Telemedicine in Oregon — Laws, Rules, and Regulations | Blog

Telemedicine policies, rules, and regulations in Oregon are scattered through several Senate Bills and enforced by a number of different entities — mainly Medicare and Medicaid. 

Although the state is becoming progressively more lenient towards telemedicine, the practice of delivering remote healthcare services in Oregon is strictly limited to two-way video communication. 

Despite the fact that the law doesn’t specify who is eligible to provide telemedicine services in Oregon, practice shows that a vast array of medical professionals have already included remote healthcare services in their offers. Oregon’s law does prescribe strict requirements that must be met before anyone can start practicing telemedicine in the state.

Let’s take a closer look at the state of telemedicine in Oregon, so you can be certain that your practice complies with all the rules and regulations before offering virtual appointments to your patients. 

Telemedicine in Oregon state law

The State of Oregon first touched on the subject of telemedicine with Senate Bill 463. The Bill directed the Central Oregon Health Council (COH) to adopt rules regarding telemedicine system compatibility, standards, and characteristics.

The Bill defines telemedicine as the technology that enables the exchange of medical information for the purpose of facilitating diagnosis. The initial definition was rigid and incomplete, stating that telemedicine covers the transmission of images, test results, diagnosis results, and other medical information between a physician or other medical professional and a patient at the originating site.

Judging by the wording of SB 463, the state initially viewed telemedicine as a way to support diagnosis when in-person visits weren’t a viable option. In 1996, the Health Resources Commission was tasked with conducting a thorough telemedicine technology assessment and determining which medical facilities would benefit from providing remote services.

Since then, the State of Oregon made quite a few changes to its telemedicine policies, all in the service of further improving the access to and availability of telemedicine. Oregon’s telemedicine parity law now includes mandates for private payers, and as of 2015, state employee health plans. Telemedicine services in Oregon are now covered by health plans, provided that insurers would reimburse the healthcare provider for the same services if they were delivered in-person.

Oregon’s parity law exclusively covers live video telemedicine. Only two-way video communication with the patient is considered a proper telemedicine service, while other forms of remote healthcare are excluded. Oregon’s Medicaid reimburses healthcare professionals for telephone and email consultations as well.

If you’re looking for a telemedicine solution to start offering remote services to patients in Oregon, Curogram is the perfect solution. Our telemedicine platform enables quick and easy two-way video communication with the patients in a secure, fully HIPAA compliant environment. 

You can also send your patients SMS appointment reminders with the link to visit your virtual clinic. They can simply respond to the message to reschedule or ask additional questions and don’t have to download any apps before joining the telemedicine appointment.

Oregon Medical Board and telemedicine

The Oregon Medical Board doesn’t provide much information regarding telemedicine. In the telemedicine section of the website, the OMB simply states that a patient’s medical history and other medical data are valuable tools that enable the physician to diagnose the patient. 

The Board also briefly mentions that healthcare providers are held to the same in-person visits standard when providing telemedicine services. 

Who can provide telemedicine services in Oregon?

Oregon law doesn’t specify which healthcare providers are eligible to offer telemedicine services to patients in the state. On several occasions, the bills and regulations mention physicians but fail to provide a comprehensive list of eligible professionals. The law only states that physicians with active, unlimited licenses and in good standing do not require an additional license to practice telemedicine in the state. 

The fact remains that Oregon is gradually increasing the availability of telemedicine. Given that Oregon doesn’t specify who can or cannot offer remote healthcare services, it’s safe to assume that all professionals licensed to practice medicine in the state can do so. 

What supports this opinion is the fact that multiple health organizations that deliver telemedicine services exclusively, such as Providence, operate freely in Oregon. Apart from physicians, you can get in touch with other medical specialists, from optometrists to dentists.

With that in mind, Oregon Medicaid does provide a list of eligible healthcare providers that will be reimbursed for offering remote services to Medicaid members:

• Physicians
• Physician assistants
• Nurse practitioners
• Midwives 
• Clinical nurse specialists 
• Clinical psychologists and clinical social workers 
• Registered dietitians or nutrition professionals

Cross-state telemedicine

Unfortunately, Oregon still hasn’t proposed any legislation that would indicate the state’s willingness to join the Interstate Medical Licensure Compact. This means that only medical professionals with established practices in Oregon can treat patients within the state. Someone practicing telemedicine outside of Oregon cannot offer remote healthcare services to Oregon’s citizens.

The state is becoming more lenient in the face of the COVID-19 emergency, but it’s still unclear whether they will provide cross-state licensing in the future or not. 

Patient consent

There are no special patient consent requirements in Oregon’s law regarding telemedicine. You should always talk to your patients first before initiating a video call, to explain the potential confidentiality risks when using a telemedicine solution. 

You can’t opt for any video conferencing platform. You need to make sure that the solution you’re using is fully HIPAA compliant to avoid the astronomical fines for violating HIPAA rules and to ensure your patients’ sensitive medical information is well protected.

Curogram complies with all HIPAA regulations and has built-in safeguards that allow you to practice medicine in a secure, HIPAA compliant environment. Choosing Curogram will help alleviate the confidentiality concerns your existing and potential patients might have regarding telemedicine. 

All the medical information shared is fully encrypted, and patients can only access it through the Curogram app, ensuring that unauthorized people don’t have access to protected medical information (PHI). Doctors can share PHI, communicate with colleagues and patients, and host video appointments through a single, web-based dashboard. 

All the information is automatically backed up on secure servers and imported into your EHR, so you don’t have to waste valuable time on administrative tasks. Curogram integrates with any EHR, allowing doctors and medical staff to dedicate more of their time to patients.

Prescription requirements

Under Oregon’s law, medical professionals can only issue online prescriptions if they already have an established relationship with the patient. The law specifies that physicians are not allowed to prescribe any medication as a result of an online consultation or virtual appointment. 

Put simply, Oregon views telemedicine as an extension of in-person medical care. The main goal of telemedicine, at least according to the state’s laws, is to facilitate diagnosis. Telemedicine is not meant to replace in-person visits but can be used as an alternative to aid in patient treatment. If the patient’s medical condition requires medication, they will have to visit the facility in-person.

Reimbursement

When it comes to reimbursement, according to Oregon’s law, telemedicine services have the same rates as in-person medical care. Payers will have to reimburse the provider in the same way they would as if the appointments were held in-person in a medical facility. Reimbursement for telemedicine in Oregon comes from four sources — self-insured employer plans, private insurers, Medicare, and Medicaid.

Although the law regarding telemedicine in Oregon isn’t exactly comprehensive, the state’s Medicare and Medicaid programs provide the much-needed rules and regulations regarding telemedicine reimbursement and eligibility.

Oregon Medicare and telemedicine

Medicare has a rather strict reimbursement policy and only compensates the providers for “eligible services,” as defined by the Centers for Medicare and Medicaid Services (CMS). 

That said, Medicare will only reimburse for telemedicine services under the following conditions:

1. The service is delivered through two-way video communication and the patient is present. The two exceptions to the rule are store-and-forward projects in Hawaii and Alaska, whose purpose is demonstration.
2. Medicare will reimburse only if the service was delivered to an originating site in a Health Professional Shortage Area (HPSA), as defined by Health Resources and Services Administration (HRSA).
3. The service is delivered by an eligible provider:
1. Physician
2. Physician assistant
3. Nurse practitioner
4. Nurse midwife
5. Clinical nurse specialist 
6. Clinical psychologist and clinical social worker
7. Registered dietitian or nutrition professional
4. The service is delivered to one of the following originating sites:
1. Hospitals
2. Critical access hospitals
3. Provider’s office
4. Rural health clinic 
5. Skilled nursing facility
6. Federally qualified health centers
7. Community mental health center
8. Hospital-based or critical access hospital-based renal dialysis center

Oregon Medicaid and telemedicine

Given that Medicaid is a collaboration effort between the federal level and individual states, it allows each state to choose whether or not it wants to cover telemedicine. Medicaid defines telemedicine as a cost-effective alternative to traditional in-person appointments. 

Oregon Medicaid expands on this definition by describing telemedicine as “the use of telephonic or electronic communications to transmit medical information” from a distant site to an originating site. 

In order to reimburse providers for telemedicine services, Medicaid requires:

• Telemedicine to be delivered via two-way video communication
• Providers to be licensed to practice within the scope of their State Practice Act

Oregon Medicaid further states that eligible providers must be licensed to practice medicine in the State of Oregon, as well as enrolled as Division of Medical Assistance Programs providers. 

Medicaid also defines the conditions that providers need to meet before billing for their telemedicine services. Telemedicine providers must:

1. Be fully compliant with the Health Information Portability and Accountability Act (HIPAA) and abide by Oregon Health Authority Confidentiality and Privacy Rules
2. Obtain communications systems that align with privacy and security standards of HIPAA and Oregon Health Authority privacy and confidentiality rules
3. Create policies and procedures that prevent and help contain data breaches or exposure of protected health information (PHI) to unauthorized persons
4. Comply with the Health Evidence Review Commission (HERC) guidelines when providing consultations via email or phone
5. Maintain all documentation related to telemedicine services, in the same fashion the information would be documented during in-person visits

On the surface, it may seem like healthcare providers have to go through a world of trouble before they can start offering telemedicine services in Oregon. With the right solution you can get started the same day. 

As we’ve mentioned, Curogram is fully HIPAA compliant and comes with built-in safeguards that ensure our clients comply with all privacy and security rules. Our platform also supports EHR integration, so the relevant information is automatically documented, allowing you to spend more of your time treating patients, rather than worrying about paperwork.

Private insurers and telemedicine in Oregon

Oregon law — specifically, Senate Bill 24 (2015) and Senate Bill 144 (2019) — states that private insurance companies must reimburse for telemedicine services, under the following conditions:

1. The plan would cover the services delivered through telemedicine if those same services would be reimbursed when delivered in-person
2. The telemedicine service is deemed medically necessary
3. The telemedicine service is provided through secure, asynchronous, two-way video conferencing, in accordance with generally accepted standards of care
4. The technology used to deliver telemedicine services meets both the federal and state standards regarding the privacy and security of PHI

The two bills also specify that insurers must not discriminate between rural and urban areas and that the originating site is the site where the patient is located, whether it’s their home, workplace, school, or healthcare facility.

Oregon’s project ECHO

Apart from standard uses of telemedicine, the State of Oregon has leveraged telecommunication to provide healthcare professionals with necessary training and advice when dealing with complex conditions. 

The project was launched under the name Extension for Community Healthcare Outcomes (ECHO) and provides telementoring for the following conditions:

• Hepatitis C
• Diabetes
• Pain management
• Addictions

Providers included in the ECHO program can rely on telemedicine to get in touch with a group of specialists — called a Hub — and get valuable insights that would facilitate the treatment of these complex medical conditions. The best part about ECHO programs is the fact that the State of Oregon offers them at no cost to the participants and provides free Continuing Medical Education (CME). 

How Oregon utilizes telemedicine to combat COVID-19

In the face of the COVID-19 pandemic, Oregon Health & Science University (OHSU) launched mobile, drive-through testing sites for OHSU patients and first responders experiencing COVID-19 symptoms.

Apart from a quick way to test for the disease, OHSU urged patients to take advantage of their Telemedicine Program. Through their initiative, OHSU aims to take down the barriers that limit access to healthcare in these difficult times. 

The university enabled over 2,000 licensed healthcare professionals to conduct virtual visits in order to provide much-needed medical care to patients, without requiring them to leave their homes. 

If you wish to aid in the battle against COVID-19, Curogram offers a complete practice management solution. We’ll help you set up a new testing site or convert your practice into one in less than 24 hours. The entire process is fully automated — from patient registration to scheduling and test coordination.

Have a successful telemedicine start in Oregon with Curogram

Curogram is an excellent choice if your practice is located in Oregon and you want to start offering remote services to patients in the state. As we’ve mentioned, our platform complies with all HIPAA rules and comes with built-in security, privacy, and technology safeguards. 

At Curogram, we understand how valuable your time is. That’s why we’ve taken care of all technical aspects, so you can focus on doing what you do best — providing medical care to patients. 

With our platform, you don’t have to worry about the back-end or hire IT professionals and lawyers and spend weeks making sure your telemedicine solution meets HIPAA and Oregon Health Authority Confidentiality and Privacy Rules. Instead, you can get started the same day you sign up, and you have 14 days to check out all of Curogram’s features, free of charge, before you make a commitment. 

Although meeting HIPAA and specific state requirements is a must, it’s not the only thing you should consider when looking for a telemedicine solution. Another critical factor is convenience — the solutions should be simple and easy to use, for both the doctors and medical staff, as well as the patients. 

That’s what makes Curogram stand out in the sea of telemedicine solutions — it’s a platform designed specifically for healthcare professionals, taking all your business needs (and the needs of your patients) and workflows into account. You can quickly set up virtual clinics, host two-way video appointments, chat with other medical staff on your team, and communicate with patients — all from a single, web-based dashboard.

Schedule a demo today and have a successful telemedicine start in Oregon!

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.