Author's note: Yesterday's post included a reference
to an "originating site" definition under Regulation
38. This post below corrects that reference, noting how the
proposed regulation does not change the statutory definition of
The Arkansas State Medical Board on Thursday voted unanimously
to pass Regulation 38 establishing key
definitions for telemedicine practice in the State. The new
regulation imposes specific Board of Medicine requirements for
practicing telemedicine, and is to be read in connection with Regulation No. 2(8) (valid doctor-patient
relationships). However, neither regulation addresses the
definition of "originating site" under Arkansas Code 17-80-118 or how the Board would
apply it to telemedicine consults where the patient is located at
his or her home.
The current Arkansas statutory definition of "originating
"The offices of a healthcare
professional or a licensed healthcare entity where the patient is
located at the time services are provided by a healthcare
professional through telemedicine; and
The home of a patient in connection
with treatment for end-stage renal disease."
Any change to that definition would likely require a legislative
solution, as the Board's regulations can interpret the law, but
do not (and likely cannot) contradict the Code. Regulation 38
expects practitioners to use synchronous audio-video technology,
and states "A patient completing a medical history online and
forwarding it to a physician is not sufficient to establish the
relationship, nor does it qualify as sort-and-forward
As we reported in
August, the Medical Board previously approved proposed
Regulation 38 and (allowing a doctor to establish a valid
relationship with a patient, without the need for an in-person
exam, if the doctor "performs a face to face examination using
real time audio and visual telemedicine technology that provides
information at least equal to such information as would have been
obtained by an in-person examination"). The Arkansas
Legislature's Rules and Regulations subcommittee voted to
approve Regulation 2.8 but sent Regulation 38 back to the Medical
Board for a new public-comment hearing. Regulation 38 will now
go back to the Rules and Regulations subcommittee. If lawmakers
approve it, the rule will become effective 10 days after it is sent
to Arkansas' secretary of state's office.
We will continue to monitor Arkansas for any changes that affect
or improve telemedicine opportunities in the state.
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Not just for the elderly lady down the street; or the least unfortunate among us. Medicaid is the single largest source of insurance in the country, covering more than 71 million Americans. 71 million.
Since their inception, HSAs have followed the same, functional format. Offered in conjunction with a high-deductible health plan, they've acted as a short-term holding tank for employee dollars to cover medical expenses.
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