Telemedicine Arkansas: State Laws and Policies

Posted by Michael Hsu on 6/13/20 9:03 AM
Michael Hsu

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Arkansas officials were among the first in the States to recognize the benefits of telemedicine. By signing the telemedicine parity law in 2015, they paved the way for the development of the practice and made it easier for the providers to offer their services to a wider range of patients.

It seems that the limitations that still apply in certain aspects of telehealth practice restrict the telemedicine providers from reaching their full potential. By failing to adopt HB 1220 bill, the authorities left some telehealth services off-limits to many of the Natural State residents. The bill was meant to democratize telemedicine even further.

The recent COVID-19 outbreak showed how concerningly ineffective the U.S. healthcare system is. What the current situation proves is that rethinking and remodeling of patient care are necessary and long overdue

Arkansas Telemedicine Definition

Telemedicine is the delivery of healthcare through the employment of digital communication channels with the physician and the patient in remote locations, according to Arkansas officials. 

Electronic health records (EHRs) became a standard even in traditional practice. They proved to be a welcome and positive change in the way we keep and access patient medical data. There is no reason to shy away from exploring other options that technology has to offer.

Patient care faces many challenges, and introducing new tools and methods can significantly improve its efficiency. Telemedicine seems to bridge the gap that exists between the needs and the possibilities in medical practice today. The main goals of the service are to: 

  1. Provide care for patients in distant areas that lack in medical personnel.
  2. Improve patient experience and quality of care.
  3. Reduce the ever-growing per-capita expenditures that are becoming a debilitating factor in the U.S. healthcare industry.
  4. Improve the overall health of the population.

Telemedicine and Telehealth

Arkansas regulation does not differentiate between the terms telemedicine and telehealth. You can use both words to describe remote care. Some other states offer separate definitions, so if your patients are not AR residents, it is mandatory to follow the rules of their state of residency.

If there is a distinction between the terms, it refers to the scope of service. Telehealth is usually a much broader term that includes education and prevention methods, while telemedicine is restricted to clinical services.

Technological Requirements

There are no specific requirements regarding the telemedicine platform you must use for your practice. The technology you should use is crucial because telemedicine depends on it, as much as it does on a doctor's expertise and knowledge.

User-friendly interface, two-way communication features, and HIPAA compliance are essential in establishing a successful telehealth practice. The system should function flawlessly and be easy to navigate for you to be able to concentrate on patients. Our Curogram platform offers all of the above and much more as we strive to deliver end-to-end solutions to telemedicine practitioners in Arkansas.

The benefits of using Curogram 

Curogram integrates with over 700 EHRs

If your telemedicine platform integrates with your EHRs, you can save time on administrative work. This enables a better allocation of services.

Curogram supports a two-way texting feature

Most patients prefer texting to any other communication tool in telemedicine. The two-way texting feature enables you to send appointment reminders and receive updates from patients regarding potential rescheduling.

Curogram enables internal communication and file sharing

The internal messaging system allows you to convey relevant information between the employees in a quick and secure way.

Curogram platform mimics in-person workflow environments

Advanced virtual waiting room tools allow the staff to prepare the patients before the appointment and physicians to initiate a video call as soon as the patient is ready. It enables an organized and structured workflow.

Arkansas Telemedicine Rules and Regulations

If you are practicing telemedicine in Arkansas, you must comply with the highest standards that apply to traditional healthcare. The patient's safety and well-being come first, and the law-makers made sure that the strictest rules are in place to prevent errors, malpractice, and ensure patient information privacy.

The regulation focuses on the following issues:

  1. Who is allowed to practice telehealth?
  2. What qualifies as a proper doctor-patient relationship?
  3. How to handle online prescriptions?
  4. How to protect data privacy?
  5. What are the location restrictions?
  6. How to keep appropriate medical records?

The Natural State appears to be liberal in some aspects of telemedicine, but quite conservative in others. Analyzing the above issues shows that additional efforts are required to allow telehealth to show its complete potential in improving the AR healthcare system.

Who Can Practice Telemedicine in Arkansas?

Providers based in the state must have a permit to practice medicine under the jurisdiction of the patient's location. Any healthcare provider who would like to establish a telehealth practice in the Natural State must possess a valid Arkansas medical license. Even if you are not an AR resident, you are not allowed to treat patients in Arkansas without it. 

There are two exceptions to this rule:

  1. Emergency situations in which the life and health of the patient are in imminent danger.
  2. Provision of general information that does not qualify as treatment of a specific condition.

Licensure is quite a challenge for telehealth practitioners because it can take forever to obtain proper permits. The Interstate Medical Licensure Compact (IMLC) is a program that should make cross-state licensing easier. The Natural State is yet to join the initiative, which will loosen up some of the red tape.

When it comes to eligible medical professionals, Arkansas law does not regulate this matter. This means that there are no restrictions regarding the healthcare providers that can engage in telemedicine practice.

What Qualifies as a Proper Doctor-Patient Relationship?

The physician-patient relationship is one of the most restricting aspects of telemedicine in Arkansas. To establish the relationship, the doctor and the patient must meet either in person or via real-time video and audio call. If the appointment is conducted through a video conference call, the doctor should be able to obtain the same information as they would in an in-person examination.

The relationship does not qualify as valid if it has been established through:

  • Audio only communication
  • Internet questionnaire
  • Email or text message
  • Medical history generated by the patient
  • Fax machine

Once the relationship is established, the ways of communication become more liberal. The state officials justify their rigid approach by claiming that proper and responsible evaluation of the patient is not possible through audio contact alone. As telehealth has its limitations regarding the scope of service, the doctors must determine whether the patient and their condition are appropriate for the telemedicine treatment. If they are not, it is the doctor's responsibility to suggest another institution or a different course of action.

How to Handle e-Prescribing?

Another restrictive measure applies to online prescriptions. Although it is one of the most beneficial aspects of telemedicine, even in conventional medical practice, the Natural State law-makers are strict when it comes to prescribing meds online.

When prescribing medication, the physicians should follow the same state and federal guidelines that apply to traditional practice. Doctors must not issue prescriptions without establishing a proper relationship with the patient. Updating medical history online does not qualify as a store-and-forward service in Arkansas.

Further limitations are as follows:

  • Controlled substances under schedules II to V cannot be prescribed unless the doctor and the patient meet in person. 
  • Abortion inducing drugs must be initially administered in the physical presence of the doctor.
  • Medical marijuana cannot be prescribed if the treatment is restricted to telemedicine.

What Are the Location Restrictions?

The most challenging issues for telehealth providers in the Natural State are the location restrictions. It is somewhat surprising that Arkansas officials are still insisting on limiting the places where remote care can happen.

In 2017, the law-makers amended the rules allowing patients' homes to be an eligible originating site. This significantly improved the accessibility of telemedicine. Medicaid beneficiaries are still subject to some limitations as they have to be in one of the following sites to receive the treatment:

  1. In-patient hospital
  2. Non-emergency hospital
  3. Clinic
  4. Physician's office
  5. Federally Qualified Health Center (FQHC)

How to Protect Data Privacy?

The data privacy and patient information protection are at the forefront of the telehealth discussion worldwide. The digital platforms used for the practice are under scrutiny, mostly because third parties may have access to the information while maintaining or updating the software, according to some concerned critics. 

With advanced measures of end-to-end encryption and password protection, compromising the data in any way is next to impossible. Any doubts the requesting patients may have should be addressed at the beginning of the treatment. Telehealth providers must explain the technology that they use, the potential dangers it involves, and the security measures that are implemented to protect the information.

Practitioners are subject to strict state and federal laws when it comes to doctor-patient confidentiality and patient information safety, so they are obliged to use HIPAA compliant communication channels. Remote care providers are responsible for any breach of privacy of their patients.

How to Keep Appropriate Medical Records?

When it comes to medical records, telemedicine providers must meet or exceed the standards that apply to traditional practice in Arkansas. Proper medical records must include:

  • Recordings or transcripts of every appointment regardless of the communication channel that was used
  • All test results, including blood tests, scans, etc.
  • Prescriptions and other information related to medication that the patient is using or is prohibited from using
  • Instructions, advice, or recommendations provided by the physician or other specialist
  • Information about allergies
  • Complete medical history before the current treatment if it is available

The ease of access to medical records revolutionized modern healthcare. Ever since EHRs became a standard in both telehealth and traditional practice, the downtime spent on administration decreased significantly. EHRs allowed the reallocation of resources, which means that the medical personnel can focus on patient care instead of red tape.

Enjoying the benefits of digital medical records is possible only if your telehealth platform integrates well with your EHR system. The Curogram platform offers integration with over 700 EHRs. By complying with the highest standards of data security, we enable you to dedicate your time to what you do best–see and treat patients.

Curogram EHR integrations

eClinicalWorks

Athena

Epic

Cerner

DrChrono

NextGen

Practice Fusion

CareCloud

Kareo

OfficeAlly

See More Integrations Here

Reimbursement for Telemedicine in Arkansas

 

Live telemedicine

Remote patient monitoring

Store-and-forward

Medicaid

Yes

No

Only for diabetic retinopathy screening

Private payers

Yes

No

Not mandatory

The turning point for telemedicine in Arkansas was the passing of the parity law in 2015. The law requires that private insurance payers, Medicaid, and state employees health plans cover for telehealth services. The fees must not exceed those that apply to traditional practice.

Medicaid

AR Medicaid defines telemedicine as the use of electronic communication and information technology to deliver healthcare services, including the assessment, diagnosis, treatment, consultation, education, and care management. Although store-and-forward technology classifies as telehealth, the state-federal partnership program is mandated to cover diabetic retinopathy screening only.

Medicaid beneficiaries in the State of Arkansas can use live video telemedicine services because the organization views telemedicine as interactive electronic consultations with a physician but only as a two-way, real-time information exchange. Arkansas Medicaid imposes certain limitations regarding the type of service, so eligible services are:

  • Consultations
  • In-patient hospital visits
  • FQHC encounters
  • Non-emergency appointments in a doctor's office, clinic, or outpatient hospital departments
  • Fetal echographs and echocardiology examination

Medicaid covers for two visits per patient annually. The beneficiaries can also use Telepsychiatry as a part of the Rehabilitative Services for Persons with Mental Illness program.

Medicaid is obliged to cover for telemedicine services if there is a comparable service in the traditional practice. Certain remote care services are only allowed for persons over the age of 18.

AR Medicaid does not consider the following communication channels appropriate for telehealth:

  • Emails
  • Audio-only communication (interactive audio calls included)
  • Text messages
  • Facsimile transmissions

Private Payers

Private insurers are obliged to cover for telehealth services in the same way they do for traditional practice. According to Arkansas law, the health carrier doesn’t have to cover telemedicine services if there are no comparable services in traditional practice.

In case the carrier deems it appropriate to reimburse for remote care services delivered via telephone, electronic mail, text messaging, or facsimile transmission, private payers are required to pay a reasonable fee to the originating site if it is operated by a healthcare professional or entity with appropriate permits and licenses.

Arkansas Telemedicine Act—What's in Store?

With last year's setback, when HB 1220 did not pass, a critical chance was missed. The most significant innovation was allowing the doctors to meet new patients via audio-only calls. In rural and remote areas that are in dire need of medical professionals, landlines are still the primary way of communication due to inadequate broadband coverage. Many patients fail to receive much needed treatment simply because of their ZIP code. The bill implied that for the audio-only call to be a valid tool, the doctor also has to have full access to the patient's medical records.

The situation needs improving in the cities as well. Since the urban areas are more affected by the coronavirus outbreak, the overcrowded hospitals are struggling to care for both COVID-19 and other patients. Telemedicine could help in various ways. Curogram offers complete practice management solutions in converting practices into coronavirus testing sites within 24 hours. We can provide the automation of the entire process, including registration, appointment scheduling, coordination, and payment. 

In light of the recent pandemic, even the opponents of the bill came to realize that something needs to be done to enable all the requesting patients to get the care they need. We hope that they will amend the telemedicine laws to reflect that need as soon as possible. 

Telemedicine by State

Don’t see your state? We just haven’t written about it yet! Stay tuned on our blog or check out our article on telemedicine reimbursement by state.

Telemedicine by State in the US

Alabama

Indiana

Nebraska

South Carolina

Alaska

Iowa

Nevada

South Dakota

Arizona

Kansas

New Hampshire

Tennessee

Arkansas

Kentucky

New Jersey

Texas

California

Louisiana

New Mexico

Utah

Colorado

Maine

New York

Vermont

Connecticut

Maryland

North Carolina

Virginia

Delaware

Massachusetts 

North Dakota

Washington

Florida

Michigan

Ohio

West Virginia

Georgia

Minnesota

Oklahoma

Wisconsin

Hawaii

Mississippi

Oregon

Wyoming

Idaho

Missouri

Pennsylvania

 

Illinois

Montana

Rhode Island

 

Topics: telemedicine

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