Please review these frequently asked questions about the Board's regulations regarding Telehealth. The Board's Telehealth Regulations are in the Code of Maryland Regulations ("COMAR") at 10.32.05. Please note, while these FAQs reflect recent legislative changes, the regulations do not.
Please note that these frequently asked questions only address the Maryland Board of Physicians' regulations and do not constitute legal advice.
No. You must be licensed in Maryland to treat patients in Maryland, including treatment via telehealth. Telehealth practitioners are subject to all the same licensing requirements and exceptions found in the Maryland Medical Practice Act, which states that an individual shall be licensed by the Board before the individual may practice medicine in this state. See Health Occ. § 1-1005, § 14-301; § 14-302; COMAR 10.32.05.03.
No. You do not need a special telehealth license, but you must have a valid Maryland license. A Maryland license authorizes you to perform telehealth for Maryland patients without any further authorization from the Board. See COMAR 10.32.05.03.
Yes. Generally, the link must be a secure and private telehealth connection as required by state and federal law and you should prevent access to data by unauthorized persons through encryption or other means. See COMAR 10.32.05.04B.
Please be advised that federal requirements may be relaxed in some limited circumstances provided you make good faith efforts to prevent access to data by unauthorized persons. However, all state rules and regulations regarding privacy requirements are still in effect. Please refer to the following website for information about HIPAA: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.aspxl.
Yes. The Board's telehealth regulations do not apply to telephone calls, emails or fax. Such interactions are not prohibited or otherwise regulated by the Board's telehealth regulations. See Health Occ. § 1-1001 (e) (3); COMAR 10.32.05.02B (8) (b).
The Board does not regulate reimbursement or provide reimbursement advice. However, please note that as of July 1, 2021, the Preserve Telehealth Access Act of 2021 went into effect. This act states that from July 1, 2021 to June 30, 2023, an audio-only telephone conversation between a health care provider and a patient that results in the delivery of a billable, covered health care service is included as telehealth under the Maryland Insurance Article.
You may use all telehealth modalities, including synchronous or asynchronous telehealth interactions. See Health Occ. § 1-1002.
Generally, no. A telehealth practitioner may only prescribe opioids for the treatment of pain if the prescription is provided to a patient in a health care facility, as defined in Health-General Article § 19-114(d)(1) or during a declared state of emergency due to a catastrophic health emergency. You must continue to follow Federal and Maryland law relating to the prescription of Controlled Dangerous Substances. See Health Occ. § 1-1003 (c); COMAR 10.32.06C.
A telehealth practitioner should verify the patient's identity, disclose to the patient the telehealth practitioner's name, contact information, and type of health occupation license, obtain oral or written consent from a patient to perform the telehealth services, utilize encryption to prevent access to data by an unauthorized person, ensure the telehealth connection is secure and complies with state and federal privacy laws, and establish safety protocols in the case of an emergency. See Health Occ. § 1-1002; COMAR 10.32.05.04.
A patient may present photo identification, or you may use any other means to identify a patient that you would accept for an in-person encounter.
Patients should be informed of the telehealth practitioner who is treating them and be able to contact the telehealth practitioner again for follow-up care. See COMAR 10.32.05.04B (3).
The statute requires oral or written consent from the patient or from the patient's parent or guardian if state law requires consent of a parent or guardian. See Health Occ. § 1-1002.
Please consider whether your technology for providing telehealth services includes encryption, password protection, or other security measures to ensure confidentiality and prevent unauthorized people from accessing the confidential visit. A written business associate agreement between the telehealth practitioner and the company providing telehealth services may be necessary to safeguard and protect privacy and security of the patient. See COMAR 10.32.05.04A (3), (5).
Just as a health care practitioner has a procedure in their office in the case of emergency, it is even more crucial that the telehealth practitioner have a procedure in place if a patient who is being seen remotely has a medical emergency. See COMAR 10.32.05.04A (6).
Yes. A telehealth practitioner should obtain an alternative method of contacting the patient if there is a technological failure, identify the practice setting of the patient and confirm whether the patient is in Maryland, and identify individuals at each location and confirm that they are allowed to hear the personal health information to be discussed. See COMAR 10.32.05.04B.
You should be aware of the location where your patient is contacting you from (a local clinic, hospital, the patient's home, a nursing home, or other location). See COMAR 10.32.05.04B (2).
Yes. Unlike an in-person visit, it is not apparent who is in the room and "off-camera" during a patient encounter. To insure patient privacy, all individuals in the room at each location are required to be identified and the patient should consent to discussing confidential information with those individuals present in the room, or you should ask those individuals to leave. See COMAR 10.32.05.04B (4).
The standard of care for telehealth treatment and documentation recording the health care services provided by telehealth is the same standard as for an in-person health care service visit. The laws regarding confidentiality of health information and a patient's right to the patient's health information also apply in the same manner as the laws apply to an in-person health care interaction. The Board uses the same standards for evaluating and investigating complaints regarding telehealth practitioners and practitioners who see patients in-person. The use of telehealth does not excuse a practitioner from failing to comply with certain requirements or failing to conduct required tests because they are not technologically feasible. If the standard of care would require information or treatment that is only obtainable in-person, the practitioner should see the patient in-person. See Health Occ. § 1-1003 (a) (1); § 1-1004; COMAR 10.32.05.06A, COMAR 10.32.05.07A.
The Board does not provide reimbursement advice. If you have questions about reimbursement please consult the Medicaid regulations at COMAR 10.09.49, or visit the Maryland Medicaid Telehealth Program's website at https://health.maryland.gov/mmcp/Pages/telehealth.aspx.
In addition, please note that as of July 1, 2021, the Preserve Telehealth Access Act of 2021 went into effect. This act states that from July 1, 2021 to June 30, 2023, an audio-only telephone conversation between a health care provider and a patient that results in the delivery of a billable, covered health care service is included as telehealth under the Maryland Insurance Article.
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