Health care providers and other entities face a host of legal and practical challenges as they implement telehealth and telemedicine initiatives.

For example, providers of telehealth services, and the entities creating or hosting telehealth platforms, must determine which federal and state privacy and security laws apply to them.  These laws, such as the federal Health Insurance Portability and Accountability Act (HIPAA), may impose privacy and security restrictions, as well as restrictions on the use of data for marketing.  Additional privacy and security complications may arise if providers choose to store data from telehealth encounters on the “cloud.”

Provider licensing laws also affect the provision of telehealth; these vary from state to state and may prevent providers from remotely treating patients in other states.  The Federation of State Medical Boards, a non-profit group representing state medical boards, is currently developing an Interstate Medical Licensure Compact which would expedite the licensure process for physicians looking to practice in multiple states, and would regulate which state medical board has jurisdiction over cross-border medical interactions.  Similarly, telehealth makes provider credentialing and privileging decisions more challenging.

Given the sometimes overlapping jurisdiction of federal and state agencies, there is also some uncertainty regarding which agencies will regulate and oversee various aspects of telehealth.  For example, the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services enforces HIPAA.  The FDA’s Center for Devices and Radiological Health (CDRH) ensures the safety and effectiveness of “medical devices” used in telehealth systems.  Similarly, the FTC has become increasingly involved in the health care sphere and may use its authority to protect patients from “unfair or deceptive acts or practices”; the FTC has also asserted jurisdiction over certain health care data breaches.

Telehealth also raises novel questions regarding medical liability.  For example, it is unclear whether liability could attach to a failure to identify patterns flagged by remote monitoring technologies or in health-related apps used by patients.  Additionally, where providers treat patients in other states, it is not certain which state medical liability laws or standards of care will apply, and whether medical malpractice policies will cover suits arising from these interactions.

In addition to these legal and regulatory questions, practical considerations in telehealth expansion include gaps in broadband access, rapidly changing technologies, and the fact that telehealth may not easily fit into a providers’ current practice patterns.  Finally, reimbursement practices are inconsistent across public and private payers, making the financial viability of telehealth programs uncertain.

Photo of Anna D. Kraus Anna D. Kraus

Anna Durand Kraus advises on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (“HHS”) gives her broad experience with, and valuable insight into…

Anna Durand Kraus advises on issues relating to the complex array of laws governing the health care industry. Her background as Deputy General Counsel to the U.S. Department of Health and Human Services (“HHS”) gives her broad experience with, and valuable insight into, the programs and issues within the purview of HHS, including Medicare, Medicaid, fraud and abuse, and HIPAA privacy and security. Anna is co-chair of the firm’s Health Care Industry practice group.

Anna regularly advises clients on Medicare reimbursement matters, particularly those arising under Part B and the Part D prescription drug benefit. She also has extensive experience with the Medicaid Drug Rebate program. She assists numerous pharmaceutical and device manufacturers, health care providers, pharmacy benefit managers, and other health care industry stakeholders to navigate the challenges and opportunities presented by the Affordable Care Act.

Anna is a trusted adviser on health information privacy, security and breach notification issues, including those arising under the Health Insurance Portability and Accountability Act (“HIPAA”) and the Health Information Technology for Economic and Clinical Health (“HITECH”) Act. Her background in this area dates back to the issuance of the original HIPAA privacy regulations.

Anna’s clients depend on her to guide them through compliance with the Anti-Kickback statute, the Stark regulations, and other laws preventing fraud and abuse in the health care industry. Her deep knowledge of these laws has made her an important component of the firm’s representation of pharmaceutical companies and health care organizations under federal investigation or facing allegations under the False Claims Act. In addition, clients contemplating acquisitions in the health care sector rely on her to guide due diligence efforts.