Page 14 - Part 2 Introduction to Telemedicine

SVMIC Introduction to Telemedicine

Self-Referral

The Stark law and the anti-kickback statute apply to telemedicine just as
4
5
they do to in-person care. Several Office of the Inspector General (OIG)
opinions deal explicitly with telemedical arrangements (e.g. 11-12, 99-14,
and 02-12), and these should be reviewed if, for example, a hospital wishes
to provide a physician with some of the equipment needed to perform

distance care services.

Parity of Professional and Ethical Standards for

In-Person and Online Services

States that have adopted the FSMB Model Policy generally share

the consensus that the standard of care for physicians is the same
for telemedicine as for practice in person. This includes adherence

to national and international codes of ethics and quality standards

applicable to each specialty.

A physician’s professional discretion as to the diagnoses, scope of

care or treatment should not be limited or influenced by non-
clinical considerations of telemedicine technologies, and physician

remuneration or treatment recommendations should not be

materially based on the delivery of patient-desired outcomes (i.e. a
prescription or referral) or the utilization of telemedicine

technologies.
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However, some states impose ethical requirements on

telemedicine above what they require for in-person visits. For

example, Tennessee (among others), stipulates that a facilitator

4 42 U.S.C. § 1395nn - Limitation on certain physician referrals
5 42 U.S. Code § 1320a-7b - Criminal penalties for acts involving Federal health care programs
6 Federation of State Medical Boards. 2014. Model policy for the appropriate use of telemedicine technologies in
the practice of medicine. Report of the State Medical Boards’ Appropriate Regulation of Telemedicine (SMART)
Workgroup. Adopted as policy by the Federation of State Medical Boards in April, 2014.

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