Telehealth Certification Institute

Call Now

Text Now

Call Now

Text Now

Ohio

 

Counselors

Source

Counselors, Social Workers, and Marriage and Family Therapists

“teletherapy delivery is defined in paragraph (GG) of rule 4757-3-01 of the Administrative Code. Licensees are reminded that standards of ethical practice and professional conduct rules 4757-5-01 to 4757-5-12 of the Administrative Code apply to teletherapy.

(A) These standards govern the use of electronic or digital services in the provision of services to include when the counselor, social worker or marriage and family therapist and the client are not located in the same place during delivery of services or when electronic systems or digitally-assisted systems are used to support in-person face to face therapy.

(1) All practitioners providing counseling, social work or marriage and family therapy via teletherapy to persons physically present in Ohio shall be licensed in Ohio.

(2) All licensees of this board providing services to clients outside the state of Ohio shall comply with the laws and rules of that jurisdiction.

(3) Licensees shall consider their education, training, and experience before providing teletherapy services and provide only services for which they are competent. Licensees shall assume responsibility to continually assess both their professional and technical competence when providing teletherapy. This includes ensuring that all methods of delivering services are compliant with commonly accepted standards of technology safety and security at the time at which services are rendered.

(4) Licensees shall screen potential distance service clients for appropriateness to receive services via distance methods, which includes considering their current mental and emotional status. Licensee shall screen the client's technological capabilities as part of the intake process. Therapists shall acknowledge power dynamics when working with a family or group with differing levels of technological competence. These considerations shall be documented in the records.

(5) Licensees shall be aware of cultural differences and how they can affect non-verbal cues. Teletherapy methods should be appropriate to the client's cultural experiences and environment, and shall also be sensitive to audio/visual impairment and cognitive impairment.

(6) Licensee shall regularly review whether teletherapy is meeting the goals of therapy.

(7) Teletherapy shall require an initial face-to-face meeting, which may be via video/audio electronically, to verify the identity of the teletherapy client. At that meeting steps shall be taken to address impostor concerns, such as by establishing passwords or phrases to identify the client in future electronic contacts.

(8) Licensees shall identify an appropriately trained professional who can provide local assistance, including crisis intervention, if needed. Licensees shall provide teletherapy clients the local crisis hotline telephone number and the local emergency mental health telephone number.

(9) Licensees shall retain copies of all written therapeutically relevant communication with clients, to include emails, texts, instant messages, and chat history. Records. Such records should be maintained for a minimum of seven years.

(10) Licensees must maintain records in accordance with rule 4757-5-09 of the Administrative Code.

(B) Prior to providing services, licensees must establish informed consent. Informed consent shall include information defining teletherapy delivery as practiced by the licensee and the potential risks and ethical considerations per paragraph (B) of rule 4757-5-02 of the Administrative Code.

(1) Clients shall be given sufficient opportunity to ask questions and receive answers about teletherapy. These discussions should be documented in the client record.

(2) Informed consent should include the risks of entering private information when using a public access computer, or one that is on a shared network, and caution against using auto-fill user names and passwords. Clients should be advised to consider employer policies related to use of work computers for personal communication.

(3) Informed consent shall include the associated needs of delivery method, for example owning a computer with the correct capabilities or internet access, possibility of technology failure and what the procedure is in the event that services are disrupted, anticipated response time to electronic communication, alternative service deliveries, and electronic communication between scheduled appointments and after normal working hours.

(4) Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

(5) Licensees shall obtain written permission prior to recording any part of the teletherapy session. If licensees are storing audiovisual data from sessions, these cannot be released to clients unless the client authorization specifically states they are to be released.

(6) Licensees shall obtain client consent when using electronic search engines to gather information about the client, except in circumstances when such searches may provide information to help protect the client or other parties who may be at risk. The licensee must document the rationale for conducting any electronic search and why it is not harmful to the client.

(7) Licensees shall provide links to websites for all of their certification bodies and licensure boards to facilitate consumer protection. Licensees shall provide a link to the board online license verification site on their web page.

(8) Licensees shall not provide services without client signed informed consent.

(C) Confidentiality in teletherapy service delivery and records maintenance shall be maintained by the licensee.

(1) Licensees shall use encryption methods that are Health Insurance Portability and Accountability Act of 1996 compliant for teletherapy, except for treatment reminders, scheduling contacts or other information provided outside of a therapeutic context.

Clients may waive encryption via informed consent. Licensees must ensure clients understand the risk of non-encrypted communications.

(2) Licensees shall develop and disclose policies for notifying clients as soon as possible of any breach of confidential information.

(3) Licensees shall create a policy for the secure storage, recovery, and destruction of data, as well as the technologies used to store, maintain, and transmit data.”

Social Workers

Source

Counselors, Social Workers, and Marriage and Family Therapists

“teletherapy delivery is defined in paragraph (GG) of rule 4757-3-01 of the Administrative Code. Licensees are reminded that standards of ethical practice and professional conduct rules 4757-5-01 to 4757-5-12 of the Administrative Code apply to teletherapy.

(A) These standards govern the use of electronic or digital services in the provision of services to include when the counselor, social worker or marriage and family therapist and the client are not located in the same place during delivery of services or when electronic systems or digitally-assisted systems are used to support in-person face to face therapy.

(1) All practitioners providing counseling, social work or marriage and family therapy via teletherapy to persons physically present in Ohio shall be licensed in Ohio.

(2) All licensees of this board providing services to clients outside the state of Ohio shall comply with the laws and rules of that jurisdiction.

(3) Licensees shall consider their education, training, and experience before providing teletherapy services and provide only services for which they are competent. Licensees shall assume responsibility to continually assess both their professional and technical competence when providing teletherapy. This includes ensuring that all methods of delivering services are compliant with commonly accepted standards of technology safety and security at the time at which services are rendered.

(4) Licensees shall screen potential distance service clients for appropriateness to receive services via distance methods, which includes considering their current mental and emotional status. Licensee shall screen the client's technological capabilities as part of the intake process. Therapists shall acknowledge power dynamics when working with a family or group with differing levels of technological competence. These considerations shall be documented in the records.

(5) Licensees shall be aware of cultural differences and how they can affect non-verbal cues. Teletherapy methods should be appropriate to the client's cultural experiences and environment, and shall also be sensitive to audio/visual impairment and cognitive impairment.

(6) Licensee shall regularly review whether teletherapy is meeting the goals of therapy.

(7) Teletherapy shall require an initial face-to-face meeting, which may be via video/audio electronically, to verify the identity of the teletherapy client. At that meeting steps shall be taken to address impostor concerns, such as by establishing passwords or phrases to identify the client in future electronic contacts.

(8) Licensees shall identify an appropriately trained professional who can provide local assistance, including crisis intervention, if needed. Licensees shall provide teletherapy clients the local crisis hotline telephone number and the local emergency mental health telephone number.

(9) Licensees shall retain copies of all written therapeutically relevant communication with clients, to include emails, texts, instant messages, and chat history. Records. Such records should be maintained for a minimum of seven years.

(10) Licensees must maintain records in accordance with rule 4757-5-09 of the Administrative Code.

(B) Prior to providing services, licensees must establish informed consent. Informed consent shall include information defining teletherapy delivery as practiced by the licensee and the potential risks and ethical considerations per paragraph (B) of rule 4757-5-02 of the Administrative Code.

(1) Clients shall be given sufficient opportunity to ask questions and receive answers about teletherapy. These discussions should be documented in the client record.

(2) Informed consent should include the risks of entering private information when using a public access computer, or one that is on a shared network, and caution against using auto-fill user names and passwords. Clients should be advised to consider employer policies related to use of work computers for personal communication.

(3) Informed consent shall include the associated needs of delivery method, for example owning a computer with the correct capabilities or internet access, possibility of technology failure and what the procedure is in the event that services are disrupted, anticipated response time to electronic communication, alternative service deliveries, and electronic communication between scheduled appointments and after normal working hours.

(4) Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

(5) Licensees shall obtain written permission prior to recording any part of the teletherapy session. If licensees are storing audiovisual data from sessions, these cannot be released to clients unless the client authorization specifically states they are to be released.

(6) Licensees shall obtain client consent when using electronic search engines to gather information about the client, except in circumstances when such searches may provide information to help protect the client or other parties who may be at risk. The licensee must document the rationale for conducting any electronic search and why it is not harmful to the client.

(7) Licensees shall provide links to websites for all of their certification bodies and licensure boards to facilitate consumer protection. Licensees shall provide a link to the board online license verification site on their web page.

(8) Licensees shall not provide services without client signed informed consent.

(C) Confidentiality in teletherapy service delivery and records maintenance shall be maintained by the licensee.

(1) Licensees shall use encryption methods that are Health Insurance Portability and Accountability Act of 1996 compliant for teletherapy, except for treatment reminders, scheduling contacts or other information provided outside of a therapeutic context.

Clients may waive encryption via informed consent. Licensees must ensure clients understand the risk of non-encrypted communications.

(2) Licensees shall develop and disclose policies for notifying clients as soon as possible of any breach of confidential information.

(3) Licensees shall create a policy for the secure storage, recovery, and destruction of data, as well as the technologies used to store, maintain, and transmit data.”

Marriage and Family Therapists

Source

Counselors, Social Workers, and Marriage and Family Therapists

“teletherapy delivery is defined in paragraph (GG) of rule 4757-3-01 of the Administrative Code. Licensees are reminded that standards of ethical practice and professional conduct rules 4757-5-01 to 4757-5-12 of the Administrative Code apply to teletherapy.

(A) These standards govern the use of electronic or digital services in the provision of services to include when the counselor, social worker or marriage and family therapist and the client are not located in the same place during delivery of services or when electronic systems or digitally-assisted systems are used to support in-person face to face therapy.

(1) All practitioners providing counseling, social work or marriage and family therapy via teletherapy to persons physically present in Ohio shall be licensed in Ohio.

(2) All licensees of this board providing services to clients outside the state of Ohio shall comply with the laws and rules of that jurisdiction.

(3) Licensees shall consider their education, training, and experience before providing teletherapy services and provide only services for which they are competent. Licensees shall assume responsibility to continually assess both their professional and technical competence when providing teletherapy. This includes ensuring that all methods of delivering services are compliant with commonly accepted standards of technology safety and security at the time at which services are rendered.

(4) Licensees shall screen potential distance service clients for appropriateness to receive services via distance methods, which includes considering their current mental and emotional status. Licensee shall screen the client's technological capabilities as part of the intake process. Therapists shall acknowledge power dynamics when working with a family or group with differing levels of technological competence. These considerations shall be documented in the records.

(5) Licensees shall be aware of cultural differences and how they can affect non-verbal cues. Teletherapy methods should be appropriate to the client's cultural experiences and environment, and shall also be sensitive to audio/visual impairment and cognitive impairment.

(6) Licensee shall regularly review whether teletherapy is meeting the goals of therapy.

(7) Teletherapy shall require an initial face-to-face meeting, which may be via video/audio electronically, to verify the identity of the teletherapy client. At that meeting steps shall be taken to address impostor concerns, such as by establishing passwords or phrases to identify the client in future electronic contacts.

(8) Licensees shall identify an appropriately trained professional who can provide local assistance, including crisis intervention, if needed. Licensees shall provide teletherapy clients the local crisis hotline telephone number and the local emergency mental health telephone number.

(9) Licensees shall retain copies of all written therapeutically relevant communication with clients, to include emails, texts, instant messages, and chat history. Records. Such records should be maintained for a minimum of seven years.

(10) Licensees must maintain records in accordance with rule 4757-5-09 of the Administrative Code.

(B) Prior to providing services, licensees must establish informed consent. Informed consent shall include information defining teletherapy delivery as practiced by the licensee and the potential risks and ethical considerations per paragraph (B) of rule 4757-5-02 of the Administrative Code.

(1) Clients shall be given sufficient opportunity to ask questions and receive answers about teletherapy. These discussions should be documented in the client record.

(2) Informed consent should include the risks of entering private information when using a public access computer, or one that is on a shared network, and caution against using auto-fill user names and passwords. Clients should be advised to consider employer policies related to use of work computers for personal communication.

(3) Informed consent shall include the associated needs of delivery method, for example owning a computer with the correct capabilities or internet access, possibility of technology failure and what the procedure is in the event that services are disrupted, anticipated response time to electronic communication, alternative service deliveries, and electronic communication between scheduled appointments and after normal working hours.

(4) Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

(5) Licensees shall obtain written permission prior to recording any part of the teletherapy session. If licensees are storing audiovisual data from sessions, these cannot be released to clients unless the client authorization specifically states they are to be released.

(6) Licensees shall obtain client consent when using electronic search engines to gather information about the client, except in circumstances when such searches may provide information to help protect the client or other parties who may be at risk. The licensee must document the rationale for conducting any electronic search and why it is not harmful to the client.

(7) Licensees shall provide links to websites for all of their certification bodies and licensure boards to facilitate consumer protection. Licensees shall provide a link to the board online license verification site on their web page.

(8) Licensees shall not provide services without client signed informed consent.

(C) Confidentiality in teletherapy service delivery and records maintenance shall be maintained by the licensee.

(1) Licensees shall use encryption methods that are Health Insurance Portability and Accountability Act of 1996 compliant for teletherapy, except for treatment reminders, scheduling contacts or other information provided outside of a therapeutic context.

Clients may waive encryption via informed consent. Licensees must ensure clients understand the risk of non-encrypted communications.

(2) Licensees shall develop and disclose policies for notifying clients as soon as possible of any breach of confidential information.

(3) Licensees shall create a policy for the secure storage, recovery, and destruction of data, as well as the technologies used to store, maintain, and transmit data.”

Psychologists

Source

Ohio is a PSYPACT PARTICIPATING STATE- OH S 2 (Enacted 4/27/2021)

"To practice telepsychology under the authority of PSYPACT, you will need to apply for and obtain an E.Passport from the Association of State and Provincial Psychology Boards (ASPPB) and apply for and obtain an Authority to Practice Interjurisdictional Telepsychology (APIT) from the PSYPACT Commission."

Psychologists

Ohio State Board of Psychology

Chapter 4732-17 Rules of Professional Conduct

Source

(H) Telepsychology.

(1) "Telepsychology" means the practice of psychology or school psychology as those terms are defined in divisions (B) and (E) of section 4732.01 of the Revised Code, including psychological and school psychological supervision, by distance communication technology such as but not necessarily limited to telephone, email, Internet-based communications, and videoconferencing.

(2) In order to practice telepsychology in the state of Ohio one must hold a current, valid license issued by the Ohio board of psychology or shall be a registered supervisee of a licensee being delegated telepsychology practices in compliance with paragraphs (B) and (C) of rule 4732-13-04 of the Administrative Code.

(3) License holders understand that this rule does not provide licensees with authority to practice telepsychology in service to clients domiciled in any jurisdiction other than Ohio, and licensees bear responsibility for complying with laws, rules, and/or policies for the practice of telepsychology set forth by other jurisdictional boards of psychology.

(4) License holders practicing telepsychology shall comply with all of these rules of professional conduct and with requirements incurred in state and federal statutes relevant to the practice of psychology and school psychology.

(5) License holders shall establish and maintain current competence in the professional practice of telepsychology through continuing education, consultation, or other procedures, in conformance with prevailing standards of scientific and professional knowledge. License holders shall establish and maintain competence in the appropriate use of the information technologies utilized in the practice of telepsychology.

(6) License holders recognize that telepsychology is not appropriate for all psychological problems and clients, and decisions regarding the appropriate use of telepsychology are made on a case-by-case basis. License holders practicing telepsychology are aware of additional risks incurred when practicing psychology or school psychology through the use of distance communication technologies and take special care to conduct their professional practice in a manner that protects the welfare of the client and ensures that the client's welfare is paramount. License holders practicing telepsychology shall:

(a) Conduct a risk-benefit analysis and document findings specific to:

(i) Whether the client's presenting problems and apparent condition is consistent with the use of telepsychology to the client's benefit; and

(ii) Whether the client has sufficient knowledge and skills in the use of the technology involved in rendering the service or can use a personal aid or assistive device to benefit from the service.

(b) Not provide telepsychology services to any person or persons when the outcome of the analysis required in paragraphs (I)(6)(a)(i) and (I)(a)(ii) of this rule is inconsistent with the delivery of telepsychology services, whether related to clinical or technological issues.

(c) Upon initial and subsequent contacts with the client, make reasonable efforts to verify the identity of the client;

(d) Obtain alternative means of contacting the client;

(e) Provide to the client alternative means of contacting the licensee;

(f) Establish a written agreement relative to the client's access to face-to-face emergency services in the client's geographical area, in instances such as, but not necessarily limited to, the client experiencing a suicidal or homicidal crisis;

(g) Licensees, whenever feasible, use secure communications with clients, such as encrypted text messages via email or secure websites, and obtain and document consent for the use of non-secure communications.

(h) Prior to providing telepsychology services, obtain the written informed consent of the client, in language that is likely to be understood and consistent with accepted professional and legal requirements, relative to:

(i) The limitations and innovative nature of using distance technology in the provision of psychological or school psychological services;

(ii) Potential risks to the confidentiality of information due to the use of distance technology;

(iii) Potential risks of sudden and unpredictable disruption of telepsychology services and how an alternative means of re-establishing electronic or other connection will be used under such circumstances;

(iv) When and how the licensee will respond to routine electronic messages;

(v) Under what circumstances the licensee and service recipient will use alternative means of communications under emergency circumstances;

(vi) Who else may have access to communications between the client and the licensee;

(vii) Specific methods for ensuring that a client's electronic communications are directed only to the licensee or supervisee;

(viii) How the licensee stores electronic communications exchanged with the client;

(7) Ensure that confidential communications stored electronically cannot be recovered and/or accessed by unauthorized persons when the licensee disposes of electronic equipment and data;

(8) If in the context of a face-to-face professional relationship the following are exempt from this rule:

(a) Electronic communication used specific to appointment scheduling, billing, and/or the establishment of benefits and eligibility for services; and,

(b) Telephone or other electronic communications made for the purpose of ensuring client welfare in accord with reasonable professional judgment.

Psychiatrists

Source

Rule 4757-5-13 | Standards of practice and professional conduct: electronic service delivery (internet, email, teleconference, etc.).

Ohio Administrative Code/4757/Chapter 4757-5 | Code of Ethics

“teletherapy delivery is defined in paragraph (GG) of rule 4757-3-01 of the Administrative Code. Licensees are reminded that standards of ethical practice and professional conduct rules 4757-5-01 to 4757-5-12 of the Administrative Code apply to teletherapy.

(A) These standards govern the use of electronic or digital services in the provision of services to include when the counselor, social worker or marriage and family therapist and the client are not located in the same place during delivery of services or when electronic systems or digitally-assisted systems are used to support in-person face to face therapy.

(1) All practitioners providing counseling, social work or marriage and family therapy via teletherapy to persons physically present in Ohio shall be licensed in Ohio.

(2) All licensees of this board providing services to clients outside the state of Ohio shall comply with the laws and rules of that jurisdiction.

(3) Licensees shall consider their education, training, and experience before providing teletherapy services and provide only services for which they are competent. Licensees shall assume responsibility to continually assess both their professional and technical competence when providing teletherapy. This includes ensuring that all methods of delivering services are compliant with commonly accepted standards of technology safety and security at the time at which services are rendered.

(4) Licensees shall screen potential distance service clients for appropriateness to receive services via distance methods, which includes considering their current mental and emotional status. Licensee shall screen the client's technological capabilities as part of the intake process. Therapists shall acknowledge power dynamics when working with a family or group with differing levels of technological competence. These considerations shall be documented in the records.

(5) Licensees shall be aware of cultural differences and how they can affect non-verbal cues. Teletherapy methods should be appropriate to the client's cultural experiences and environment, and shall also be sensitive to audio/visual impairment and cognitive impairment.

(6) Licensee shall regularly review whether teletherapy is meeting the goals of therapy.

(7) Teletherapy shall require an initial face-to-face meeting, which may be via video/audio electronically, to verify the identity of the teletherapy client. At that meeting steps shall be taken to address impostor concerns, such as by establishing passwords or phrases to identify the client in future electronic contacts.

(8) Licensees shall identify an appropriately trained professional who can provide local assistance, including crisis intervention, if needed. Licensees shall provide teletherapy clients the local crisis hotline telephone number and the local emergency mental health telephone number.

(9) Licensees shall retain copies of all written therapeutically relevant communication with clients, to include emails, texts, instant messages, and chat history. Records. Such records should be maintained for a minimum of seven years.

(10) Licensees must maintain records in accordance with rule 4757-5-09 of the Administrative Code.

(B) Prior to providing services, licensees must establish informed consent. Informed consent shall include information defining teletherapy delivery as practiced by the licensee and the potential risks and ethical considerations per paragraph (B) of rule 4757-5-02 of the Administrative Code.

(1) Clients shall be given sufficient opportunity to ask questions and receive answers about teletherapy. These discussions should be documented in the client record.

(2) Informed consent should include the risks of entering private information when using a public access computer, or one that is on a shared network, and caution against using auto-fill user names and passwords. Clients should be advised to consider employer policies related to use of work computers for personal communication.

(3) Informed consent shall include the associated needs of delivery method, for example owning a computer with the correct capabilities or internet access, possibility of technology failure and what the procedure is in the event that services are disrupted, anticipated response time to electronic communication, alternative service deliveries, and electronic communication between scheduled appointments and after normal working hours.

(4) Informed consent should include a discussion of how teletherapy may affect billing and access to insurance benefits.

(5) Licensees shall obtain written permission prior to recording any part of the teletherapy session. If licensees are storing audiovisual data from sessions, these cannot be released to clients unless the client authorization specifically states they are to be released.

(6) Licensees shall obtain client consent when using electronic search engines to gather information about the client, except in circumstances when such searches may provide information to help protect the client or other parties who may be at risk. The licensee must document the rationale for conducting any electronic search and why it is not harmful to the client.

(7) Licensees shall provide links to websites for all of their certification bodies and licensure boards to facilitate consumer protection. Licensees shall provide a link to the board online license verification site on their web page.

(8) Licensees shall not provide services without client signed informed consent.

(C) Confidentiality in teletherapy service delivery and records maintainence shall be maintained by the licensee.

(1) Licensees shall use encryption methods that are Health Insurance Portability and Accountability Act of 1996 compliant for teletherapy, except for treatment reminders, scheduling contacts or other information provided outside of a therapeutic context.

Clients may waive encryption via informed consent. Licensees must ensure clients understand the risk of non-encrypted communications.

(2) Licensees shall develop and disclose policies for notifying clients as soon as possible of any breach of confidential information.

(3) Licensees shall create a policy for the secure storage, recovery, and destruction of data, as well as the technologies used to store, maintain, and transmit data.

(D) During the COVID-19 state of emergency as declared by the governor, licensees may:

(1) Provide services without completing an initial face to face video or in-person session;

(2) Obtain and record verbal acknowledgement of informed consent when it cannot be obtained in writing; and

(3) Follow guidance issued by the United States department of health and human services regarding compliance with HIPAA requirements.”

Ohio Professional Regulation/Health & Safety Online Prescribing

Source

Rule 4731-11-09 | Prescribing to persons not seen by the physician.

Ohio Administrative Code/4731/Chapter 4731-11 | Controlled Substances

“(A) Except as provided in paragrah (D) of this rule, a physician shall not prescribe, personally furnish, otherwise provide, or cause to be provided, any controlled substance to a person on whom the physician has never conducted a physical examination.

(B) Except as provided in paragraph (C) of this rule, a physician shall not prescribe, personally furnish, otherwise provide, or cause to be provided, any prescription drug that is not a controlled substance to a person on whom the physician has never conducted a physical examination.

(C) A physician may prescribe, personally furnish, otherwise provide, or cause to be provided a prescription drug that is not a controlled substance to a person on whom the physician has never conducted a physical examination and who is at a location remote from the physician by complying with all of the following requirements:

(1) The physician shall establish the patient's identity and physical location;

(2) The physician shall obtain the patient's informed consent for treatment through a remote examination;

(3) The physician shall request the patient's consent and, if granted, forward the medical record to the patient's primary care provider or other health care provider, if applicable, or refer the patient to an appropriate health care provider or health care facility;

(4) The physician shall, through interaction with the patient, complete a medical evaluation that is appropriate for the patient and the condition with which the patient presents and that meets the minimal standards of care, which may include portions of the evaluation having been conducted by other Ohio licensed healthcare providers acting within the scope of their professional license;

(5) The physician shall establish or confirm, as applicable, a diagnosis and treatment plan, which includes documenation of the necessity for the utilization of a prescription drug. The diagnosis and treatment plan shall include the identification of any underlying conditions or contraindications to the recommended treatment;

(6) The physician shall document in the patient's medical record the patient's consent to treatment through a remote evaulation, pertinent history, evaluation, diagnosis, treatment plan, underlying conditions, any contraindications, and any referrals to appropriate health care providers, including primary care providers or health care facilities;

(7) The physician shall provide appropriate follow-up care or recommend follow-up care with the patient's primary care provider, other appropriate health care provider, or health care facility in accordance with the minimal standards of care;

(8) The physician shall make the medical record of the visit available to the patient;

(9) The physician shall use appropriate technology that is sufficient for the physician to conduct all steps in this paragraph as if the medical evaluation occurred in an in-person visit.

(D) A physician may prescribe, personally furnish, otherwise provide, or cause to be provided a prescription drug that is a controlled substance to a person on whom the physician has not conducted a physical examination and who is at a location remote from the physician in any of the following situations:

(1) The person is an active patient, as that term is defined in paragraph (D) of rule 4731-11-01 of the Administrative Code, of an Ohio licensed physician or other health care provider who is a colleague of the physician and the drugs are provided pursuant to an on call or cross coverage arrangement between them and the physician complies with all steps of paragraph (C) of this rule;

(2) The patient is physically located in a hospital or clinic registered with the United States drug enforcement administration to personally furnish or provide controlled substances, when the patient is being treated by an Ohio licensed physician or other healthcare provider acting in the usual course of their practice and within the scope of their professional license and who is registered with the United States drug enforcement administration to prescribe or otherwise provide controlled substances in Ohio.

(3) The patient is being treated by, and in the physical presence of, an Ohio licensed physician or healthcare provider acting in the usual course of their practice and within the scope of their professional license, and who is registered with the United States drug enforcement administration to prescribe or otherwise provide controlled substances in Ohio.

(4) The physician has obtained from the administrator of the United States drug enforcement administration a special registration to prescribe or otherwise provide controlled substances in Ohio.

(5) The physician is the medical director, hospice physician, or attending physician for a hospice program licensed pursuant to Chapter 3712. of the Revised Code and both of the following conditions are met:

(a) The controlled substance is being provided to a patient who is enrolled in that hospice program, and

(b) The prescription is transmitted to the pharmacy by a means that is compliant with Ohio board of pharmacy rules.

(6) The physician is the medical director of, or attending physician at, an institutional facility, as that term is defined in rule 4729-17-01 of the Administrative Code, and both of the following conditions are met:

(a) The controlled substance is being provided to a person who has been admitted as an inpatient to or is a resident of an institutional facilty, and

(b) The prescription is transmitted to the pharmacy by a means that is compliant with Ohio board of pharmacy rules.

(E) Nothing in this rule shall be construed to imply that one in-person physician examination demonstrates that a prescription has been issued for a legitimate medical purpose within the course of professional practice.

(F) A violation of any provision of this rule, as determined by the board, shall constitute any or all of the following:

(1) "Failure to maintain minimal standards applicable to the selection or administration of drugs," as that clause is used in division (B)(2) of section 4731.22 of the Revised Code;

(2) "Selling, prescribing, giving away, or administering drugs for other than legal and legitimate therapeutic purposes," as that clause is used in division (B)(3) of section 4731.22 of the Revised Code; or

(3) "A departure from or the failure to conform to minimal standards of care of similar practitioners under the same or similar circumstances, whether or not actual injury to a patient is established," as that clause is used in division (B)(6) of section 4731.22 of the Revised Code.

(G) For purposes of this rule, "informed consent" means a process of communication between a patient and physician discussing the risks and benefits of, and alternatives to, treatment through a remote evaluation that results in the patient's agreement or signed authorization to be treated through an evaluation conducted through appropriate technology when the physician is in a location remote from the patient.

(H) This rule shall not apply to any prescribing situations specifically authorized by the Revised Code or Administrative Code.

(I) For purposes of this rule, "patient" means a person for whom the physician provides healthcare services or the person's representative.”

Refer to the source provided for all requirements and limitations.

Nurses

We are not aware of any specific rules and regulations of the practice of telemental health services for Nurses.

Ohio Professional Regulation/Health & Safety Online Prescribing

Source

Rule 4731-11-09 | Prescribing to persons not seen by the physician.

Ohio Administrative Code/4731/Chapter 4731-11 | Controlled Substances

“(A) Except as provided in paragrah (D) of this rule, a physician shall not prescribe, personally furnish, otherwise provide, or cause to be provided, any controlled substance to a person on whom the physician has never conducted a physical examination.

(B) Except as provided in paragraph (C) of this rule, a physician shall not prescribe, personally furnish, otherwise provide, or cause to be provided, any prescription drug that is not a controlled substance to a person on whom the physician has never conducted a physical examination.

(C) A physician may prescribe, personally furnish, otherwise provide, or cause to be provided a prescription drug that is not a controlled substance to a person on whom the physician has never conducted a physical examination and who is at a location remote from the physician by complying with all of the following requirements:

(1) The physician shall establish the patient's identity and physical location;

(2) The physician shall obtain the patient's informed consent for treatment through a remote examination;

(3) The physician shall request the patient's consent and, if granted, forward the medical record to the patient's primary care provider or other health care provider, if applicable, or refer the patient to an appropriate health care provider or health care facility;

(4) The physician shall, through interaction with the patient, complete a medical evaluation that is appropriate for the patient and the condition with which the patient presents and that meets the minimal standards of care, which may include portions of the evaluation having been conducted by other Ohio licensed healthcare providers acting within the scope of their professional license;

(5) The physician shall establish or confirm, as applicable, a diagnosis and treatment plan, which includes documenation of the necessity for the utilization of a prescription drug. The diagnosis and treatment plan shall include the identification of any underlying conditions or contraindications to the recommended treatment;

(6) The physician shall document in the patient's medical record the patient's consent to treatment through a remote evaulation, pertinent history, evaluation, diagnosis, treatment plan, underlying conditions, any contraindications, and any referrals to appropriate health care providers, including primary care providers or health care facilities;

(7) The physician shall provide appropriate follow-up care or recommend follow-up care with the patient's primary care provider, other appropriate health care provider, or health care facility in accordance with the minimal standards of care;

(8) The physician shall make the medical record of the visit available to the patient;

(9) The physician shall use appropriate technology that is sufficient for the physician to conduct all steps in this paragraph as if the medical evaluation occurred in an in-person visit.

(D) A physician may prescribe, personally furnish, otherwise provide, or cause to be provided a prescription drug that is a controlled substance to a person on whom the physician has not conducted a physical examination and who is at a location remote from the physician in any of the following situations:

(1) The person is an active patient, as that term is defined in paragraph (D) of rule 4731-11-01 of the Administrative Code, of an Ohio licensed physician or other health care provider who is a colleague of the physician and the drugs are provided pursuant to an on call or cross coverage arrangement between them and the physician complies with all steps of paragraph (C) of this rule;

(2) The patient is physically located in a hospital or clinic registered with the United States drug enforcement administration to personally furnish or provide controlled substances, when the patient is being treated by an Ohio licensed physician or other healthcare provider acting in the usual course of their practice and within the scope of their professional license and who is registered with the United States drug enforcement administration to prescribe or otherwise provide controlled substances in Ohio.

(3) The patient is being treated by, and in the physical presence of, an Ohio licensed physician or healthcare provider acting in the usual course of their practice and within the scope of their professional license, and who is registered with the United States drug enforcement administration to prescribe or otherwise provide controlled substances in Ohio.

(4) The physician has obtained from the administrator of the United States drug enforcement administration a special registration to prescribe or otherwise provide controlled substances in Ohio.

(5) The physician is the medical director, hospice physician, or attending physician for a hospice program licensed pursuant to Chapter 3712. of the Revised Code and both of the following conditions are met:

(a) The controlled substance is being provided to a patient who is enrolled in that hospice program, and

(b) The prescription is transmitted to the pharmacy by a means that is compliant with Ohio board of pharmacy rules.

(6) The physician is the medical director of, or attending physician at, an institutional facility, as that term is defined in rule 4729-17-01 of the Administrative Code, and both of the following conditions are met:

(a) The controlled substance is being provided to a person who has been admitted as an inpatient to or is a resident of an institutional facilty, and

(b) The prescription is transmitted to the pharmacy by a means that is compliant with Ohio board of pharmacy rules.

(E) Nothing in this rule shall be construed to imply that one in-person physician examination demonstrates that a prescription has been issued for a legitimate medical purpose within the course of professional practice.

(F) A violation of any provision of this rule, as determined by the board, shall constitute any or all of the following:

(1) "Failure to maintain minimal standards applicable to the selection or administration of drugs," as that clause is used in division (B)(2) of section 4731.22 of the Revised Code;

(2) "Selling, prescribing, giving away, or administering drugs for other than legal and legitimate therapeutic purposes," as that clause is used in division (B)(3) of section 4731.22 of the Revised Code; or

(3) "A departure from or the failure to conform to minimal standards of care of similar practitioners under the same or similar circumstances, whether or not actual injury to a patient is established," as that clause is used in division (B)(6) of section 4731.22 of the Revised Code.

(G) For purposes of this rule, "informed consent" means a process of communication between a patient and physician discussing the risks and benefits of, and alternatives to, treatment through a remote evaluation that results in the patient's agreement or signed authorization to be treated through an evaluation conducted through appropriate technology when the physician is in a location remote from the patient.

(H) This rule shall not apply to any prescribing situations specifically authorized by the Revised Code or Administrative Code.

(I) For purposes of this rule, "patient" means a person for whom the physician provides healthcare services or the person's representative.”

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

Source: OAC 5160-1-18

Originating Site Reimbursement: The Patient's home is an eligible originating site.

Refer to the source provided for all requirements and limitations.

Private Pay Telehealth Parity Law

Source: OH Revised Code Annotated, 3902.30. (HB – 166)

"(B)(1) A health benefit plan shall provide coverage for telemedicine services on the same basis and to the same extent that the plan provides coverage for the provision of in-person health care services.
(2) A health benefit plan shall not exclude coverage for service solely because it is provided as a telemedicine service."

Refer to the source provided for all requirements and limitations.

Payment Parity

We are not aware of any explicit payment parity.

*Clinicians who have had an experience with telehealth reimbursement in this state are invited to share their experiences in the comments section below: a) type of service provided; b) insurance provider; c) payment parity, payment issues, or insurance requirements

Permission for the Temporary Practice of Clinicians Licensed Outside the State

We are not aware of any permission that allows for services delivered by out-of-state providers.

Note: As this is a free resource and Rules and Regulations regarding Telehealth are always changing, we appreciate any updates or corrections. They can be emailed to us at [email protected] with a link to the source or a citation of the rule or regulation.

Telemental Health Training Certificate Program

Telemental health is not a separate service from mental health services. All state licensing boards require that licensed clinicians follow all the regulations for practicing under their license no matter what medium of communication is used. All licensing boards also require that clinicians only practice within the boundaries of their competence. This usually requires education, continuing education, and/or supervision in telemental health. Complete our telehealth training program to cover all the essential competencies of providing telemental health services and earn the THTC (Telemental Health Training Certificate).