Telemedicine in Georgia: Law, Rules, Regulations, and Policies

Posted by Michael Hsu on 6/15/20 9:19 AM
Michael Hsu

Georgia was among the first states in the U.S. to embrace telemedicine as a valid form of providing patient care, back in 2005. Over the following years, Georgia’s legislators and the state’s Medical Board invested considerable efforts in improving the accessibility and availability of remote medical care to patients in the state.

Let’s take a closer look at Georgia’s laws, regulations, and policies regarding telemedicine, so you can get a better idea if you’re eligible to provide remote healthcare services to your patients, and if so — under what conditions. 

Georgia Telehealth Law

In 2005, the State of Georgia introduced amendments to the Official Code of Georgia Annotated, in order to enact the Georgia Telehealth Law. The goal was to provide definitions and a legislative framework for providing remote medical services in the state. 

Right off the bat, Georgia Telehealth Law states that no insurance policy can enforce face-to-face contact as a requirement for reimbursing medical care. This marked Georgia as one of the first states in the U.S. to legally enforce payment parity for telemedicine and telehealth services.

In other words, since 2005, private insurance companies in Georgia must provide coverage for telemedicine and telehealth services if the same services would be covered if they were delivered in-person.

Telemedicine and telehealth definitions

Georgia law views telemedicine and telehealth as separate, although similar terms. The main differences stem from the purpose of remote doctor-patient communication and the way in which remote medical care is delivered.

Telemedicine — Under Georgia Telehealth Law, Telemedicine is considered the delivery of clinical healthcare services by utilizing two-way audio and video, or other electronic and telecommunication technologies. The law explicitly excludes telephone doctor-patient consultations and facsimile transmission from the definition. 

The purpose of telemedicine, as defined by law, is assessment, diagnosis, consultation, treatment, education, and exchange of medical information. Georgia Telehealth law also forbids the discrimination between urban and rural areas and states that medical professionals — licensed in the state and working within their scope of practice — can offer telemedicine services to patients in Georgia, without face-to-face contact. 

There is no reference regarding consent for telemedicine in the Telehealth Law. That said, the strong emphasis on removing the in-person requirement implies that providers can establish a valid doctor-patient via telemedicine. 

Telehealth — The 2019 Senate Bill 118 made several amendments to the Georgia Telehealth Law. The Bill introduced the term “telehealth” with the purpose of expanding the utilization of remote healthcare services. The law now recognizes telehealth as the use of information and telecommunication technologies — including phones and remote patient monitoring — to facilitate:

  • Clinical healthcare
  • Consultations with medical professionals
  • Health-related education
  • Health administration

Although both types of medical services are delivered remotely, the difference is in intent — telemedicine helps providers diagnose and treat patients through live audio-video communication, while telehealth enables other forms of communication that aid in-person clinical care. 

Other definitions and policies

SB 118 introduced a few additional definitions regarding remote healthcare services and expanded on the state’s telemedicine policy. 

The new definitions and policies pertained to:

  1. Originating sites
  2. Distant sites
  3. Insurers

Originating sites — SB 118 defines an “originating site” as any site in the State of Georgia in which the patient who receives remote healthcare services is located. It also gives insurers and patients the liberty to “agree to alternative setting arrangements” that both parties deem appropriate. This effectively means that a patient’s home can be considered an originating site, along with any medical facilities in which the patient is receiving in-person medical care. 

Distant sites — The amended Georgia Telehealth Law is quite flexible when it comes to the location of the provider offering telemedicine and telehealth services. There are no restrictions regarding distant sites. Any site where a medical professional licensed to practice medicine in Georgia offers remote healthcare services is considered a distant site. 

The wording of this definition reinforced the interpretation that any licensed medical professional in the State of Georgia can offer remote healthcare services to patients in the state. 

Insurers — Given that Georgia Telehealth Law enforces payment parity for healthcare services delivered via telehealth and telemedicine, the legislator deemed it important to clearly define which entities are considered “insurers” under law. Anyone authorized to sign contracts under this title or to provide health benefit policies is considered an insurer. This includes, but is not limited to:

  • Accident insurers
  • Sickness insurers
  • Fraternal benefit societies
  • Hospital service corporations
  • Medical service corporations
  • Health care corporations
  • Health maintenance organizations
  • Provider sponsored health care corporations
  • Managed care entities

SB 118 highlights that no insurer can refuse to cover telemedicine and telehealth services solely on the basis that these services are provided remotely. Insurers must reimburse healthcare providers for diagnosis, treatment, and consultation delivered via telemedicine. The basis and the reimbursement rates must be the same as with in-person medical services covered by the insurer. 

The amendments also remove the possibility of enforcing any limitations on coverage for telemedicine services. This means that insurers cannot set a yearly or lifetime dollar maximum for telemedicine — they must reimburse the provider for all telemedicine services delivered, regardless of their frequency. 

Insurers also cannot impose any copayment, coinsurance, or deductibles if they are not equally imposed on all services covered under the health benefit policy, regardless of whether they’re delivered remotely or in-person.

Store-and-forward technology — SB 118 defines store-and-forward technology as the transmission of medical data to and from an originating site or to and from a provider. This encompasses both sharing protected health information (PHI) between a patient and a provider, as well as between different providers for the purposes of facilitating remote medical care. 

The technology used doesn’t have to be real-time, and the patient doesn’t need to be present for the transmission of their medical information. 

All the changes introduced by SB 118 have been in effect since January 1, 2020. 

Practice Through Electronic or Other Such Means

In 2014, the Georgia Composite Medical Board issued a regulation called Practice Through Electronic or Other Such Means with the purpose of establishing standards of practice the providers will be held to when delivering remote healthcare services. 

What’s particularly interesting regarding the Board’s prescribed standards is that the regulation explicitly states that all remote treatment and/or consultation must be done by:

  • Licensed physicians
  • Physician assistants
  • Advanced practice registered nurses (APRNs)

This severely limited the utilization of telemedicine and telehealth in the state, but it was not long-lived. The SB 115, passed in 2019, corrected this narrow view by stating that any person who delivers remote healthcare services will be subject to regulation by the Board. 

Looking at Georgia’s law chronologically, the Telehealth Law of 2005 didn’t provide any reference regarding who can practice telemedicine in the state. In 2014, the Board sought to provide clearly defined standards of practice and, in doing so, provided an extremely narrow list of eligible providers. This hindered the use of telemedicine and telehealth in Georgia, so legislators introduced SB 155 five years later that explicitly states that all medical professionals licensed in Georgia can offer remote health care services to patients in the state. 

Remote patient examination

Going back to the standards prescribed by the Board, another requirement stated in the Practice Through Electronic or Other Such Means is that patient history should be available to the provider, prior to engaging in telemedicine. 

Before providing remote treatment and/or consultation, healthcare professionals must meet one of the following conditions:

  1. Have examined the patient in-person and are leveraging telemedicine to provide ongoing or intermittent care
  2. Are providing remote healthcare services at the request of a medical professional in Georgia who has personally examined the patient
  3. Are providing remote healthcare services using technology that is equal or superior to an in-person examination, at the request of the following: 
    1. Public Health Nurse
    2. Public School Nurse
    3. The Department of Family and Children’s Services
    4. Law enforcement
    5. Community mental health center
  4. Can examine the patient themselves, using technology equal or superior to in-person examination

Everyone practicing telemedicine in the State of Georgia is subject to disciplinary action by the Board for unprofessional conduct. This signifies that, while it is possible to admit new patients and examine, diagnose, and treat them via telemedicine, providers should be confident that the tools they’re using are on par with in-person examination. Should a medical condition require an in-person examination, the provider is under the obligation to convey that information to the patient and cancel the scheduled virtual appointment. 

If you’re looking for a telemedicine solution that will comply with Georgia’s law and the Board’s requirements — Curogram is the perfect fit! Our platform is designed specifically for healthcare providers that want to practice telemedicine. It allows you to host high definition two-way video appointments with patients and examine, diagnose, and treat them in accordance with the Board’s standards. 

Curogram also automatically sends patient intake forms a few days in advance of the appointment. This gives you enough time to determine whether the patient’s medical condition requires an in-person examination or can be treated remotely. 

Patient records

The Georgia Composite Medical Board also states that anyone practicing telemedicine and telehealth in the state must update and maintain patient medical records, as well as document the evaluation and treatment of each patient and the identity of the practitioners providing the service. If telemedicine is performed at the request of a different medical professional or facility, providers must also send them a copy of this record.

Doing so manually is tedious and time-consuming. We foresaw this requirement and made sure that Curogram integrates with over 700 EHRs. This way, all the relevant patient information is automatically updated in your electronic health record, so you don’t have to waste time on redundant administrative tasks. Curogram also enables you to quickly and easily share PHI with your partners and patients, all through a single web-based dashboard. 

Curogram EHR integrations

eClinicalWorks

Athena

Epic

Cerner

DrChrono

NextGen

Practice Fusion

CareCloud

Kareo

OfficeAlly

See More Integrations Here

Follow-up care

The Georgia Composite Medical Board views telemedicine as an aid to in-person medical care, or as an alternative in situations where in-person examination, diagnosis, and treatment isn’t immediately available. This is evident from the Board’s policy, which states that all telemedicine and telehealth providers should “make diligent efforts to have the patient seen and examined in person.” 

This examination doesn’t have to be performed by the provider, so long as the patient is examined in-person by a Georgia licensed medical professional at least once per year. 

Telemedicine and telehealth practitioners in Georgia must also provide their patients with clear instructions regarding follow-up care, in case the need for emergency medical treatment arises in the future. This includes giving the patient the name of the practitioner, as well as their credentials, and emergency contact information. The only exception to this rule is if remote medical care is provided to an inmate.

Online prescriptions

When it comes to issuing prescriptions following a telemedicine or telehealth visit, the Board prohibits prescription of controlled substances and dangerous drugs. That said, telemedicine practitioners in Georgia can prescribe over-the-counter medication and non-controlled substances, without having to meet the patient face-to-face.

Intestate telemedicine license

Another thing the SB 115 introduced was the possibility for out-of-state medical professionals to leverage telemedicine to provide remote healthcare services to patients in Georgia

Following the Bill, Georgia joined the Interstate Medical Licensure Compact, making it even easier for out-of-state telemedicine practitioners to obtain a license to offer remote healthcare to patients in the state.

Georgia Medicaid

Georgia Medicaid defines telemedicine as using two-way, real-time video to exchange patient medical information between two sites. 

Medicaid’s definition is somewhat misleading, given that it explicitly states telemedicine involves “the exchange of patient information,” yet only through live video. The wording makes Medicaid’s telemedicine definition a bit convoluted, so we’ll simplify it:

Medicaid will only reimburse for live video visits, and will not reimburse for store-and-forward technology, remote patient monitoring, phone, and email consultations.

Eligible healthcare providers

Apart from only reimbursing live video telemedicine, Georgia’s Medicaid program enforces several more limitations. 

Whereas the law permits all licensed medical professionals in the state to practice telemedicine and telehealth, Medicaid has a limited list of eligible providers:

  • Physicians
  • Physician assistants
  • Nurse practitioners
  • Nurse-midwives
  • Clinical nurses specialists
  • Nurse anesthetists
  • Speech-language pathologists
  • Audiologists
  • Clinical psychologists
  • Clinical social workers
  • Dentists
  • Dietitians and nutrition professionals

Eligible telemedicine services

In order for Medicaid to reimburse healthcare providers for telemedicine services, said services must be deemed medically necessary and appropriate for the patient. 

The list of services Medicaid covers is limited to:

  1. Office visits — telemedicine services equivalent to the patient visiting the professional’s office in-person
  2. Pharmacologic management
  3. Limited office psychiatric services
  4. Limited radiological services
  5. Limited other physician fee scheduled services

If you’re participating in Georgia’s Medicaid program, it’s best to contact Medicaid directly and inquire whether they cover a specific telemedicine service, prior to admitting the patient online.

Informed patient consent

Georgia’s Medicaid program states that, in order to reimburse for telemedicine services, the provider must obtain written patient consent before a telemedicine visit. We also recommend familiarizing your patients with the potential security and confidentiality risks associated with providing medical care remotely.

Location restrictions

Medicaid also imposes some restrictions regarding eligible originating and distant sites for telemedicine visits. 

Eligible sites under Georgia’s Medicaid Program are:

  • Provider Offices 
  • Hospitals
  • Federally Qualified Health Centers (FQHC)
  • Rural Health Clinics (RHC)
  • CAH-based renal Dialysis Centers 
  • School-based clinics 
  • Skilled nursing facilities 
  • Pharmacies 
  • Emergency Medical Services Ambulances 
  • County Boards of Health

Note that GA Medicaid doesn’t consider a patient’s home to be an eligible originating site. Patients must be admitted to one of the medical facilities listed above, and telemedicine services will only be reimbursed, provided that the facility that acts as an originating site cannot provide specific services in-person. 

Reimbursement rates

For all eligible services, Georgia Medicaid will reimburse providers according to their current physician fee schedule amount. This essentially means that all eligible remote healthcare services will be reimbursed at the same rates as the same services delivered in-person.

Have a successful telemedicine start in Georgia with Curogram

Curogram is a telemedicine platform designed specifically for healthcare professionals. What we mean by this is that it takes all your business needs and existing workflows into consideration and enables you to set up a virtual clinic in less than 48 hours!

Curogram is fully HIPAA compliant and comes with built-in safeguards, so you don’t have to bang your hand on the table, trying to figure out the technical details. The platform is simple and easy to use — both for your doctors and medical staff, as well as your patients. 

You can do everything from a single dashboard — send appointment reminders, communicate with your patients, share PHI among staff members and partners, host video appointments, bill your patients, and more.

Main reasons why you’ll love Curogram

EHR integration

Curogram integrates with your electronic health record and automatically updates it after each virtual visit. You can also easily send visit summaries and other relevant medical information to your patients, with a single click. This eliminates the bulk of administrative work and leaves your doctors and medical staff with more time to dedicate to your patients.

Smart appointment reminders

With telemedicine, there’s always the risk that a patient simply won’t show up for an online appointment. In most cases, they’d simply forget. Curogram reduces no-shows by 75% by sending automated SMS appointment reminders. You can fully customize the reminder template, and patients can respond to the text message if they need to reschedule.

Automated electronic patient intake forms

Imagine how much time you would save if your doctors didn’t have to spend 15+ minutes of each virtual visit gathering the necessary medical information. With Curogram, this is reality. Our platform will automatically send patient intake forms a few days prior to the appointment, so your doctors will have all the required info by the time the patient joins a virtual appointment. 

Virtual waiting rooms

Curogram supports your existing workflows, so your staff won’t feel like they’re suddenly transitioning to an entirely different environment. Our platform lets you create virtual waiting rooms, where your MAs, nurses, and doctors can continue working in the same fashion as if the visits were conducted in-person. 

These are just some of Curogram’s awesome features. If you want to learn more about Curogram and test out the platform — click here and start your free 14-day trial!

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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