In today’s video, we look at some of the convoluted, quirky paths that teletherapy laws and regulations can take.

Hi, I’m Michael H. Cohen, founding attorney of the Cohen Healthcare Law Group. We help healthcare industry clients like you, navigate healthcare and FDA legal issues so you can grow, scale your healthcare business.

Today, we’ll look at two quirky telemedicine rules.

The first is Colorado Revised Statutes, Section 12-43-226(2).  It says that Colorado allows an out-of-state psychologist, social worker, marriage and family therapist, licensed professional counselor, psychotherapist, or addiction counselor to practice under the following restrictions:

“The provisions of this article shall not apply to a person who resides in another state and who is currently licensed or certified as a psychologist, marriage and family therapist, clinical social worker, professional counselor, or addiction counselor in that state to the extent that the licensed or certified person performs activities or services in this state, if the activities and services are:

Performed within the scope of the person’s license or certification; Do not exceed twenty days per year in this state; Are not otherwise in violation of this article; and Disclosed to the public that the person is not licensed or certified in this state.”

So, there’s some teletherapy quirky allowance there. If you’re licensed somewhere outside Colorado, and say your patient goes to Colorado for vacation or their second home, you can continue to provide services, but only up to 20 days per year in Colorado, and you must disclose that you are not licensed in the state. That’s how it works.

At first, this sounds liberal, in that you can provide up to 20 days of therapy to a Colorado resident if you’re not licensed there, but on second thought, if it is your patient that is traveling there and it’s more than 20 days, what happens? Seems you’re stuck; seems to imply that you can’t continue having phone calls with them, if phones calls are considered teletherapy.  Unless you can make the argument that you are not providing services “in” Colorado, that will be another possibility. A lot of ambiguity, a lot of quirkiness.

Here is the second quirky legal rule, this is from another state, a Board regulation that states: “The Board recommends an initial face-to-face visit before teletherapy is used and expects psychologists to have periodic face-to-face visits throughout the therapeutic relationship….”

Further: “It is recommended that the initial therapeutic contact be in person and adequate to provide a conclusive diagnosis and therapeutic treatment plan prior to implementing any psychotherapy through electronic means. The healthcare professional is expected to establish an ongoing therapeutic relationship including face-to-face visits on a periodic basis thereafter.”

So, you don’t get off the hook, like you do in other States, just by “establishing” the relationship with the patient or client.  But you have to conduct periodic “face-to-face” visits during the therapeutic relationship.

Presumably, that means your face has to be in the same room as their face, not just digitally—unless somewhere else the rules define “face-to-face” like including Zoom or Facetime. Again, this stuff is so layered and dense, you got to break your way through it.

You can see how convoluted the telehealth rules get, how much they vary by State. So, we want to dive deep with you and make sure that you get it right.

Thanks for watching. Please contact us with your questions. We have helped hundreds and hundreds of clients navigate the telemedicine, telehealth space. We look forward to working with you on your journey to success!