emergency Proclamation] - Telemedicine and Telehealth Services: All rules which

establish preconditions, limitations, or restrictions on the provision of telehealth or

telemedicine services in Iowa, including the use of audio-only telephone transmissions,

continue to be suspended. All rules which require face-to-face interactions with health

care providers, and impose requirements for residential and outpatient substance use

disorder treatment and for face-to-face visitations, continue to be suspended.

• [3/7/22 Update] re: grace period - The Iowa Board of Medicine announced that although the

emergency proclamation expired on February 15, the Board is authorizing a grace period to

avoid disruptions in staffing and patient care. Physicians have 90 days (May 17, 2022) to

obtain licensure in Iowa to comply with the Board’s normal licensure requirements. (Article).

• Status – Inactive, out-of-state waivers expired February 15, 2022, per Gov. Reynolds' 2/3

Announcement. However, there is a grace period in effect until May 17, 2022; please see

above.

Board of Med

Emergency

Declaration (3/16 &

4/27)

Governor’s Press

Release

State Resource Page

Kansas

• Gov. Laura Kelly on March 19 announced she had issued executive orders [EO 20-08] to

expand the use of telemedicine and waive restrictions on motor carriers who are delivering

relief for COVID-19. Out-of-state doctors may provide telemedicine services in Kansas if they

are licensed in another state, provided the physician holds an unrestricted license and is in

good standing. All physicians are encouraged to utilize telemedicine, including those under

self-quarantine.

• Every physician treating a patient through telemedicine shall conduct an appropriate

assessment and evaluation of the patient’s current condition and document the appropriate

medical indication for any prescription issued.

• Passed and signed KS HB 2016, which says, in part “A physician may issue a prescription for

or order the administration of medication, including a controlled substance, for a patient

without conducting an in-person examination of such patient. (b) A physician under

quarantine, including self-imposed quarantine, may practice telemedicine. (c) (1) A physician

holding a license issued by the applicable licensing agency of another state may practice

telemedicine to treat patients located in the state of Kansas, if such out-of-state physician:

(A) Advises the state board of healing arts of such practice in writing and in a manner

Article re: Executive

Orders

Executive Order 20-

(NEW) Telemedicine

Waiver

determined by the state board of healing arts; and (B) holds an unrestricted license to

practice medicine and surgery in the other state and is not the subject of any investigation or

disciplinary action by the applicable licensing agency...”

• [1/22/21 Update] Re: controlled substances, establishing physician/patient relationship – SB

14, signed into law January 25, allows physicians to issue prescriptions (including for

controlled substances) without conducting an in-person examination. It also extends the

ability for out-of-state practitioners in good standing and without disciplinary or investigation

actions to practice telemedicine on Kansas patients until March 31, 2021, provided that they

notify the Board in writing in a manner determined by the Board. Lastly, the bill gives the

Board flexibility to extend these waivers to other healthcare professionals. (Article).

• [9/14/21 Update] re: Permanent out-of-state telemedicine – “Notwithstanding any other

provision of law, a physician holding a license issued by the applicable licensing agency of

another state or who otherwise meets the requirements of this section may practice

telemedicine to treat patients located in the state of Kansas, if such physician receives a

telemedicine waiver issued by the state board of healing arts. The state board of healing

arts shall issue such a waiver within 15 days from receipt of a complete application…” [KS HB

2208].

• [1/19/22 Update] re: reinstated waivers – “Any and all provisions in Kansas law are

temporarily suspended… to the extent necessary to allow health care professionals licensed

and in good standing in any state or territory in the United States…” [EO 22-01].

• [2/22/22 Update] re: long term waiver extension – On January 21, 2022, Gov. Laura Kelly

signed HB 2477 into law, which, among other things, “Notwithstanding any statute to the

contrary, a healthcare professional licensed and in good standing in another state may

practice such profession in the state of Kansas for the purpose of preparing for, responding

to or mitigating any effect of COVID-19…”

• Status – Inactive, the reinstated Kansas state of emergency expired January 20, 2023, per HB

2477. (See above).

• Further, Kansas allows for OOS telemedicine for physicians that register with the state Board

of Healing Arts, for more information, see above. According to the Telemedicine Waiver, “If

your waiver was issued before May 1, you will be required to renew during that year’s

renewal period. If your waiver is issued after May 1, you will not be required to renew until

the following calendar year. Renewal begins May 15 of each year. All Telemedicine Waivers

cancel August 1, if not renewed.”

KS HB 2016

KS SB 14

KS HB 2208 re:

Permanent OOS

Telemedicine

KS HB 2477

State Resource Page

Kentucky

• (Broad provision in Executive Order) - Medical and Osteopathic physicians not already

licensed to practice in the Commonwealth of Kentucky may register to practice within

Kentucky during the state of emergency declared by Governor Beshear.

• Additionally, the law [KY SB 150] waives requirements of in-person examination for

establishing a provider-patient relationship for the purposes of providing telehealth (to the

extent this complies with federal law). It also gives the Kentucky Board of Medical Licensure,

the Kentucky Board of Emergency Medical Services, and the Board of Nursing the ability to

waive or modify state statutes and regulations: … (f) For standards that are not necessary for

the applicable standards of care to establish a patient-provider relationship, diagnose, and

deliver treatment recommendations utilizing telehealth technologies.

• Other temporary changes DMS has made to the 1915(c) HCBS (Medicaid) waivers include: …

Expanding the provider base by waiving requirements that out of state providers be licensed

and located in Kentucky as long as they are licensed by another state’s Medicaid agency.

• DMS is allowing providers to deliver services via phone and telehealth, as is appropriate.

• [1/7/22 Update] re: interstate telemedicine - A provider must be licensed in Kentucky with

the exception of persons who, being nonresidents of Kentucky and lawfully licensed to

practice medicine or osteopathy in their states of actual residence, infrequently engage in

the practice of medicine or osteopathy within this state, when called to see or attend

particular patients in consultation and association with a Kentucky-licensed physician. (KY

Rev. Stat. § 311.560).

• [2/22/22 Update] – re: extension of waivers – On January 14, 2022, Kentucky Gov. Andy

Beshear signed SB 25 into law, which, among other things, “Extend(s) 2020 SB 150… until

April 14, 2022…”

• The extension of SB 150 also thereby extends the “Temporary Telehealth Registry” (the

registry for out-of-state health care providers to provide telehealth services to patients in

Kentucky during the COVID-19 declared State of Emergency) to May 15, 2022, which

provides a grace period for out-of-state providers to refer their Kentucky patients to

providers who are licensed to practice in Kentucky. [Link].

• [4/15/22 Update] re: recission of waiver/State of Emergency – Despite SB 25 setting

Kentucky’s SoE end date to April 14; on March 22, 2022, Kentucky’s legislature overrode Gov.

EO 2020-215

KBML Guidance

OOS Registration

Form

Article re: OOS

Licensing

KY SB 150

CFHS Guidance (4/1)

CFHS Guidance

(3/13)

Beshear’s veto of SJR 150 effectively ending the state of emergency immediately.

• Status – Inactive, Kentucky’s State of Emergency expired on March 22, 2022, and the one-

month grace period means that out-of-state telemedicine privileges expired April 21, 2022.

State Resource Page

Louisiana

• [18 JBE 2022] - Louisiana state licensure laws, rules, and regulations for medical professionals

and personnel hereby remain suspended for those medical professionals and personnel from

other states or other countries offering medical services in Louisiana to those needing

medical services as a result of this disaster provided that said out-of-state or out-of-country

medical professionals and personnel possess a current medical license in good standing in

their respective state or country of licensure and that they practice in good faith and within

the reasonable scope of his or her skills, training, or ability.

• The Louisiana State Board of Medical Examiners has an emergency temporary permit

application on their website for licensed out-of-state medical professionals seeking a

temporary, voluntary license for an emergency event in the state of Louisiana. While there is

no explicit mention of telemedicine, the LSBME has a list of approved out-of-state

telemedicine permits, implying it is allowed.

• [Proc. 2020-32] - There is a need to allow for additional telehealth opportunities. To facilitate

the provision of telehealth services where available and appropriate, the following guidelines

are adopted: (A) The requirement that each state agency or occupational licensing board…

regulate the use of telehealth in the delivery of healthcare services within the scope of

practice regulated by said agency is suspended. (B) It will not be considered a violation of

licensing standards… to provide a service via telehealth. (C) The practice of the provider…

must be within the scope of the provider’s license, skill, training… (D) Prescribing of any

controlled substance via telehealth must be medically appropriate, well-documented and

continue to conform to rules applicable to the prescription of such medications.

• [LDH Guidance] Re: modality, origination site - Providers offering services via

telemedicine/telehealth must use a secure, HIPAA-compliant platform, if available. If not

available, providers may use everyday communication technologies, including audio-only

delivery of telemedicine/telehealth services (e.g., telephone) or use of videoconferencing

(e.g., Skype, FaceTime) programs that have reasonable security measures, with each

recipient’s permission. Audio-only delivery is allowed only in situations where an audio/video

system is not available or not feasible… There is currently no formal limitation on the

originating site (i.e., where the recipient is located) and this can include, but is not limited to,

a healthcare facility, a school or the recipient’s home. Regardless of the originating site,

providers must maintain adequate medical documentation to support reimbursement of the

visit.

• [1/4/22 Update] re: interstate telemedicine - The board shall issue a telemedicine license to

allow the practice of medicine across state lines to an applicant who holds a full and

unrestricted license to practice medicine in another state or territory of the United States.

The board shall establish by rule in accordance with the Administrative Procedure Act the

requirements for licensure including not opening an office in Louisiana, not meeting with

patients in Louisiana, and not receiving calls in Louisiana from patients. The physician, when

examining a patient by telemedicine, shall establish a bona fide physician-patient

relationship by: (A) Conducting an appropriate examination of the patient as determined by

the board. (B) Establishing a diagnosis through the use of accepted medical practices

including but not limited to patient history, mental status, and appropriate diagnostic and

laboratory testing. (C) Discussing with the patient any diagnosis as well as the risks and

benefits of various treatment options. (D) Ensuring the availability for appropriate follow-up

care. (E) Fulfilling any other requirements as deemed appropriate and necessary by the

board. (LA Revised Statutes § 37:1276.1).

• Status – Inactive, Louisiana’s State of Emergency expired on March 16, 2022, per Gov. Bel

Edward’s 3/14 statement. However, the waivers did not immediately close “For an orderly

transition and continuity of care for Louisiana citizens, the LSBME will extend the duration of

all temporary permits issued during the Covid public health emergency until 90 days after

the termination of the declared health care emergency, whenever that is determined by the

governor or the judicial branch of the state of Louisiana.” (LBSME Guidance). Therefore,

temporary licenses expired June 14, 2022.

LSBME OOS

Telemedicine Permits

Emergency

Temporary

Application

Proclamation 2020-

LDH Guidance 3/20

Telehealth Guidance

During COVID-19

Pandemic

LSBME Guidance re:

Covid Changes

LA Emergency

Proclamations

LA Revised Statutes

§ 37:1276.1 (re:

interstate license)

State Resource Page

Maine

• The order signed by Gov. Mills gives greater flexibility to physicians, physician assistants and

nurses to practice in Maine. According to the order, those who are licensed in these

professions in other states and in good standing can now: (1) Receive an emergency license

to provide health care services via telehealth to Maine people with no application fee; (2)

See patients via telehealth without obtaining a license if already serving those patients at

out-of-state locations; (3) Get their licenses automatically renewed during the state of

emergency if their active license is about to expire.

3/20 Executive Order

Article re: OOS

Licensing

• [3/20 EO] – A physician, physician assistant, or nurse who is licensed and in good standing in

another state and has no disciplinary or adverse action in the last ten years involving loss of

license, probation, restriction or limitation, and who seeks immediate licensure to assist in

the health care response to COVID-19, shall forthwith be issued an emergency Maine license

that shall remain valid during the state of emergency. All physicians, physician assistants, or

nurses licensed under this provision may provide health care services in-person in Maine or

across state lines into Maine using telemedicine or telehealth.

• Re: Telemedicine waivers - Maximize the use of telemedicine and telehealth and eliminates

the need for some in-person patient visits for the duration of the emergency by: (1) Allowing

voice-only technology to be used; and (2) Suspending any laws or rules related to state

medical record privacy and HIPAA that would interfere with the use of telemedicine and

telehealth technology.

• [1/7/22 Update] re: interstate telemedicine - A physician not licensed to practice medicine in

this State may provide consultative services through interstate telehealth to a patient

located in this State if the physician is registered… (Maine Rev. Stat. Ann., Tit. 32, § 3300-D).

• Status – Inactive, the Maine State of Emergency expired June 30, 2021, per 6/11

Proclamation.

Supplemental Order

3/20

Executive Order 3/24

State Resource Page

Maryland

• Passed SB 1080, which, among other things, authorizes the Governor to establish or waive

telehealth protocols for COVID-19, including authorizing health care professionals licensed

out-of-state to provide telehealth to patients in the State, and to order the Department of

Health to reimburse synchronous and asynchronous telehealth services for COVID-19

provided to a patient, without regard to whether the patient is at a clinical site, if the service

is covered by Medicaid, provided by a participating Medicaid provider, and authorized under

the health care provider’s scope of practice.

• [Maryland BOP Telehealth FAQs] - For the duration of the Maryland State of Emergency,

health care practitioners who have an active license in good standing in another state or the

District of Columbia may practice telehealth without a Maryland license to provide continuity

of care to existing Maryland patients.

• Re: preexisting relationships - SB 402 and HB 448 authorized certain health care practitioners

the ability to establish a practitioner-patient relationship through telehealth interactions.

Require a health care practitioner provide telehealth services to be held to the same

standards of practice that are applicable to in-person settings and, if clinically appropriate,

provide or refer a patient for in-patient services or another type of telehealth service.

• Re: prescribing controlled substances – Maryland law requires that licensed healthcare

practitioners have a Maryland controlled dangerous substances (CDS) registration in order to

prescribe CDS… Federal law also requires that licensed healthcare practitioners have a DEA

registration to prescribe CDS… the DEA has waived the requirement registration in each state

in which the practitioner practices for the duration of the PHE… Accordingly, the MDOH

interprets the order to allow out-of-state practitioners to practice in Maryland… to be

allowed to prescribe CDS in Maryland without obtaining a Maryland CDS registration.

• Re: privacy requirements - The requirement that a link must be a secure and private

telehealth connection in accordance with state and federal law and the required use of

encryption has been relaxed during the Federal and Maryland states of emergency. During

the Federal and Maryland states of emergency a provider shall make good faith efforts to

prevent access to data by unauthorized persons.

• Re: opioids - Yes, during the state of emergency, prescriptions for Opioids may be prescribed

for pain. Please see the Office of Controlled Substances Administration frequently asked

questions for more details about prescribing Controlled Dangerous Substances during the

State of Emergency

• Re: real-time evaluations - One of the bills Gov. Hogan is signing expands the list of doctors

and practitioners who can make use of telehealth platforms, and it allows evaluations to be

done in real time. It also allows for a physician to perform an evaluation after data is

collected via a telehealth meeting… Another bill allows mental health providers to use

telehealth to deliver services directly to a patient in their home.

• Re: audio-only calls - A health care practitioner authorized to use telehealth or audio-only

calls or conversations may establish a practitioner–patient relationship through an exchange

of information between a patient and a health care practitioner, if: (A) The health care

practitioner: (i) Verifies the identity of the patient receiving health care services through

telehealth or audio-only calls or conversations; (ii) Discloses to the patient the health care

practitioner’s name, contact information, and the type of health occupation license held by

the health care practitioner; (iii) Obtains oral or written consent from the patient or from the

patient’s parent or guardian if state law requires the consent of a parent or guardian; and (B)

Any audio-only calls or conversation occur in real time.

Maryland SB 1080

Maryland BOP

Telehealth FAQs

Notice re: CDS

prescription (5/8)

Article re:

Telemedicine

Expansion

Executive Order (4/1)

COVID-19 Pandemic:

Orders and Guidance

Board of Physicians

Guidance re: End of

the Maryland State

of Emergency

MD Health Occ Code

§ 14-302 re:

Reciprocal Licensing

EO 22-01-04-01 (re:

• [1/10/22 Update] re: interstate reciprocity – “Any person who holds a valid, unexpired

license as a health care practitioner that is issued by another state may, at a Health Care

Facility, engage in the activities authorized under such license without first obtaining a

license or practice letter from the applicable Maryland licensing agency or board… b. The

Secretary, and all boards and commissions responsible for the licensing of health care

practitioners, are ordered to expedite all applications for temporary licenses and temporary

practice letters from health care practitioners licensed in other states…” (EO 22-01-04-01).

• Status – Inactive, out-of-state waivers were reinstituted January 4, 2022, but expired on

February 3, 2022, when the public health emergency expired, per 2/3/22 Memo.

reinstituting waivers)

State Resource Page

Massachusetts

• Massachusetts’ Order offers broad credentialing privileges: “With the Governor declaring a

State of Emergency, the Board of Registration in Medicine has established an Emergency

Temporary License Application for out-of-state physicians to assist in meeting the increased

demand for physician services in Massachusetts. To qualify for an Emergency Temporary

License a physician must hold an active full, unlimited and unrestricted medical license in

good standing in another U.S. state/territory/district. "Good standing" shall not include a

license that has been revoked, cancelled, surrendered, suspended, or is subject to

disciplinary restrictions.”

• Re: preexisting relationships - The new rule approved by the board makes it explicit that a

doctor can treat a patient whom he or she has never seen in person as long as the physician

considers it best for the patient during the health crisis.

• Re: coverage rates - Gov. Charlie Baker ordered all commercial insurers, self-insured plans

and state health plans to cover all clinically appropriate telehealth services and at the same

rate as in-person care. The order specifies that all payers in the state “are required to allow

all in-network providers to deliver clinically appropriate, medically necessary covered

services to members via telehealth.”

• Re: uninsured populations - Doctor on Demand has struck a deal with the state of

Massachusetts to provide free telehealth visits to the state's uninsured during the

coronavirus pandemic… Uninsured and Medicaid patients with symptoms of COVID-19 or

have been targeted as needing care as the result of contact tracing are eligible to receive the

service, which will be available 24/7, at no charge.

• [5/18/21 Update] Re: end of State of emergency - And the state of emergency that's been in

place since March 10, 2020, will be lifted June 15, [2021], Gov. Charlie Baker announced

[May 17]. (Article).

• Status – Inactive, the state of emergency was rescinded on June 15, 2021, ending the

temporary license waiver. (Article).

BORIM Press Release

Expedited License

Application

Article re: Preexisting

relationship

requirements

Article re: Coverage

Article re: Uninsured

PHE Order #2022-09

re: waivers in effect

State Resource Page

Michigan

• Michigan law provides: “Under the circumstances and subject to the limitations stated in

each case, the following individuals are not required to have a license issued under this

article for practice of a health profession in this state: (c) An individual who by education,

training, or experience substantially meets the requirements of this article for licensure while

rendering medical care in a time of disaster...” (MCL § 333.16171). This provision does not

require an individual apply for or be granted an exemption by the Department.

• Re: origination site - Michigan’s governor called on health plans to do more to encourage the

use of telehealth and ordered the state Medicaid program to include the home as a

telehealth site.

• [EO 2020-86] All health care providers are authorized and encouraged to use telehealth

services when medically appropriate and upon obtaining patient consent. To facilitate the

provision of telehealth services: (a) Written consent for treatment is not required. A health

care provider may obtain verbal consent… (b) Health care providers engaging in telehealth

services may use asynchronous store and-forward technology for the transmission of

medical information... (c) Remote patient monitoring, which may or may not take place in

real-time, may be conducted as part of telehealth services... (d) A physician is not required to

conduct an in-person examination before prescribing medication or ordering the

administration of medication, including controlled substances except for methadone…

• Re: Rescinding out of state waivers - On July 13, 2020, Gov. Whitmer issued Executive Order

2020-150 to rescind a previous order (Executive Order 2020-61) that had permitted… health

care professionals who are licensed in good standing in other states or United States

territories to practice in Michigan without criminal, civil or administrative/licensure

penalties for lack of Michigan licensure.

• Status – Inactive, out-of-state practice privileges rescinded per EO 2020-150.

LARA Clarification

Article re: Origination

site

Executive Order

2020-86

Article re: Rescinding

waivers

Executive Order

2020-150

State Resource Page

Minnesota

• Minnesota’s April 25 Executive Order provides: “qualified out-of-state healthcare

professionals to render aid in Minnesota to meet the healthcare needs of Minnesotans

during the COIVD 19 peacetime emergency… (2) Out-of-State Healthcare Professionals who

hold an active, relevant license, certificate, or other permit in good standing issued by a state

Press Release re:

OOS Waivers

of the United States or the District of Columbia… (3) Before rendering any aid… [providers]

must be engaged with a healthcare system or provider, such as a hospital, clinic, or other

healthcare entity, in Minnesota. (4) A [Minnesota] healthcare system or provider must verify

that each Out-of-State Healthcare Professional holds an active, relevant license, certificate,

or other permit in good standing…

• Re: out-of-state telemedicine - Minnesota law provides: “A physician licensed in another

state can provide telemedicine services to a patient in Minnesota if their license has never

been revoked or restricted in any state, they agree to not open an office in Minnesota, meet

with patients in Minnesota, or receive calls in Minnesota from patients and they register with

the state’s board. These requirements do not apply in response to emergency medical

conditions, the services are on an irregular or infrequent basis, or the physician provides

interstate telemedicine services in consultation with a physician licensed in Minnesota” (MN

Stat. § 147.032).

• Re: establishing patient-physician relationship – Minnesota law provides “that a physician-

patient relationship may be established through telemedicine, and that physicians who

provide services by telemedicine are held to the same standards of practice and conduct as

apply to the provision of in-person services. (MN Stat. § 147.033).

• Re: telemental health - On April 6, Gov. Walz authorized out-of-state mental health providers

to provide telehealth services to Minnesota patients (this waiver appears to be explicitly

limited to mental health professionals).

• Re: Medicaid waivers - On March 27, 2020, CMS approved Minnesota’s state Medicaid

waiver request allowing certain flexibilities, including: Temporarily waiving the requirement

that out-of-state providers be licensed in Minnesota. The temporary waiver still requires

minimum data collection about the out-of-state provider, exclusion screening, and no

payments to providers who temporarily enrolled six months after the Public Health

Emergency ends.

• Re: SUD treatment – Minnesota’s legislature passed a law that “allows the examination

requirement for prescribing drugs to treat substance use disorder to be met if the

prescribing practitioner performs a telemedicine examination.” This provision is time-limited

and terminates 60 days after the peacetime emergency ends (Laws 2020, ch. 115, art. 2, §

30).

• Status – Inactive, as of May 6, 2021, out-of-state telehealth registration applications will no

longer be processed. (Minnesota Board of Behavioral Health and Therapy Guidance).

However, out-of-state professionals can provide telemedicine services to Minnesota

residents if they are registered with the Medical Board per Minnesota Statute § 147.032.

Executive Order 20-

MN Statute §

147.032

MN Statute §

147.033

Governor’s Press

Release

Emergency Executive

Order 20-28

Article re:

Medicaid/Waivers

Laws 2020, ch. 115,

art. 2, § 30

State Resource Page

Mississippi

• [10/26/20 Proc.] – As to those out-of-state physicians who currently hold an emergency

license to treat Mississippi patients via telemedicine, such licenses shall remain in force and

effect until January 31, 2021… those wishing to continue to provide care must submit an

application for a full, unrestricted licensed on or before December 31, 2020.

• [4/5/20 Proc.] - The Board hereby waives any and all Mississippi licensing requirements for

out of state physicians whose specialty services are determined to be necessary by MSDH

[specifically pulmonologists and nephrologists], provided the out of state physicians holds

an unrestricted license to practice medicine in the state in which the physician practices and

currently is not the subject of an investigation or disciplinary proceeding.

• [3/24/20 Proc.] - Out-of-state physicians may only utilize telemedicine when treating

patients in Mississippi with whom they have a pre-existing doctor-patient relationship.

• Re: pre-existing relationships - The requirement for a preexisting doctor-patient relationship

does not apply for in-state physicians.

• Re: controlled substances – As to those holding a valid unrestricted license to practice

medicine in Mississippi, the emergency telemedicine waiver of the prohibition against

prescribing controlled substances shall remain in effect [10/26/20 Proc.]

• [1/7/22 Update] re: interstate telemedicine - No person shall engage in the practice of

medicine across state lines (telemedicine) in this state, hold himself out as qualified to do the

same, or use any title, word or abbreviation to indicate to or induce others to believe that he

is duly licensed to practice medicine across state lines in this state unless he has first

obtained a license to do so from the State Board of Medical Licensure… (MS Code § 73-25-

34).

• Status – Inactive, waivers expired January 31, 2021, for out-of-state physicians currently

holding an emergency license, per 10/26/20 Proclamation.

10/26/20

Proclamation

Supplemental

Proclamation 4/5/20

Amended Proc.

3/24/20

Emer. Telemedicine

Licensure Form

State Resource Page

Missouri

• During this state of emergency in Missouri, physicians and surgeons licensed in another state

can provide care to Missouri citizens, in person or using telehealth options, as long as they

are actively licensed in another state and their license has not been disciplined.

• Re: documentation waivers - The executive order temporarily suspends rules requiring a

Article re: Telehealth

physical exam and maintaining a contemporaneous record.

• Re: establishing physician/patient relationship – HB 1682, signed July 13, allows physicians

to establish physician-patient relationship via a telemedicine encounter, if the standard of

care does not require an in-person encounter, and in accordance with evidence-based

standards of practice and telemedicine practice guidelines.

• [8/30/21 Update] re: Renewed waivers: I do hereby order suspension of certain statutory

and regulatory provisions related to telemedicine, and I further vest state agencies and

executive boards and commissions with authority to waive or suspend statutory or

regulatory requirements, subject to my approval, where strict compliance would hinder the

State’s recovery from COVID-19, and to ease licensing requirements to eliminate barriers to

the provision of health care services and other professions. [EO 21-09].

• [1/7/22 Update] re: interstate telemedicine - In order to treat patients in this state through

the use of telemedicine or telehealth, health care providers shall be fully licensed to practice

in this state… (MO Rev. Stat. Ch. 191 § 191.1145).

• Status – Inactive, waivers expired December 31, 2021, per EO 21-09, and have not been

renewed. (Press Release).

Executive Order 20-

MO HB 1682

MO Executive Orders

State Resource Page

Montana

• Pursuant to § 10-3-118, MCA, the Montana Department of Labor and Industry may provide

interstate licensure recognition whenever a state of emergency or disaster is in effect by

registering professionals who possesses an active, unrestricted license in another state.

Health care practitioners shall be allowed to perform health care services using all modes of

telehealth, including video and audio, audio-only, or other electronic media… Strict

adherence to the following requirements of board specific telehealth requirements for these

practitioners is suspended.

• Strict compliance with [Montana Code] is suspended to the extent that providers are not

limited for the duration of the emergency to the use of any specific technologies to deliver

telemedicine, telehealth, or telepractice services, and may provide such services using secure

portal messaging, secure instant messaging, telephone conversations, or audio-visual

conversations. To the extent any of these provisions prevent providers from delivering

telemedicine, telehealth, or telepractice services from their or their patients’ homes, work,

or other appropriate venue, strict compliance with those provisions is suspended, provided:

(A) To the extent possible, providers must ensure that patients have the same rights to

confidentiality and security as provided during traditional office visits. (B) Providers must

follow consent and patient protocol consistent with those followed during in-person visits… a

pre-existing provider/patient relationship is not required to provide telemedicine, telehealth,

or telepractice services.

• Re: payment parity - The coverage for health care services delivered by telemedicine “must

be equivalent to the coverage for services that are provided in person.”

• Status – Inactive, the Montana State of Emergency was rescinded on June 30, 2021, per EO

2021-10.

3/20 Executive

Directive on

Telehealth

MCA § 10-3-118

Gubernatorial

Directive (4/21)

EO 2021-10 re:

Recission of SoE

State Resource Page

Nebraska

• Out-of-state providers who work in Nebraska pursuant to Executive Order 20-10,

Coronavirus, Additional Healthcare Workforce Capacity, are authorized to use telehealth

under the same statutory provisions that permit Nebraska health care providers to use

telehealth… Because a declared state of emergency related to the coronavirus (COVID-19) is

in effect, health care providers are not required to obtain a patient’s signature on a written

agreement prior to providing telehealth services, and insurance claims for telehealth will not

be denied solely on the basis of lack of a signed written statement.

• [EO 20-10] – “The provisions of Neb. Rev. Stat. § 38-121 regarding credentialing, and its

implementing regulations, are hereby temporarily suspended in order to permit individuals

who are properly and lawfully licensed to engage in advanced practice nursing, emergency

medical services, medicine and surgery, mental health practice, nursing, osteopathy,

perfusion, pharmacy, psychology, respiratory care, and surgical assisting in a U.S. state or

territory to work in Nebraska during the state of emergency so long as they are in good

standing and free from disciplinary action in the states where they are licensed…”

• Status – Inactive, waivers expired 30 days after the end of the COVID-19 emergency, which

was rescinded on June 30, 2021, per Gov. Rickett’s 6/28 announcement, meaning the

waivers expired July 30, 2021.

DHHS Guidance

Executive Order 20-

State Resource Page

Nevada

• Professional licensing boards regulating providers of medical services shall temporarily waive

certain licensing requirements to allow the practice of currently unlicensed skilled medical

professionals during the pendency of the COVID-19 crisis… including without limitation,

medical doctors, physician assistants… The waiver and exemption of professional licensing

requirements shall apply to qualified providers of medical services during this declared

emergency who currently hold a valid license in good standing in another state, providers of

medical services whose licenses currently stand suspended for licensing fee delinquencies,

Emergency Directive

011

NV SB 5

providers of medical services whose licenses currently stand suspended for failure to meet

continuing medical education requirements, and providers of medical services who have

retired from their practice in any state with their license in good standing. These waivers and

exemptions shall not apply to persons whose licenses have been revoked or voluntarily

surrendered as a result of disciplinary proceedings.

• [6/22/21 Update] re: audio-only telemedicine/establishing patient-physician relationship –

SB 5, which was signed into law on June 4, 2021, allows the delivery of telehealth services

through audio-only interactions and allows providers to establish a patient relationship

through telehealth, among other actions.

• [9/8/21 Update] re: Special licensure – Nevada statute provides for Special Purpose Medical

Licenses that “can be issued to a physician who is licensed in another state to perform any of

the acts described in subsections 1 and 2 of NRS 630.020 by using [telemedicine] if the

physician: i) Holds a full and unrestricted license to practice medicine in that state; ii) Has not

had any disciplinary or other action taken against him or her by any state or other

jurisdiction; and iii) Is certified by a specialty board of the American Board of Medical

Specialties or its successor. (NRS 630.261).

• [5/13/22 Update] re: End of State of Emergency – On May 6, Nevada Gov. Steve Sisolak

announced that he will end Nevada’s state of emergency on May 20, 2022. (Article).

• Status – Inactive, Nevada’s state of emergency was rescinded May 20, 2022, per Gov.

Sisolak’s 5/6 announcement (see above). (Article re: ending emergency).

[MDs]: Emergency

License Application

[DOs]: Emergency

License Application

NRS 630.261 re:

Special Purpose

License

Gov. Sisolak rescinds

SoE

State Resource Page

New Hampshire

• (Broad provision in Executive Order) - Temporary authorization for out of state medical

providers to provide medically necessary services and provide services through telehealth…

any out-of-state medical provider whose profession is licensed within this State shall be

allowed to perform any medically necessary service as if the medical provider were licensed

to perform such service within the state of New Hampshire subject to the following

conditions: (a) The medical provider is licensed and in good standing in another United States

jurisdiction. (b) The medical services provided within New Hampshire are in-person or

through appropriate forms of telehealth, c) …Such medical providers shall be issued an

emergency New Hampshire license at no cost, which shall remain valid during the declared

state of emergency…

• Re: modality - Allowed to perform health care services through the use of all modes of

telehealth, including video and audio, audio-only, and/or other electronic media

• Re: reimbursement - All carriers shall cover, without any cost-sharing (i.e. copayments,

deductibles, or coinsurance), medically necessary treatment delivered via telehealth related

to COVID-19 by in-network providers. There shall be no restriction on eligible originating

sites for telehealth services… including locations such as a practitioner's office, a patient's

home, schools, hospitals including critical access hospitals and those with renal dialysis

centers, skilled nursing facilities, FQHCs/RHCs, and community mental health centers.

• Re: controlled substances - The prohibition… of prescribing schedule II through IV controlled

drugs by means of telemedicine is hereby suspended for the duration of the State of

Emergency…

• Re: telemental health – A New Hampshire licensed mental health provider will not be

disciplined in New Hampshire for providing inter-state services through telehealth,

consistent with the requirements for telehealth… Before providing such services, licensees

shall review the laws and rules of the jurisdiction where the client is receiving the services to

determine whether the licensee needs to also be licensed in that jurisdiction.

• Re: permanent telehealth changes – NH HB 1623, signed into law July 22, amends the state’s

definition of telemedicine to include audio-only modalities, requires Medicaid and private

payers to reimburse for telehealth services on the same basis as for in-person care, ends

restrictions on originating and distant sites for telehealth services, expands the list of care

providers able to use telehealth to encompass physicians, PAs, APRNs, psychologists,

dentists, and mental health practitioners, among others; and enables access to medication

assisted treatment (MAT) in specific settings by telemedicine.

• [1/7/22 Update] re: interstate telemedicine - An out-of-state physician providing services via

telemedicine or teleradiology shall be deemed to be in the practice of medicine and required

to be licensed in New Hampshire. This does not apply to physicians who provide consultation

services. (NH Rev. Stat. Ann. 329:1-d-II).

• [6/13/22 Update] re: extending temporary healthcare licenses – On June 7, 2022, NH SB 277

was signed into law, which, among other things, makes valid emergency or temporary

healthcare licenses issued during the COVID-19 pandemic prior to January 31, 2022 until

June 30, 2023.

• Status – Active, only for holders of temporary/emergency licenses issued on or prior to

January 31, 2022, until June 30, 2023 (please see above). Otherwise, the NH State of

Emergency Order

#15

Executive Order #8

Exhibit H to EO #29

Board of Mental

Health Practice

Guidance

NH HB 1623

Article re: HB 1623

State Resource Page

Emergency expired June 11, 2021. (Article).

New Jersey

• In response to the on-going COVID-19 state of emergency, the State of New Jersey has

waived certain regulatory provisions regarding licensure of health care practitioners through

reciprocity. These waivers will allow health care providers licensed in other states to obtain

New Jersey temporary licensure and provide services to New Jersey patients either through

telemedicine, pursuant to P.L. 2017, c. 117, or in-person. The following boards have

temporarily waived criminal history background check and fee for licensure requirements,

among other requirements: State Board of Medical Examiners

• New Jersey will waive a host of regulatory requirements for healthcare professionals licensed

in other jurisdictions to become licensed in New Jersey and offer services to New Jersey

residents, including telemedicine and telehealth services. The waivers will apply during the

public health emergency related to COVID-19.

• Re: telehealth Reimbursement/Coverage Expansion: Increased access to telehealth under

state Medicaid and direct third-party insurance administrators to inform beneficiaries about

the availability of telemedicine and telehealth services.

• Re: controlled substances – An Administrative Order signed [August 11] by the Acting

Director of the Division temporarily waives certain regulatory requirements for in-person

medical evaluations when providers prescribe controlled dangerous substances (“CDS”) in

the treatment of chronic pain or authorize medical marijuana. It is effective immediately…

The Order will remain in effect… [until] the end of the state of emergency or public health

emergency…

• Re: continuity of care - On July 1, Gov. Murphy signed NJ S. 2467, which ensures that out-of-

state healthcare practitioners may continue to provide telemedicine to New Jersey residents

until 90 days following the public health emergency.

• Re: telemedicine providers - The state’s Division of Consumer Affairs last month adopted

standards for telehealth use by audiologists, speech language pathologists, acupuncturists,

physical therapists, psychologists, social workers, genetic counselors and nurses. The new

rules will remain in effect for the duration of the COVID-19 public health emergency.

• [1/7/22 Update] re: interstate telemedicine - Any health care provider who uses

telemedicine or engages in telehealth while providing health care services to a patient, shall:

Be validly licensed, certified, or registered, pursuant to Title 45 of the Revised Statutes, to

provide such services in the State of New Jersey… (NJ Statute C.45:1-62(2)(b)).

• [1/12/22 Update] re: EO 281 reinstituting waivers – “Authorizes individuals licensed in other

states to practice in New Jersey without a New Jersey license. Allow health care providers

licensed in other states to obtain New Jersey temporary licensure and provide services to

New Jersey patients either through telemedicine or in-person.”

• [1/20/22 Update] re: temporary emergency licensure – On January 12, 2022, Gov. Murphy

signed S. 4139, which extends the temporary authorization to practice (including through

telemedicine) for licensed, out-of-state health care professionals, as well as recently

graduated health care workers, until June 30, 2022, as well as a 60 day grace period after the

conclusion of the federal public health emergency.

• Status – Inactive, practitioners with temporary licenses expired August 31, 2022, when the

NJ Division of Consumer Affairs discontinued the Temporary Emergency Reciprocity

Licensure (TERL) Program, for all professions other than respiratory therapists.

• Further NJ DCA guidance: The Division continues to urge all TERL holders who wish to

continue providing health care in the State of New Jersey after August 31, 2022 to apply for a

plenary license in the State of New Jersey. To that end, the Division is authorizing a "bridge

program" to plenary licensure available to all TERL holders. Any TERL holder who files a

complete application for a plenary license in New Jersey (using the electronic application

process available on the board websites) by 11:59 p.m. on August 31, 2022 will qualify for

the "bridge program," and will be authorized to continue practicing in New Jersey under the

TERL until the earliest of:

o The date of issuance of a New Jersey license;

o The date of notification of denial of an application for a plenary license in New Jersey;

o The end of the day on March 31, 2023.

NJ DCA Guidance

AG Guidance

Temp. License

Application

Telehealth Insurance

Bulletin (3/10)

Press Release re: CDS

NJ S. 2467

Article re:

professions

NJ S 4139

EO 292 re: rescinded

SoE

State Resource Page

New Mexico

• New Mexico’s order offers broad credentialing privileges: “The Department of Health and

the Department of Homeland Security and Emergency Management shall credential out-of-

state professionals who can render aid and necessary services during the pendency of this

order. NMSA 1978 §§ 12-10-10.1 through 12-10-13.”

• NM Stat § 12-10-11: During an emergency, a person who holds a license, certificate or other

permit that is issued by a state or territory of the United States and that evidences the

meeting of qualifications for professional, mechanical or other skills may be credentialed, if

appropriate and approved by the department of health or the homeland security and

Emergency

Declaration

NM Stat § 12-10-11

Instructions and

emergency management department, to render aid involving those skills to meet an

emergency, subject to limitations and conditions as the governor may prescribe by executive

order or otherwise.

• Use of electronic means (internet, texting, phone, email) to assess and provide responsible

care during emergency will not be considered unethical or a violation of Medical Board rules.

• [6/29/21 Update] re: permanent interstate telemedicine – On April 6, 2021, Gov. Lujan

Grisham signed SB 279 into law, which, among other things, states “The [Medical] board shall

issue a licensed physician a telemedicine license to allow the practice of medicine across

state lines to an applicant who holds a full and unrestricted license to practice medicine in

another state or territory of the United States.

• Status – Inactive, Temporary licenses issued in June 2020 were active until July 1, 2021 per

Federal Emergency Licensure FAQs. However, SB 279 creates a process that allows physicians

licensed in other jurisdictions to provide services via telemedicine to New Mexico residents,

please see above for more information.

• Further, the Board of Osteopathic medicine offers a limited telemedicine license that allows

an osteopathic physician located outside New Mexico to practice osteopathic medicine on

patients located in New Mexico. The annual fee is $100. (NMAC 16.17.2.7 & .8.)

Application for

Temporary Licensure

NMMB Guidance re:

Electronic Means

SB 279 (Interstate

Telemedicine)

State Resource Page

New York

• [EO 202.5] (Broad provision in Executive Order): Sections 6512 through 6516, and 6524 of

the Education Law and Part 6o of Title 8 of the NYCRR, to the extent necessary to allow

physicians licensed and in current good standing in any state in the United States to practice

medicine in New York State without civil or criminal penalty related to lack of licensure;

Section 6502 of the Education Law and Part 59.8 of Title 8 of the NYCRR, to the extent

necessary to allow physicians licensed and in current good standing in New York State but

not registered in New York State to practice in New York State without civil or criminal

penalty related to lack of registration.

• Section 596 of Title 14 of the NYCRR to the extent necessary to allow for rapid approval of

the use of the telemental health services, including the requirements for in-person initial

assessment prior to the delivery of telemental health services, limitations on who can deliver

telemental health services, requirements for who must be present while telemental health

services are delivered, and a recipient's right to refuse telemental health services.

• State Department of Financial Services will require insurance companies to waive co-pays for

telehealth visits related to Covid-19.

• Re: encouraging continued telehealth use - Providers should continue to use telephone,

telehealth, and electronic communications as much as is feasible and limit in-person visits to

essential medical services that cannot be provided remotely. Providers can help patients

weigh the benefits of seeking in-person medical care against the potential risks of leaving

home. This is especially important for patients who have urgent medical needs but are

reluctant to seek care due to fear of COVID-19.

• Re: audio-only telehealth – On July 12, 2021, Gov. Cuomo signed SB 8416, which added

audio-only forms of telehealth (e.g., telephone) to the state’s definition of telehealth and

telemedicine.

• [8/10/21 Update] re: distant sites – On April 19, 2021, Gov. Cuomo signed SB 2507, which

amends the definition of "distant site" so that "any site within the United States or United

States' territories is eligible to be a distant site for delivery and payment purposes.”

• [10/4/21 Update] re: waivers reinstated - Governor Kathy Hochul [Sept. 27] signed an

executive order to alleviate potential staffing shortages in hospitals and other health care

facilities statewide. The executive order significantly expands the eligible health care

workforce and allows additional health care workers to administer COVID-19 testing and

vaccinations. (Press Release).

o EO #4 - Effective September 27, 2021

• Temporary Suspension and Modification of Education law and Regulations, to the extent

necessary to allow physicians licensed and in current good standing in any state in the

United States to practice medicine in New York State without civil or criminal penalty related

to lack of licensure, and to allow physicians licensed and in current good standing in any

province or territory of Canada, or any other country as approved by the Department of

Health to practice medicine in New York State without civil or criminal penalty related to lack

of licensure… to the extent necessary allow physicians licensed and in current good standing

in New York State but not registered in New York State to practice in New York State without

civil or criminal penalty related to lack of registration… to allow physician assistants licensed

and in current good standing in any state in the United States to practice in New York State…

• Status – Inactive, waivers expired October 27, 2022, per EO #4.13. On September 12, 2022,

Gov. Hochul announced the NY SoE would expire on September 28. However, according to

the NYSED COVID EO Directory, EO #4.13 stayed in effect until the above date.

Executive Order

202.5

Executive Order 202

Statement on Co-Pay

Waived (3/14)

NYC Health Advisory

5/29

NYSED FAQs

NY SB 8416

NY SB 2507

Executive Order 4 re:

Reinstituting Waivers

NYSED COVID EO

Directory

State Resource Page

North Carolina

• Any persons licensed in other states, territories, or the District of Columbia who are

providing healthcare services under the authority of the first paragraph of section 16 of

Executive Order No. 116 may continue to provide those services through April 15, 2020,

unless otherwise authorized by a professional healthcare licensure board under the authority

delegated in this Subsection… (2) Out-of-state licensees; telehealth. For the pendency of the

State of Emergency: (i) a health provider licensed, registered, or certified in good standing in

another United States jurisdiction (or reinstated pursuant to emergency action) may apply

for an emergency license with the appropriate North Carolina licensing board and, if deemed

eligible to be licensed, may deliver services in North Carolina, including through any remote

telecommunications technologies (telehealth), provided those services are within the

provider’s authorized scope of practice in such other jurisdictions; and (ii) any restrictions

under North Carolina state law restricting the use of telehealth… have their enforcement

waived.

• In North Carolina, Blue Cross Blue Shield of North Carolina, the biggest insurance provider in

the state, announced March 17 it would cover virtual visits that occur over the phone, as well

as video, at the same rates as face-to-face visits.

• Status – Inactive, although North Carolina’s state of emergency expired August 15, 2022

(Source), there is a 30 day grace period, so emergency licenses expired September 14, 2022.

Executive Order No.

130

Executive Order No.

116

Emergency Disaster

License Application

Article re:

Reimbursement

COVID-19

Telemedicine FAQs

State Resource Page

North Dakota

• (North Dakota’s order offers broad credentialing privileges) - The licensure requirements for

health care or behavioral health professionals licensed under the following Chapters of the

North Dakota Century Code are hereby suspended… Chapter 43-17 (Physicians and

Surgeons)… who are licensed and in good standing in other states, as needed to provide

health care and behavioral health services, to include telehealth care, for citizens impacted

by COVID-19, subject to identification, verification of credentials and other temporary

emergency requirements… certain statutory and regulatory requirements must be

suspended… b) the “audio-only” provision… c) insurance carriers shall cover virtual check-ins

and e-visits for established patients…

• [3/9/22 Update] re: reciprocal licenses - The board may also, in its discretion, enter into

reciprocal agreements with the licensing agencies of other states or territories or the District

of Columbia providing for a reciprocal waiver of further examination or any part thereof. (ND

CC § 43-17-21 p. 8).

• Status – Inactive, the North Dakota state of emergency was rescinded on April 30, 2021

(Article). EO 2021-09 rescinded prior Covid executive orders. However, North Dakota allows

reciprocal licensure, please see above.

Executive Order

2020-05.1

State Resource Page

Northern

Mariana Islands

• Existing CNMI law holds that “A physician licensed to practice in a foreign country other than

Canada may be granted a license to practice subject to the requirements and conditions

provided in regulations of the Board… (b) The Board shall provide regulation of the practice

of a regulated physician in the Commonwealth by a professional licensed to practice in a

foreign country with acceptable education, training, examination results and experience

comparable to that of a person who is otherwise qualified for licensure under this Chapter…”

(Health Care Professions Licensing Act of 2007).

P.L. 15-105 Health

Care Professions

Licensing Act of 2007

§ 2214

Territory Resource

Page

Ohio

• Emergency Licensure — The Board authorizes board staff to work with the State Emergency

Management Agency, or other governmental entities as identified, to effectuate Ohio

licensure eligibility for out-of-state doctors who are called upon to respond to the COVID-19

emergency in Ohio, which is necessary to practice in Ohio [and, by extension, to practice

telemedicine with Ohio residents].

• The board has two existing statutory provisions in Ohio Rev. Code § 4731.36 that support

out-of-state telemedicine: (1) Physicians treating patients who are visiting Ohio and unable

to leave because of the emergency; (2) Physicians in contiguous states that have existing

patient relationships with Ohio residents.

• Beginning immediately, the Medical Board will suspend enforcement of any regulations

requiring in-person visits between providers and patients. This exercise of enforcement

discretion includes, but is not limited to, enforcement of regulations related to providers

prescribing to patients not seen in-person by the physician.”

• Re: establishing patient-provider relationship – EO 2020-29D extends the waiver on initial in

person visits, and allowing any real-time audio/visual communications of such quality as to

permit accurate and meaningful interaction between at least two persons, including

asynchronous modalities. Lastly, the requirement to provide written documentation of

potential risks and obtain written acknowledgment prior to services being rendered is

removed (the practitioner is required to describe the potential risks).

o [6/22/21 Update] - In response to the COVID-19 pandemic, the Medical Board

temporarily suspended the enforcement of rules that require in-person visits and

allowed providers to use telemedicine to safely treat patients. On June 9, the board

ODH Telehealth FAQs

(May 2020)

Board of Med 4/20

Meeting Summary

Ohio Rev. Code §

4731.36

Med Board

Telemedicine

Guidance

21 
 
voted to resume enforcement of these rules and prioritize continuity of care for Ohio 
patients. Enforcement of these rules were to begin three months after the lifting of the 
state  declaration  of  emergency.  Governor  DeWine  has  announced  that  the  state 
emergency  order  will  be  lifted  on  Friday,  June  18.  The  board  intends  to  resume 
enforcement of these rules on September 17, 2021.  
•  Re: controlled substances - Effective March 9, 2020, providers can use telemedicine in place 
of in-person visits. Throughout the declared Covid-19 emergency, the SMBO will not enforce 
in-person  visit  requirements  normally  required  in  SMBO  rules.  Suspension  of  these 
enforcement  requirements  includes,  but  is  not  limited  to:  (1)  Prescribing  controlled 
substances (2) Prescribing for subacute and chronic pain (3) Prescribing to patients not seen 
by the provider (4) Pain management (5) Medical marijuana recommendations and renewals 
(6)  Office-based treatment for opioid addiction. 
•  Re: permanent changes to telehealth (Medicaid)  - The rule changes to Ohio Administrative 
Code §5160-1-18 include: Expanding the definition of telehealth to include telephone calls, 
remote  patient  monitoring  and  other  electronic  communication  that  does  not  have  both 
audio  and video elements…  Fewer  restrictions  on  patient  and  practitioner site locations… 
Expanding the types of telehealth services that may be paid for by Medicaid… 
•  [7/1/21  Update]  re:  reversing  pandemic  waivers:  Ohio  State  Medical  Board  (OSMB)  – On 
June 17, the OSMB announced it would revert back to requirements for in-person visits and 
various  telemedicine  laws  on September  17,  2021.  OSMB  will  post  more  detail  on  these 
changes. (Article). 
•  [8/25/21 Update] re: pandemic waivers - At a June meeting, the Medical Board decided to 
resume  enforcing  the  pre-pandemic  telemedicine  rules  effective  September  17,  2021,  90 
days after the lifting of the state of emergency order. However, at a subsequent meeting on 
August  11,  2021,  the  Medical  Board  reconsidered  and  delayed  the  enforcement  date  to 
December 31, 2021. (Article). 
•  [11/11/21  Update]  re:  prescription  drugs/medical  marijuana  -  Ohioans  will  be  able  to 
continue using telemedicine through March  2022 for doctor visits that involve  prescribing 
drugs or  renewing  medical  marijuana  cards.  The State  Medical  Board on  delayed  the 
scheduled  expiration  of  COVID-19  emergency  rules  [Dec.  31,  2021]  that  allow  for  more 
liberal use of telemedicine. The extended telemedicine rules will continue to lift in-person 
visitation requirements for: Prescribing controlled substances, Prescribing for subacute and 
chronic  pain,  Prescribing  to  patients  not  seen  by  the  provider…  Medical  marijuana 
recommendations and renewals, Office-based treatment for opioid addiction. (Article). 
•  Ohio licensure required during  the state  of emergency - The Medical  Board has received 
many inquiries regarding temporary licensure during the state emergency. Please be aware, 
Ohio  law  does  not  currently  offer  emergency  or  temporary  licensure  for  out-of-state 
physicians. Unless an exemption applies (Ohio Revised Code 4731.36), physicians must hold 
an active Ohio license to practice medicine in the state of Ohio. 
•  Status – Ohio has no waivers for license reciprocity. 
 
 
Article re: EO 2020-
29D 
 
 
 
EO 2020-29D 
 
 
 
Article re: Permanent 
Medicaid changes 
 
 
 
OMB Newsletter (re: 
No license 
reciprocity) 
 
 
 
Article re: Reversing 
waivers 
 
 
 
OMB Telemedicine 
FAQs 8/11/21 
 
 
 
State Resource Page 
Oklahoma 
•  Oklahoma’s order offers broad credentialing privileges: “Any medical professional who holds 
a license, certificate, or other permit issued by any state that is a  party to the Emergency 
Management Compact  evidencing the meeting of qualifications  for the  practice of certain 
medical services… shall be deemed license to practice in Oklahoma so long as this order is in 
effect…  b)  Any  medical  professional  intending  to  practice  in  Oklahoma…  must  receive 
approval from appropriate Board; c) It is the responsibility of each Board to verify the license 
status of any applicant. All occupational licenses… shall be extended so long as this Order is 
in effect.” 
•  Telemedicine  and  Telehealth  (a)  To  the  extent  not  already  allowed  by  applicable  law, 
licensed  medical  doctors,  surgeons,  and  physician  assistants  may  utilize  telemedicine  or 
telehealth  to  provide  care  for  new  or  existing  patients.  (b)  Subsection  (a)  shall  not  be 
construed to allow licensed medical doctors, surgeons, or physician assistants to prescribe 
opiates and other controlled dangerous substances COVID - 19 Emergency Rules Adopted by 
the Oklahoma Medical Board in  its Virtual  Special  Meeting on April  14, 2020 Page  4  of 4 
without a preexisting physician-patient relationship… 
•  Re:  establishing  relationship  -  Gov.  Stitt’s  order  also  waives  part  of  Oklahoma  state  law 
requiring  an  existing doctor-patient  relationship before  telemedicine consultations can  be 
conducted. 
•  Re:  controlled  substances  –  [5
th
  Amended  EO  2020-20]  Telemedicine  shall  be  used  to 
maximum  potential  and  shall  be  allowed  for  non-established  patients…  The  preexisting 
patient  relationship  requirement  for  telemedicine…  only  applies  to  the  prescribing  of 
opiates and other controlled substances… 
•  [8/25/21 Update] re: reinstituting waivers - The Oklahoma Board of Medical Licensure and 
Amended Executive 
Order 2020-07 
 
 
 
COVID-19 Pandemic 
Emergency Rules 
 
 
 
Article re: Preexisting 
Relationship 
 
 
 
[MDs]: Application 
for Emergency 
Licensure 
 
 
 
[DOs]: Emergency 
Temporary License 

Supervision and the State Board of Osteopathic Examiners recently passed emergency rules

to fast-track temporary, "critical need" licenses for physicians and other medical

professionals. The rules approved by Gov. Kevin Stitt allow inactive or out-of-state doctors,

respiratory therapists and physician assistants in good standing to quickly qualify for a

temporary license to be able to get to work… The temporary licenses aren't reserved solely

for physicians treating COVID-19 patients, said Board of Osteopathic Examiners Executive

Director Michael Leake Jr. (Article).

• [1/11/22 Update] re: interstate telehealth - Physician treating patients in OK through

telemedicine must be fully licensed in OK. (OK Ad. Code § 435:10-7-13(a)). The State Board of

Osteopathic Examiners has the authority to issue a telemedicine license. (OK Stat., Tit. 59, §

633)

• Status – Inactive, according to the emergency rules, the temporary, critical need licenses

expired September 14, 2022.

Application

EO 2021-11

State Resource Page

Oregon

• [Board of Med Guidance] - Physicians and PAs with an active status license to practice

medicine in Oregon may provide care via telemedicine to their Oregon patients. Out-of-state

physicians with a telemedicine license may provide remote care to their Oregon patients.

• Re: controlled substances - Out-of-state Licensees who hold an active license at telemedicine

status have the same duties and responsibilities and are subject to the same penalties and

sanctions as any other licensed physician in Oregon. Physicians with telemedicine status in

Oregon may not act as a dispensing physician, treat a patient for intractable pain, act as a

supervising physician of a licensed physician assistant or an Oregon-certified First Responder

or Emergency Medical Technician.

• [9/8/21 Update] re: Out-of-state license – Upon application, the Oregon Medical Board may

issue to an out-of-state physician a license for the practice of medicine across state lines if

the physician holds a full, unrestricted license to practice medicine in any other state of the

United States, has not been the recipient of a professional sanction by any other state of the

United States and otherwise meets the standards for Oregon licensure under this chapter…

(4) A license for the practice of medicine across state lines is not a limited license… (5) A

license for the practice of medicine across state lines does not permit a physician to practice

medicine in this state… (ORS 677.139).

• [12/23/21 Update] re: State of Emergency reinstated - Similarly, having the emergency

declaration in place has allowed state licensing boards greater flexibility around professional

health licensing, ensuring that we have as much flexibility with our healthcare workers as

possible. [EO 21-36].

• Status - Inactive, the Oregon State of Emergency was rescinded April 1, 2022. (Article).

Board of Med

Guidance

Emergency

Application

ORS 677.139 re: OOS

License

State Resource Page

Pennsylvania

• Governor Wolf also granted the department's request for a suspension to allow licensed

practitioners in other states to provide services to Pennsylvanians via the use of

telemedicine, without obtaining a Pennsylvania license, for the duration of the emergency.

Out-of-state practitioners must: (1) Be licensed and in good standing in their home state,

territory or country; (2) provide the Pennsylvania board from whom they would normally

seek licensure with the following information prior to practicing telemedicine with

Pennsylvanians: (1) their full name, home or work mailing address, telephone number and

email address; and (2) their license type, license number or other identifying information

that is unique to that practitioner's license, and the state or other governmental body that

issued the license.

• Re: Opioid use disorder treatment – The Pennsylvania Department of Drug and Alcohol

Programs (DDAP) suspended the requirement that licensed Narcotic Treatment Programs

(NTPs) make a face-to-face determination before admission to treatment for clients who

receive buprenorphine treatment. DDAP also suspended the requirement that NTPs have

narcotic treatment physician services onsite. These regulatory suspensions by DDAP will

remain in effect for the duration of the COVID-19 disaster emergency in Pennsylvania.

• [8/10/21 Update] re: telemedicine prescriptions - Physicians providing Prescriptions: This

waiver suspends a State Board of Medicine regulation requiring physicians to provide paper

prescriptions within 72 hours of issuing an emergency prescription by telephone.

Expiring: September 30

• Buprenorphine Treatment Via Telemedicine Expands Access to Treatment of Opioid Use

Disorder: This waiver suspends the requirement that physician and surgeons must take an

initial medical history and physical examination requirement to expand access to

buprenorphine treatment to treat opioid use disorder.

Expiring: September 30

• [9/7/21 Update] re: Extraterritorial licenses - Pennsylvania issues extraterritorial licenses that

allow practice in Pennsylvania to physicians residing or practicing with unrestricted licenses

in an adjoining state, near the Pennsylvania boundary, and whose practice extends into

Press Release

PA Dept. of State

Guidance

PA Dept. of State

Guidance 9/4

PA DOS Waived and

Suspended Licensing

Regulations

PA Stat. tit. 63, §

422.34 re:

Extraterritorial

Licenses

Pennsylvania… [based] on the availability of medical care in the area involved, and whether

the adjoining state extends similar privileges. (PA Stat. tit. 63, § 422.34)

• [10/4/21 Update] re: Waiver extension - Out-of-State Health Care Practitioners: This waiver

allows for the issuance of expedited temporary licenses to practitioners in other states to

provide services to Pennsylvanians. The suspension applies to the State Board of Medicine,

the State Board of Osteopathic Medicine, and the State Board of Nursing.

Expiring: March 31, 2022

• [4/4/22 Update] re: Waiver extension - On March 30, 2022, Act 14 of 2022 was signed into

law, further extending active suspensions until June 30, 2022. Agencies were again provided

with the authority to terminate their own waivers and suspensions sooner than June 30.

• [5/5/22 Update] – re: End of waivers - The Pennsylvania Department of State announced

[May 4

] that its professional licensing waivers issued under the COVID-19 disaster

declaration will begin expiring in phases starting May 23, 2022. The following waivers will

expire June 30, 2022: Licensed Health Care Practitioners providing Telemedicine Services,

Buprenorphine Treatment Via Telemedicine Expands Access to Treatment of Opioid Use

Disorder

• Status – Inactive, waivers expired October 31, 2022, per HB 2401 (2022). See above for

more information on the reciprocity the state offers in the form of “Extraterritorial licenses.”

PA Proclamations

PA DOS

Announcement re:

Ending Waivers

State Resource Page

Puerto Rico

• Existing PR law provides for broad discretion during emergencies: “The Board may grant a

provisional license to any physician who legally practices medicine in other state[s] or

jurisdiction[s], contingent upon the request by the physician to the Board and on condition

that the physician comes to the Commonwealth of Puerto Rico to assist in emergency

services during a disaster, as authorized by the Department of Justice. The Department of

Health shall approve regulations to such effect... (4) The Board may grant a provisional

license to any physician who legally practices medicine at a state or jurisdiction, with the

purpose of having said physician render gratis and volunteer medical services or assistance in

Puerto Rico during a period of time that is not to exceed ninety (90) days a year as of its date

of issue. Provided, that this license shall be granted without paying any fees… (4) The Board

may grant a provisional license to any physician who legally practices medicine at a state or

jurisdiction, with the purpose of having said physician render gratis and volunteer medical

services or assistance in Puerto Rico during a period of time that is not to exceed ninety (90)

days a year as of its date of issue. Provided, that this license shall be granted without paying

any fees.” (P.R. Laws tit. 20, § 133g)

• On March 20, 2020, the Governor of Puerto Rico signed Joint Senate Resolution 491, which

provides the flexibility for physicians who are authorized to practice in Puerto Rico to use

telemedicine and telephone medical consultations as a remote means to care for patients,

regardless of whether or not they have telemedicine certification issued by the Medical

Licensure and Discipline Board. Under the Joint Resolution, in its relevant part, it is provided

that individuals who are authorized to practice the profession in Puerto Rico may invoice for

services rendered through telemedicine, telephone consultations, or by any other authorized

method, and the health insurers and health service organizations shall have the obligation to

pay for such as if it were an in-person consultation for the health services rendered.

• Status – N/A. However,

P.R. Laws tit. 20, §

133g

Ruling Letter re:

Telemedicine

Territory Resource

Page

Rhode Island

• The Board wishes to make clear that it encourages all physicians to use telemedicine to

deliver care to their patients and that the Board will not take action against physicians not

licensed to practice in Rhode Island who, during the state of emergency, use telemedicine to

deliver care to their established Rhode Island patients. The patient location requirement for

telemedicine contained in Rhode Island General Laws § 27-81-3 (9) is hereby suspended.

Patients may receive telemedicine services at any location. The prohibition against audio-

only telephone conversation and the limitations on video conferencing… is hereby

suspended. All such clinically appropriate, medically necessary telemedicine services

delivered by in-network providers shall be reimbursed at rates not lower than services

delivered through traditional (in-person) methods.

• [1/21/21 Update] - If you are providing telehealth services to a patient who lives in Rhode

Island and you wish to continue providing treatment you must apply for a full Rhode Island

license or the patient must obtain treatment from a provider who holds an active Rhode

Island license.

• Re: insurance - Health insurers must cover telemedicine for primary care, specialty care and

mental and behavioral health care.

• [6/22/21 Update] - If you are providing telehealth services to a patient who lives in Rhode

Island and you wish to continue providing treatment you must apply for a full Rhode Island

license or the patient must obtain treatment from a provider who holds an active Rhode

Island license.

RIDOH Guidance

Executive Order 20-

06 re: Expanded

Telemedicine

Press Release re:

Coverage

RI Executive Orders

• [7/19/21 Update] EO 20-06 terminated – On July 6, 2021, EO 20-06 (Fourth Supplemental

Emergency Declaration - Expanding Access to Telemedicine Services) was rescinded per EO

21-76.

• [1/11/22 Update] re: interstate telemedicine - RI allows physicians who have a license in

good standing in another state to consult with RI licensed physician on a singular occasion or

provide teaching assistance for no more than seven days unless extended with written

permission from the director. (RI Gen. Law, § 5-37-16.2(a)(3)).

• Status – Inactive, the waiver allowing out-of-state physicians to practice telemedicine with RI

established patients, was rescinded by EO 21-76.

State Resource Page

South Carolina

• The South Carolina Board of Medical Examiners is temporarily waiving South Carolina

licensing requirements for physicians, physician assistants, and respiratory care practitioners

licensed and in good standing in another state and whose services are determined to be

necessary by the South Carolina Department of Health and Environmental Control (DHEC).

The Board has indicated that this means South Carolina will permit these categories of out-

of-state practitioners to treat South Carolina residents, in person or through telehealth

technologies, to screen or treat patients for the coronavirus. The scope of permitted

practice and treatment by these practitioners may expand during the course of the

coronavirus emergency, subject to additional agency input.

• Re: controlled substances - The Board hereby suspends enforcement of the prohibition on

prescribing Schedule II and III medications via telemedicine without prior Board approval,

subject to certain conditions. Such approval is granted to the following practitioners who are

permanently licensed in good standing in South Carolina and physically present in South

Carolina at the time care is provided… the Board will enforce all other aspects of the

Telemedicine Act… including the practitioner’s participation in the South Carolina

Prescription Monitoring Program… and the prohibition on prescribing all other classes of

drugs.

• Re: medication-assisted treatment - Practitioners previously approved by the Board may, in

accordance with state and federal law, initiate MAT treatment for patients diagnosed with

an opioid use disorder via telemedicine, without the need for an in-person visit, provided

that the initiation of MAT is documented in the patient’s chart and the practitioner sees the

patient in-person within sixty) days after the end of the public health state of emergency.

• [1/11/22 Update] re: interstate telemedicine - The physician must be licensed in South

Carolina; however, they do not need to reside in South Carolina. (SC Code Ann. § 40-47-

37(C)(9)).

• Status – Inactive, the state’s emergency declaration expired June 6, 2021, per EO 2021-25.

(Article).

Article re: OOS

Licensing

BME Order

Temporary License

Application

EO 2020-BME-PH-03

re: controlled

substances

Emergency Order

2020-BME-PH-05 re:

MAT

SC Executive Orders

State Resource Page

South Dakota

• Pursuant to [South Dakota Code], [Gov. Noem] will grant full recognition to the licenses held

by a professional by any compact member state, in accordance with the Uniform Emergency

Management Assistance Compact (EMAC) should those facilities require additional

professionals to meet patient demand during the COVID-19 emergency, whether in-person

or by remote means.

• Pursuant to [S.D. Code], I temporarily suspend the regulatory provisions of [S.D. Regs.],

which limit or restrict the provision of telehealth or telemedicine services which require face-

to-face treatment, visits, interviews and sessions with providers.

• Emergency Management Assistance Compact - On March 23, 2020, Gov. Noem

issued Executive Order 2020-07 which recognizes the licenses of medical professionals

licensed in another state in accordance with the EMAC. The following professions licensed in

other states have the authority to practice in SD based on an active license in another state.

They do not need to gain another license in SD. The Board of Medical and Osteopathic

Examiners recommends that if you are utilizing the services of one of the professionals

licensed in other states that you verify the licensure status of that individual… Physicians and

Surgeons (SDCL 36-4), Physicians Assistants (SDCL 36-4A)…

• [EO 2020-16] – I hereby suspend… requirements that telehealth may not be utilized without

a prior provider-patient relationship… ability to prescribe certain medications based on a

telehealth encounter… requiring real-time visual technology or prohibiting audio-only… the

statutory provision… requiring healthcare providers to obtain a South Dakota controlled

substance license… so long as the individual possesses a federal DEA controlled substance

registration…

• [1/21/21 Update] - South Dakota Gov. Kristi Noem announced plans to permanently extend

emergency telehealth rules enacted during the coronavirus pandemic. The governor

announced this week that she would introduce two bills, one to keep in place telehealth

access and coverage rules and the other to “make permanent the recognition of certain out-

of-state healthcare licenses.”… Whether Noem is calling for license recognition only during

Executive Order

2020-07

SDMOE Guidance

Article re: Permanent

changes

SDAR 20:78:03:12 re:

Reciprocal Licenses

an emergency or at all times will depend on how the bills are phrased.

• [9/8/21 Update] re: Reciprocal licenses – South Dakota allows “Reciprocity. An applicant

who holds a valid medical license issued by another state may be licensed by reciprocity in

South Dakota under the provisions of SDCL 36-4-19 only if i) the applicant has completed a

residency program in the United States or Canada; ii) has passed one of the following

licensure examinations…; iii) has not had any allegations of misconduct or proceedings

instituted for the cancellation, conditioning, suspension or revocation of the applicant's

license in any state; and completion of a state and federal criminal background investigation.

(SDAR 20:78:03:12)

• Status – Inactive, the South Dakota State of Emergency expired June 30, 2021, per EO 2020-

34 and was not renewed. However, South Dakota does offer a reciprocal license, see above

for more information.

State Resource Page

Tennessee

• [EO #15] - Out of state health care professionals authorized pursuant to this Order to

temporarily practice in Tennessee are permitted to engage in telemedicine with respect to

Tennessee patients if scope of practice of applicable professional license would authorize

professional to diagnose and treat humans.

• Statutory restrictions on telehealth with respect to pain management clinics and chronic

nonmalignant pain treatment are suspended.

• The provisions of Tennessee Code Annotated… [the establishment of provider-patient

relationship], are hereby suspended to the extent necessary to allow telehealth or

telemedicine services to be provided by any provider license… regardless of the provider's

authority to diagnose. This suspension does not otherwise alter or amend any licensee's

scope of practice or record keeping requirements.

• The relevant provisions of Tennessee Code Annotated… are hereby suspended to the extent

necessary to give the Commissioner of Health the authority to allow persons who have

completed a master's degree or doctoral degree in a behavioral or mental health field… to

treat diagnosed behavioral or mental health conditions without a license and through use of

telemedicine services; provided, that the person is, at all times, supervised by a person

licensed… with authorization to diagnose a behavioral or mental health condition.

• Re: insurers - Blue Cross Blue Shield of Tennessee has seen telehealth use surge during the

coronavirus crisis… The insurer is making its coverage of virtual visits with in-network

providers permanent.

• Status – Inactive, waivers allowing out-of-state healthcare professionals to practice via

telemedicine, most recently included in EO 90, expired November 19, 2021, and haven’t

been renewed.

• [1/4/22 Update] re: out-of-state DO telemedicine licensure - The TN Osteopathic Board will

issue a telemedicine license. An applicant who has an unrestricted license in good standing

in another state and maintains an unencumbered certification in a recognized specialty area;

or is eligible for such certification and indicates a residence and a practice outside the State

of Tennessee but proposes to practice osteopathic medicine across state lines on patients

within the physical boundaries of the State of Tennessee, shall in the discretion of the Board

be issued a telemedicine license. See Rule 1050-02-.17 for full details.

• The Tennessee Medical Board eliminated the telemedicine license. Individuals granted a

telemedicine license under the former version of the rule may apply to have the license

converted to a full license. Under certain circumstances individuals who do not convert to a

full license can retain their telemedicine license. See TN Rule 0880-02.-16. (2).

Article re: OOS

Licensing

Executive Order #15

Executive Order #20

Executive Order #24

EO #83 (reaffirming

waivers)

Emergency License

Application

Tenn. Rule 1050-02-

.17 (DO

Telemedicine)

TN Executive Orders

State Resource Page

Texas

• (Broad provision in Executive Order) - Out-of-state licensed physicians may also receive a

Texas limited emergency license or hospital-to-hospital credentialing for no more than 30

days from the date the physician is licensed or until the Disaster Declaration is withdrawn or

ends. Additionally, the Governor instructed the TMB and Texas Board of Nursing to “fast-

track” licensing for all out-of-state medical professionals.

• By utilizing TMB and TBN's disaster emergency licensure rule, Texas will have an increased

supply of health care professionals who will be able to provide necessary in-person and

telemedicine services to Texans across the state.

• [TMB Guidance 4/9] - Re: chronic pain - The extended waiver continues to allow for

telephone refill(s) of a valid prescription for treatment of chronic pain by a physician with an

established chronic pain patient. The physician(s) remains responsible for meeting the

standard of care and all other laws and rules related to the practice of medicine. The

standard of care must still be maintained related to the treatment of chronic pain patients.

• [TMB Guidance 5/8] - Re: chronic pain extension – On May 8, Gov. Abbott today approved

the Texas Medical Board's request to extend the previously issued waiver which temporarily

suspends Title 22, Chapter 174.5 (e) (2)(A) of the Texas Administrative Code, as the measure

is still necessary to protect public health by providing patients access to ensure on-going

Article re: OOS

Practice

Governor’s Press

Release

treatment of chronic pain and curbing the spread of COVID-19. The suspension is in effect

until June 6, 2020.

• [TMB Guidance 6/5] - Re: prescription emergency rule - The Governor previously extended

the waiver to temporarily suspend Title 22, Chapter 174.5 (e) (2)(A) of the Texas

Administrative Code. That waiver is set to expire later today [June 6]… The adopted rule

amends 22 TAC Chapter 174.5, Issuance of Prescriptions, adding the following under

§174.5(e):… (A) Treatment of chronic pain with scheduled drugs through use of telemedicine

medical services is prohibited, unless: (i) a patient is an established chronic pain patient of

the physician and is seeking telephone refill of an existing prescription, and the physician

determines that such telemedicine treatment is needed due to the COVID-19 pandemic; or

(ii) the treatment is otherwise allowed under federal and state law. (B) If a patient is treated

for chronic pain with scheduled drugs through the use of telemedicine medical services as

permitted by (A)(i) or (ii) above, the patient's medical records must document the exception

and the reason that a telemedicine visit was conducted instead of an in-person visit. (until

June 30, 2021, per 4/30/21 TMB Guidance.

• [Article re: Telemedicine] - Re: modality/preexisting relationship - Audio-Only Telemedicine

Encounters Temporarily Allowed in Texas: Gov. Abbott approved the Texas Medical Board’s

request to temporarily allow the use of telephone-only encounters to establish a physician-

patient relationship in Texas. Only a patient (or a patient’s proxy decision maker) may initiate

the audio-only encounters by telephone. The standard of care remains the same whether the

encounter is via technology or in-person, and physicians should always attempt to ensure

patient continuity of care. A patient must give written or oral consent to the physician via

telemedicine. This consent must be documented in the patient’s medical record. The Texas

Medical Board notes that for the encounter to be eligible for payment, services provided

through a telemedicine visit (including audio-only telephone calls) must be medical services

that would be billable if provided in person. The Texas Medical Board is indicating that the

temporary expanded use of telemedicine may be used for diagnosis, treatment, ordering of

tests, and prescribing for all patient conditions.

• Re: reimbursement - State-regulated health plans in Texas will continue to reimburse for

telehealth services at the same rate as in-person care through the end of the year… a move

designed to help care providers dealing with a surge of cases brought about by the

coronavirus pandemic. [Gov. Abbott] said the state’s Employee Retirement System and

Teacher Retirement System would also continue payment parity for telehealth through 2020.

• [1/11/22 Update] re: interstate telemedicine - A telemedicine license may be issued for out

of state providers. To qualify for an out-of-state telemedicine license, a person must: (A) Be

21 years of age or older; (B) Be actively licensed to practice medicine in another state which

is recognized by the board for purposes of licensure, and not the recipient of a previous

disciplinary action by any other state or jurisdiction; (C) Not be the subject of a pending

investigation by a state medical board or another state or federal agency; (D) Have passed

the Texas Medical Jurisprudence Examination; (E) Complete a board-approved application

for an out-of-state telemedicine license for the practice of medicine across state lines and

submit the requisite initial fee; and (F) Not be denied based on failure to demonstrate the

requisite qualifications. (TX Admin. Code, Tit. 22, § 172.12).

• Status – Active, until 30 days after the end of the Texas State of Emergency, which is

currently scheduled to expire June 14, 2023, per 5/15 Proclamation. Emergency Visiting

Practitioner Temporary Permit is valid for no more than thirty (30) days from the date the

physician is licensed or until the emergency or disaster declaration has been withdrawn or

ended, whichever is longer.)

TMB Guidance 4/9

TMB Guidance 5/8

TMB Guidance 6/5

Article re:

Telemedicine

Article re:

Reimbursement

TX Proclamations

State Resource Page

Utah

• Utah law provides: “An out-of-state physician may practice without a Utah license if: (1)

The physician is licensed in another state, with no licensing action pending and at least 10

years of professional experience; (2) The services are rendered as a public service and for a

noncommercial purpose; (3) No fee or other consideration of value is charged, expected or

contemplated, beyond an amount necessary to cover the proportionate cost of malpractice

insurance; (4) The physician does not otherwise engage in unlawful or unprofessional

conduct.” (UT Code Ann. § 58-67-305(7)).

• A medical provider that pursuant to this Order offers telehealth services that do not comply

with HIPAA or HITECH, so long as the provider: (1) inform the patient the telehealth service

does not comply with those federal acts; (2) give the patient an opportunity to decline use of

the telehealth service; and (3) take reasonable care to ensure security and privacy of the

telehealth service.

• [EO 2020-68] Continues the suspension of certain aspects of the Utah Telehealth Act,

including allowing HIPAA exceptions (with proper notice).

• Status – Inactive, Utah’s State of Emergency expired June 1, 2021, according to the National

UT Code Ann. § 58-

67-305(7) re:

Interstate

telemedicine

DOPL COVID

Resources

EO 2020-07

EO 2020-68

DOH Orders and

Directives

Academy for State Health Policy (NASHP); the state’s licensing waiver persisted much longer,

as of April 21, 2022, Utah’s Division of Occupational and Professional Licensing (DOPL) is no

longer listing emergency, out-of-state licenses. However, Utah does offer limited, pro bono

interstate telemedicine, please see above.

State Resource Page

Vermont

(osteopathic

only)

• Special provisions for the COVID-19 public health emergency have been passed to facilitate

practice in Vermont by healthcare professionals who are not licensed in Vermont. This sets

forth information for physicians (MD), physician assistants, and podiatrists. There are two

different paths available to be able to practice during the emergency, “deemed” and

“emergency”, both are expedited and free.

• MDs, physician assistants, and podiatrists who meet all the criteria below can be deemed to

be licensed to practice in Vermont for practice in the following circumstances: (1) Providing

remote services by telemedicine (note that this refers to “telemedicine” in a generic sense,

following the guidance in the emergency law and advisories issued by Vermont agencies and

federal authorities). (2) As part of the staff of a licensed facility in Vermont.

• To be deemed licensed to practice in one of the settings specified above, you must: (1) Be

licensed in at least one US jurisdiction and be in good standing in all jurisdictions where you

are licensed. (2) Not be subject to professional disciplinary proceedings in any other US

jurisdiction... (3) Not be barred from practice in Vermont for reasons of fraud or abuse,

patient care, or public safety.

• VT H. 960, which was signed into law on July 6, ensures that physicians licensed out-of-state

will be able to practice in-person or provide telemedicine or to Vermont residents until

March 31, 2021.

• VT H. 795, signed into law October 5, extends telehealth waivers including the expansion of

telehealth access, provider reimbursement, and audio-only coverage through July 1, 2021.

• [3/25/22 Update] re: waiver extension – On March 23, 2022, H. 654 was signed into law,

which extends pandemic-era license waivers until June 30, 2023, including allowing

physicians licensed in other jurisdictions to practice telemedicine in Vermont, so long as they

are registered with the Office of Professional Regulation or Board of Medical Practice. Bill

would also allow for buprenorphine prescriptions via telemedicine without an in-person

evaluation until March 31, 2023. Bill would also allow for inactive/retired practitioners (for a

period equal to or less than three years) to reactivate their licenses until March 31, 2023.

• [8/29/22 Update] re: Osteopath only waivers – According to Vermont’s Secretary of State

website only osteopaths are eligible for the interim telehealth registration. “These Interim

Telehealth Registrations expire on June 30, 2023. A health care professional, who is licensed

in good standing in another state and wishes to provide healthcare in Vermont via telehealth

after June 30, 2023, will be required to obtain a Telehealth Registration or Telehealth

License.”

• [8/29/22 Update] re: permanent interstate telemedicine - Beginning on July 1, 2023, a health

care professional who is not otherwise licensed, certified, or registered to practice in

Vermont may obtain a Telehealth Registration to provide health care services in Vermont via

telehealth to a total of not more than 10 unique patients or clients for a period of not more

than 120 consecutive days from the date the Telehealth Registration was issued. OR they

may obtain a Telehealth License to provide healthcare services in Vermont via telehealth to a

total of not more than 20 unique patients or clients located in Vermont during the two-year

license term.

• Status – Although the Vermont State of Emergency expired on June 15, 2021 (Press Release),

on March 23, 2021, Gov. Phil Scott signed H. 654, which extends pandemic-related waivers

until June 30, 2023; please see above.

Med Board Guidance

Deemed License

Application

VT H. 960

VT H. 795

VT S. 117

VT H. 657

VT SOS Guidance:

Telehealth, Out-of-

State & Expired

License Registration

State Resource Page

U.S. Virgin

Islands

• Pending legislation states, in part “A physician or health care provider not licensed in this

Territory may provide health care services to a patient located in this Territory using

telehealth if the heath care professional registers with the applicable Board, or the

Department if there is no Board, and provides health care services within the applicable

scope of practice… if the health care provider (A) Completes an application… (B) Is licensed

with an active, unencumbered license that is issued by another state, the District of

Columbia… (C) Has not been subject of disciplinary action… during the 5-year period

immediately prior…”

Virgin Islands

Telehealth Act

Territory Resource

Page

Virginia

• [Board Brief #91] - Governor Northam’s Executive Order 57 allowed practice by out-of-state

health care professionals and expanded authority for physician assistants, nurse

practitioners, interns/residents/fellows/senior medical students...

• Virginia’s order offers broad credentialing privileges: “During the state of emergency

declared in Amended Executive Order 51, a license issued to a health care practitioner by

another state, and in good standing with such state, shall be deemed to be an active license

issued by the Commonwealth to provide health care or professional services as a health care

BOM Board Brief #91

(November 2020)

practitioner of the same type for which such license is issued in another state, provided such

health care practitioner is engaged by a hospital, or an affiliate of such hospital where both

share the same corporate parent, licensed nursing facility, or dialysis facility in the

Commonwealth for the purpose of assisting that facility with public health and medical

disaster response operations.”

• COVID-19 Expedited Licensure: During the declared coronavirus emergency in Virginia, the

board of medicine is streamlining its licensing process for the following professions: medicine

and surgery, osteopathic medicine and surgery, physician assistant… in addition, the Board

already has an expedited licensure by endorsement process for medicine and

osteopathy applicants who: 1) Have practiced in another state for 5 years, 2) Are board

certified.

• [EO 57] - Health care practitioners with an active license issued by another state may provide

continuity of care to their current patients who are Virginia residents through telehealth

services. Establishment of a relationship with a new patient requires a Virginia license unless

pursuant to [the paragraph above].

• Re: adjoining state licensing exceptions – [According to] Va. Code Ann. § 54.1-2901(A), the

requirement that a physician be licensed in the state of Virginia before providing clinical

services to a patient located in Virginia does not apply to the rendering of medical advice or

information through telecommunications from a physician licensed to practice medicine in

Virginia or an adjoining state.

• Re: modality - A healthcare practitioner may use any non-public facing audio or remote

communication product that is available to communicate with patients. This exercise of

discretion applies to telehealth provided for any reason regardless of whether the telehealth

service is related to the diagnosis and treatment of COVID-19.

• Re: originating site - Virginia Governor Ralph Northam has signed legislation (HB 5046/SB

5080) that amends the Commonwealth’s telehealth laws to eliminate originating site

restrictions and the requirement that the patient be accompanied by a care provider during

the telehealth session… The bill expands the telehealth platform to allow care providers to

treat patients in their own homes or other locations, including businesses, schools and

clinics. It also mandates that payers cover telehealth services regardless of the originating

site and whether a provider is with the patient and directs the state Medicaid program to

continue covering audio-only phone services.

• [1/11/22 Update] re: interstate telemedicine - To practice telemedicine into Virginia requires

a license from the Board of Medicine. The Board notes that § 38.2-3418.16 states

“Telemedicine services” does not include an audio-only telephone, electronic mail message,

facsimile transmission, or online questionnaire. The Board believes that these

communications do not constitute telemedicine, and therefore do not require licensure,

when used in the follow-up care of a Virginia resident with whom a bona fide practitioner-

patient relationship has been previously established. (VA BOM Telemedicine Guidelines

6/24/21).

• [1/19/22 Update] re: reactivating waivers – “Healthcare workers across the country are

facing severe burnout and exhaustion 22 months into the pandemic. Reinstituting both the

authorization of out-of-state licensed professionals to provide care to the citizens of the

Commonwealth and the availability of telehealth services will assist in meeting that

demand…” [EO 84, 1/10/22].

• Status – Inactive, Virginia’s state of emergency expired March 22, 2022, per EO 16, and

hasn’t been renewed.

Board of Medicine

Guidance

Executive Order #42

Executive Order #57

Article re: Adjoining

state licensing

exceptions

Article re: originating

sites

State Resource Page

Washington

• Washington offers broad credentialing privileges: “If volunteers are registered in the

volunteer health practitioner system and verified to be in good standing in all states where

they are licensed, they may practice in Washington without obtaining a Washington license

once activated and assigned by DOH… Out-of-state practitioners may: (1) Become volunteers

via RCW § 70.15 by registering and completing the Emergency Volunteer Health Practitioners

Application; (2) Out of state MDs and DOs that would like an expedited Washington license

and to volunteer, may use the Interstate Medical License Compact and become registered

under RCW § 70.15.

• RCW § 70.15.050: “(1) While an emergency declaration is in effect, a volunteer health

practitioner, registered with a registration system that complies with RCW 70.15.040 and

licensed and in good standing in the state upon which the practitioner's registration is based,

may practice in this state to the extent authorized by this chapter as if the practitioner were

licensed in this state…”

• [Proc. 20-29] - Re: payment parity - I also prohibit the following activities by health carriers to

encourage… telemedicine services by providing for payment parity between telemedicine

and in-person medical services: (1) Reimbursing in-network providers for telemedicine claims

Medical Commission

Guidance

Emergency Volunteer

Health Practitioners

Application

RCW § 70.15.050

Emergency

for medically necessary covered services at a rate lower than the contracted rate that would

be paid if the services had been delivered through traditional (in-person) methods. (2)

Denying a telemedicine claim from an in-network provider for a medically necessary covered

service due to an existing provider contract term with that provider that denies

reimbursement for services provided through telemedicine. (3) Establishing requirements for

the payment of telemedicine services that are inconsistent with the emergency orders, rules

or technical advisories to carriers issued by the Office of the Insurance Commissioner.

• Re: establishing relationship – New administrative code rule, WAC 182-551-2040, allows

face-to-face requirements for home health care to be met using telemedicine or telehealth

services (makes permanent a COVID-19 emergency rule).

• [1/11/22 Update] re: interstate telemedicine - There is no prohibition against the

consultation through telemedicine by a practitioner, licensed by another state or territory in

which he or she resides, with a practitioner licensed in WA who has responsibility for the

diagnosis and treatment of the patient within WA. (RCW 18.71.030(6) & RCW 18.57.040).

• [8/25/22 Update] Re: recission announcement – On July 29, 2022, Gov. Inslee announced his

intent to rescind 12 Proclamations, including Proclamation 20-32, which have been in place

during the COVID-19 public health emergency… To ensure that allopathic physicians (MDs)

and physician assistants (PAs) have ample time to resume pre-COVID licensing and regulatory

requirements Proclamation 20-32’s rescission will become effective on October 27, 2022.

• Status – Inactive, waivers expired on October 27, 2022, please see above.

Proclamation 20-29

WA SSB 5423 (2021)

| SSB 5423 Bill

Summary (re:

consultation

exemption)

WMC announcement

re: waiver recission

State Resource Page

Washington, DC

• Any healthcare provider who is licensed in their home jurisdiction in their field of expertise

who is providing healthcare to residents of the District shall be deemed temporary agents of

the District for the duration of this Order, pursuant to the limitations: (1) the healthcare

provider is only providing healthcare services to individuals at a licensed healthcare facility

in the District of Columbia; (2) the healthcare provider has an existing relationship with a

patient who has returned to the District, providing continuity of services via telehealth.

• The use of telehealth does not eliminate the requirement for licensure. The practice of your

healthcare profession occurs where the patient is located, so any practitioner providing

telehealth services to patients located in the District of Columbia must be licensed in the

District of Columbia by their appropriate licensing board.

• Existing Washington D.C. law provides that “The provisions of this chapter prohibiting the

practice of a health occupation without a District of Columbia license, registration, or

certification shall not apply: (1) To an individual who administers treatment or provides

advice in any case of emergency… (DC Code § 3–1205.02) – however, according to the

Guidance on Telemedicine memo, it does not appear to be invoked.

• [7/19/21 Update] re: Valid waivers – A. Licensure, registration or certification requirements,

permits and fees be waived for healthcare practitioners appointed as temporary agents of

the District of Columbia… C. Any healthcare provider who is licensed in their home

jurisdiction in their field of expertise who is providing healthcare to District residents shall

be deemed a temporary agents of the District of Columbia… a. The healthcare provider is

only providing healthcare services to individuals at a licensed healthcare facility located in

the District of Columbia. This includes providing any services via telehealth… per 3/18/21

Revised Administrative Order.

• [10/29/21 Update] – On October 25, DC B 24-0399 was enacted, which amends UEVHPA to

allow healthcare professionals licensed in other jurisdictions to practice in DC without a

"state" license until August 10, 2022, regardless of whether an emergency declaration is in

effect. As it pertains to telemedicine, the law allows for out-of-state telemedicine for “an

established patient who has returned to the District… for the purposes of continuity of care.”

• [1/7/22 Update] re: interstate telemedicine – [Practitioners] Must have license to practice

medicine in the District of Columbia. (DC Regs. Sec. 17-4618.1 & .6.).

• Status – Inactive, DC’s Public Health Emergency, which governs physician licensure waivers,

was terminated on July 25, 2021 per Mayor’s Order 2021-096. The 60-day grace period for

the waivers expired on September 23, 2021, per DC DOH website.

Waiver of Licensure

Requirements

Guidance on use of

Telemedicine

DC Code § 3–1205.02

Press Release re:

Extension

3/18/21 Revised

Administrative Order

District Resource

Page

West Virginia

• The following statutory regulations are to be suspended for the duration of the State of

Emergency: Requirement for telemedicine providers to be licensed in West Virginia…

provided that such provider possess a license within their own state… requirement that

telemedicine be performed by video only.

• West Virginia has expanded the use of audio-visual telehealth for non-emergent E&M

services to Medicaid members, for mental health visits and in federally qualified health

centers (FQHCs) and rural health clinics (RHCs).

• [WV BOM Fall 2020 Newsletter] Re: preexisting relationships/audio-only

modalities/reimbursements – For the duration of the COVID-19 emergency, the prohibition

on establishing a provider-patient relationship via audio-only communication is suspended

Executive Order 07-

Article re: Audio-only

telehealth

temporarily. If audio-only communication satisfies the standard of care for a particular

patient presentation, it may be used to establish a provider-patient relationship and to

provide patient care. Effective March 1, the U.S. Department of Health and Human Services

and Centers for Medicare & Medicaid Services increased telehealth reimbursements to equal

other audiovisual and in-person visitation reimbursements.

• [6/22/21 Update] WV HB 2024, which was signed into law on May 20, 2021, allows health

care practitioners licensed and in good standing in another jurisdiction to pay a fee to

become registered with the appropriate medical board (allopathic or osteopathic) and

become an “interstate telehealth practitioner” and practice medicine with West Virginia

patients. West Virginia holds jurisdictional authority, but the registrant has the responsibility

to report any restrictions placed on their license in other jurisdictions to WV boards.

• [9/9/22 Update] re: Emergency waivers – According to WVBOM guidance, eligible physicians

and physician assistants may register with the Board to practice in West Virginia during the

COVID-19 State of Emergency. Providers are only eligible for one emergency registration,

which are valid for a period of sixty days or five business days after the declared state of

emergency terminates, whichever is sooner.

• [12/1/22 Update] re: end of SoE - On November 30, 2022, West Virginia Gov. Jim Justice said

that the state’s COVID state of emergency would be allowed to expire on January 1, 2023.

The SoE has been in effect since March 16, 2020, and allows for a series of waivers, including

allowing out-of-state physicians to practice in person and via telemedicine, and expediting

the licensure of inactive and retired physicians.

• Status – Inactive, West Virginia’s State of Emergency expired on January 1, 2023. Please see

above for more information. Additionally, West Virginia offers interstate telemedicine

registration, please see the 6/22/21 update above.

WV BOM Fall 2020

Newsletter

WV HB 2024

WV BOM COVID-19

Information

Emergency Order 1-

22 (ending SoE)

State Resource Page

Wisconsin

• [EO 16] - III. Telemedicine. A. The following is ordered as it relates to telemedicine for

Wisconsin residents: 1) A physician providing telemedicine in the diagnosis and treatment of

a patient located in this state must have a valid and current license issued by this State,

another state, or Canada… 2) A physician practicing under this section cannot be currently

under investigation and must not currently have any restrictions or limitations placed on

their license by their credentialing state or any other jurisdiction.

• Re: recission of waivers – [Em. O 16; 3/27/20] This Order is effective immediately and shall

remain in effect for the duration of the public health emergency as declared in Executive

Order #72 [3/12/20], including any extensions. On May 11, 2020, EO 72 expired and was

replaced by EO 82, which did not adopt EOs #16 & #20 (a modification of EO 16) and thus an

out-of-state practitioner is not able to work in Wisconsin through Interstate Reciprocity.

• [Wisconsin DSPS Memo] - The legislature did not extend the public health emergency and it

ended May 11, 2020. Therefore, your temporary license will expire on June 10, 2020. This

temporary license cannot be renewed.

• [October 1, 2020 Update] – [The October 1] order provides for temporary interstate license

reciprocity for healthcare providers to work in Wisconsin healthcare facilities, extends

licenses that may expire during the federal emergency declaration for 30 days after its

conclusion, and makes it easier for healthcare providers with a recently lapsed license to

apply for a reinstatement with the Department of Safety and Professional Services (DSPS).

Out-of-state physicians can also practice telemedicine in Wisconsin with proper

notification of DSPS.

• [April 5, 2021 Update] – EO 105 expired on April 5, 2021, meaning that Em. Order #2 is no

longer in force and Wisconsin is no longer in a state of emergency.

• [1/11/22 Update] re: interstate telemedicine - WI medical license required. (WI Admin. Code

MED Ch. 24.04).

• Status – Inactive, waivers rescinded with the expiration of EO 105 on April 5, 2021.

Executive Order #16

Telemedicine

Physician Notification

of Healthcare

Provision

Wisconsin DSPS

Guidance (re:

recission of EOs 16

&20)

Wisconsin DSPS

Memo

Emergency Order #2

(reinstituting

waivers)

State Resource Page

Wyoming

• Wyoming offers broad credentialing privileges: “Physicians and physician assistants not

licensed in Wyoming may qualify to work here during the declared public health emergency

through the “consultation exemption.” If approved to do so, the physician or physician

assistant is considered to be “consulting” with the State Health Officer. The exemption from

licensure, if approved, will be valid until the earlier of the end of the Public Health

Emergency or the termination by the State Health Officer of the physician’s or physician

assistant’s “consultation.” Current, full and unrestricted licensure in at least one U.S.

jurisdiction or country is required. The exemption is not automatic, requires approval of the

Board of Medicine and the State Health Officer, and does not apply to all physicians and

physician assistants.

• A physician licensed in another state who has been approved for the "consultation

exemption" (See above) may initiate a physician-patient relationship with a new patient

under the exemption.

Board of Med

Guidance

Emergency Licensure

Application

• The Wyoming Medical Board has an emergency temporary permit application on their

website for licensed out-of-state medical professionals seeking a temporary, voluntary

license. While there is no explicit mention of telemedicine, the WMB has a list of approved

out-of-state telemedicine permits, implying it is allowed.

• If you have an existing physician-patient relationship established in a face-to-face encounter

in your state, and the patient is not able to travel to your state now due to the Public Health

Emergency, you may continue that patient’s care via telehealth, including telephone, without

a Wyoming physician license. This includes following up on procedures performed in your

home state, adjusting medication dosing, prescription refills, ordering diagnostic testing, etc.

The telehealth technology must allow you to meet the standard of care at all times. You may

not, however, provide care that treats a new diagnosis or condition without a Wyoming

physician license if you have not seen the patient for it in a face-to-face encounter in your

home state. You also may not provide care beyond such a time as the standard of care

dictates that a face-to-face encounter should occur.

• Status – Inactive, on February 28, 2022, Gov. Mark Gordon announced the public health

emergency declaration will be rescinded on March 14, 2022. (Article).

State Resource Page

Questions, comments, or corrections? Please contact Andrew Smith ([email protected])