In a recent report by the American Telemedicine Association, on “telemedicine practice standard”, Arkansas was rated as dead last, among all states in the U.S. In response, the Arkansas Board of Medicine stated that it’s, Telemedicine Advisory Committee, intends to address the issues relating to telemedicine, in 2016.
Passed in April 2015, the Arkansas Code 17-80-117, instituted the requirement that, all physician-patient relationships, must be established in-person — telemedicine may not be used to satisfy this requirement, unlike many of the other states nationwide.
In October 2015, the Arkansas Medical Board proposed draft rules for consideration, with the intention of relaxing the State’s current telemedicine laws. The draft rules, circulated by the Board’s Committee, outlines it’s plan to improve the practice protocol by permitting physicians to establish a relationship with a patient “using a face-to-face real-time audio and visual technology”. Additionally, the draft rules require a bonafide provider-patient relationship be established, as such, the following applies to patient-physician relationships, established via telemedicine: health care practitioners are required to document and record the patient’s informed consent, received prior to commencing service; physicians may not issue prescriptions for controlled substances, without a prior in-person history and physical; within twenty-four hours of a patient’s appointment, physicians are required to send the patient a medical record document of the telemedicine encounter, via either email or postal mail; should the patient require an in-person consult relating to the present and existing medical condition, the treating physician is expected to refer the patient to an appropriate medical facility/provider, with accompanying medical documentation of the patient’s chart recommendation; additionally, all telemedicine consultation’s will be required to be of the same standard of care, as in-person consultations; all telemedicine consultations will be required to include a documented statement advising that the patient seek to establish a physician-patient relationship with a primary care advisor, with whom the patient is advised to seek follow-up care; all physicians who will be providing telemedicine consultations to patients in Arkansas, will have to be licensed to practice medicine, in the state of Arkansas; and upon request, all doctors practicing telemedicine will be required to handover the patient’s complete medical record, to the Arkansas State Medical Board.
To date, no parity laws have yet been enacted in Alabama, that would require private payers to recognize and reimburse telemedicine services at the same rates as the equivalent health care service provided in-person — however, Arkansas Medicaid recognizes and reimburses telemedicine encounters, provided that take place in real-time.
All out-of-state health care practitioners intending to provide telemedicine services, to patients geographically situated in the state of Arkansas must first obtain either a full medical license or a special purpose license, from the Arkansas Medical Board, prior to commencing service — however, physician-to-physician (P2P) exemptions apply.
Arkansas — along with Alabama and Texas — has the strictest requirements for delivering telemedicine services, as compared to in-person health care.