Oregon’s Medicaid programs is one of the few that will reimburse for email and telephone under its telehealth policy.
Oregon’s interstate practice laws are still a little restrictive, and with no legislation proposed for joining the Interstate Medical Licensure Compact, we don’t know how long it could take for those policies to change. Regardless, Oregon is well on its way to being a true leader in the telehealth policy department.
As of January 1, 2021, Oregon Health Authority covers medically necessary and appropriate physical, behavioral and oral health services within Oregon Health Plan (OHP) covered benefit plans. A recently passed piece of legislation also requires coverage of synchronous and asynchronous transmission using audio-only, video only, audio and video and transmission of data from remote monitoring devices in certain circumstances.
The Oregon Medical Board supports a consistent standard of care and scope of practice for licensees, regardless of the delivery tool or business method enabling provider-patient communication. Telemedicine is not a separate form of medicine, but rather a delivery tool. It is the practice of medicine, through means of electronic communication, information technology, or other means of interaction between a licensee at one location and a patient in another location. See the Oregon Medical Board’s Statement of Philosophy on Telemedicine for guidance.
The practice of medicine occurs at the patient’s location when technology is used to provide care. The provider must possess appropriate licensure in all jurisdictions where the patient receives care. Providers practicing via telemedicine on patients located in Oregon must be licensed in Oregon.*
Oregon Medical Board licensees intending to practice via telemedicine on patients outside of Oregon (including patients located in Washington) must check with the other state’s licensing board. Most states or jurisdictions require providers to be licensed, and some have enacted limitations on telemedicine practice or require or offer a special registration. See the Federation of State Medical Boards Directory for a list of all U.S. medical boards.
When practicing via telemedicine, the licensee is expected to maintain an appropriate provider-patient relationship and is held to the same standard of care. The Board does not require an in-person visit to establish or maintain the provider-patient relationship; however, some situations and presentations are appropriate to provide care via telemedicine, while some are not.
*On December 3, 2020, the U.S. Department of Health and Human Services issued a 4th amendment to the Declaration under the Public Readiness and Emergency Preparedness Act (PREP Act) to increase access to critical countermeasures against COVID-19. The amendment authorizes health care personnel who are permitted to order and administer a Covered Countermeasure (defined in the PREP Act) through telehealth in a state may do so for patients in another state so long as the health care personnel comply with the legal requirements of the state in which the health care personnel are permitted to order and administer the Covered Countermeasure by means of telehealth.Please note during the COVID-19 declared emergency in Oregon, an out of state physician or physician assistant may also request Temporary Authorization to practice in Oregon under OAR 847-010-0068. There is no fee for this request and the scope of practice is not limited to Covered Countermeasures.
During the COVID-19 declared emergency, House Bill 4212 (2020 Special Session) section 46 allows PAs to practice via telemedicine for Oregon patients if:
*To maintain an Active status license, a PA must actively practice at an Oregon practice location.
Outside of the COVID-19 declared emergency, a PA may practice via telemedicine for Oregon patients, if:
*To maintain an Active status license, a PA must actively practice at an Oregon practice location. A PA may not practice via telemedicine if the PA is located outside of Oregon because there is no statutory allowance for PAs to practice across state lines in ORS 677.135 to 677.141.
Oregon licensed acupuncturists may practice via telemedicine for Oregon patients, if:
An acupuncturist may not practice via telemedicine if the acupuncturist is located outside of Oregon.