Once limited to rural or remote communities, telehealth (including telemedicine) is increasingly being used, both inside and outside the United States, to expand the geographic reach of health services and improve access to health care. Telehealth encompasses a wide range of practices, including medically related interactions among providers and patients through email, telephone, Internet, video-conference, and remote devices.

Many factors are driving growth and innovation in telehealth. Individuals now armed with smartphones, laptops, and tablet computers are often only an application away from telehealth platforms that can link them to physicians and other health professionals who can potentially diagnose, treat, monitor, and provide medical consultations on a diverse and growing number of health conditions. Along with such improvements in technology, telehealth is also increasingly being seen as an effective tool for improving health outcomes and access to care, especially in underserved areas. For example, many hospitals are using telehealth to expand their service offerings by collaborating with other hospitals, both domestically and internationally, in the development of programs such as "Tele-ICU," "Tele-Stroke," and "TelePathology." Also, physician groups are using telehealth to better track and more frequently interact with patients.

Services/Scope of Practice

Epstein Becker Green (EBG) helps companies navigate the many legal challenges affecting telehealth and manage the risks that can arise in a telehealth setting. We counsel clients on all aspects of the law as it relates to telehealth, including:

  • Pathways for third-party reimbursement under federal and state health care programs and within the private payer market
  • Compliance with state and federal laws affecting the practice of telehealth
  • Compliance with health care fraud and abuse laws
  • Medical liability risk management
  • Contract negotiations with providers, payers, and telehealth technology companies
  • The impact of current and pending legislation and regulations on client operations
  • The impact of legislation on corporate structures and reimbursement
  • The coordination of client issues with professional and trade associations
  • State legislation and regulation
  • The development of coalitions supporting policy issues

Epstein Becker Green attorneys have an in-depth focus on the regulation of telemedicine, mobile health, health information technology, and other software and remote monitoring applications used in the health care context. We have been at the forefront of the development of global regulatory policy for health information technology and integrally involved in the regulatory challenges facing the telehealth market.

Representative Experience

We counsel companies involved in all aspects of telehealth, including hospitals, physicians and health care professionals, medical groups, clinics, device manufacturers, information technology companies, web-service providers, and investors. In addition, we have assisted clients in the following matters:

  • EBG represented a client that provides personalized second opinions to primary care and attending physicians from specialists at some of the most respected hospitals in the country. The firm provides continuing counseling on a range of regulatory issues impacting the company’s business model, marketing, and physician arrangements.
  • EBG advised a service provider that connects treating physicians facing challenging cases with medical experts and enables patients to seek second opinions through their services platform. The expert review and report can be provided peer to peer or directly to the patient. EBG has advised on scope of practice, licensure, terms of use, and marketing issues.
  • EBG counseled one of the largest providers of telehealth medical consultations in the United States. The company provides access to U.S. board-certified doctors and pediatricians via phone or online video consultations and is expected to perform almost 250,000 virtual consults in 2014. In addition to health care regulatory matters, our services included advising on ERISA and a number of state policy and advocacy matters.
  • EBG has advised multiple clients that provide video consults via smartphone/tablet apps between a network of available physicians and patients all across the United States. One client-involved network of U.S. licensed physicians is affiliated with independent physician-owned medical practices throughout the United States. EBG has provided continuing counsel and advice on a number of regulatory matters, including scope of practice, licensure, prescribing, privacy and security, corporate practice of medicine, and fraud and abuse.
  • EBG has advised a clinic in Washington, D.C., providing primary care services to Latino residents of Washington, D.C. The clinic won a half-million dollar grant from a large insurer to implement a regional telepsychiatry program. EBG is currently advising the clinic on a number of regulatory issues regarding implementation of the telepsychiatry program.
  • EBG is providing regulatory counsel to a large insurer regarding the various telehealth initiatives that the company is launching around the country.
  • EBG has advised a client that has initiated a national genetic counseling testing program provided via a telehealth platform. EBG provided counsel and advice on a number of state regulatory matters.
  • EBG has counseled one of Montana’s largest comprehensive hospitals, serving the health care needs of more than 400,000 people in a four-state area, focused on being a technology leader in the health care industry. EBG advised on transactional matters and prepared a number of agreements between the health system and the participating telehealth sites.
  • EBG has advised a legal and regulatory telehealth organization—delivering vital support to the community on topics such as physician and nurse licensure, credentialing and privileging, Medicare and Medicaid reimbursement, and private insurance payment policies. EBG provides regulatory and reimbursement counseling.

EBG has extensive experience working with telehealth, peer-to-peer, and similar virtual care businesses to develop business models and arrangements that navigate various federal and state laws and regulations to achieve the business’ goal. We also regularly advise on data privacy and security and other legal issues arising in the context of a technology-based and virtual health care model.

Thought Leadership

In keeping with the firm's commitment to telehealth, Epstein Becker Green has developed TechHealth Perspectives—a popular blog dedicated to telehealth legal and regulatory issues, which has addressed such issues as telehealth reimbursement, privacy and security, FDA-related issues, corporate-related issues, and other issues affecting telehealth.

The practice has also published the 50-State Survey of Telemental/Telebehavioral Health (2016)a groundbreaking, comprehensive survey on the laws, regulations, and regulatory policies impacting telemental health in all 50 states and the District of Columbia.

One of the firm's lawyers is also a member of the Legal Resource Team for the Center for Telehealth and eHealth Law ("CTeL") and was the former Regulatory Counsel for CTeL. He also co-authored “Navigating the Telehealth Landscape: Legal and Regulatory Issues,” published by Bloomberg BNA’s Portfolio Series. EBG lawyers write and speak frequently regarding issues related to telehealth.

For more information on Epstein Becker Green and its telehealth-related services, please contact one of our Telehealth lawyers.