Telehealth and in-person visits for controlled substances
As we all have seen since the onset of the pandemic, physicians across Ohio have continued to embrace remote healthcare services. What started as a way to provide care due to the virus, has now blossomed to provide care to anyone with internet or phone access. In that vein, the Ohio General Assembly created a new law updating the use of telehealth and telemedicine services. Revised Code 4743.09, effective March 23, 2022, permits physicians and other allied practitioners to use telehealth to care for patients. The new law also requires the Medical Board to create administrative rules providing more detail of how telehealth services can be provided.
After a lengthy rule promulgation process, including OPPA member feedback, the State Medical Board of Ohio has finalized these telehealth rules which will become effective on February 28, 2023.
Guidance document/rule/law https://med.ohio.gov/Publications/Recent-News/updated-telehealth-rules
Key New Elements of Rules
Standard of Care
The rules require that telehealth services meet the standard of care of an in-person visit, and that it meets the standard of care for that patient’s condition. Please note that the location of the patient is important as it determines where those services are being performed—specifically that if that patient is outside of Ohio the treating physician is providing care in that state and is subject to the laws of that state for the provision of medical care. Thus, you will need to know where your patient is located before providing telehealth care.
Prescribing Controlled Substances
The rules provide specific guidelines as to when it is and is not lawful to prescribe. A physician must require an in-person examination of any new patient as part of an initial in-person visit prior to prescribing controlled substances, but there are limited exceptions. The rules do permit the prescription of controlled substances via visit telehealth if meet the criteria of the rule (i.e. abiding by federal laws and the telehealth laws of Ohio, etc.).
Documentation/Requirements For In Person Visit/Etc.
The rules also outline what information must be documented in the patient’s medical file during a telehealth visit, when a telephone call is permitted as a telehealth services, when physicians must require an in person visit rather than a telehealth visit, and when physicians can utilize remote monitoring devices as telehealth services. It also contains the criteria that physician assistants with delegated prescriptive authority must meet for purposes of telehealth care.