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Louisiana State Board Of Medical Examiners Publishes New Rules on Telemedicine and Unprofessional Conduct
In the July 20th issue of the Louisiana Register, the Louisiana State Medical Board of Medical Examiners (LSBME) published two Notices of Intent to amend the rules governing the practice of telemedicine and the current definition of "unprofessional conduct" as it relates to the Medical Practice Act. As you may recall, the LSBME originally published rules regarding telemedicine and unprofessional conduct on October 20, 2014. The LSMS submitted comments to each of the proposals, a copy of which can be seen here and here.
The most recent proposals reflect LSBME's effort to respond to feedback received from the LSMS and other organizations regarding the rules. We encourage our members to review these proposed changes and provide any comments or feedback to LSMS Vice President of Legal Affairs, Wes Hataway, wes@lsms.org by August 7, 2015.
To assist with your review, the LSMS submits the following:
Unprofessional Conduct
The original Notice of Intent published July 20, 2015, suggested adding the following two prohibitions to the definition of unprofessional conduct: (1) prohibiting physicians from holding themselves out "specialists" unless certain criteria were met, and (2) prohibiting physicians from prescribing controlled substances to themselves or their family members.
In light of the comments received following the original publication, the LSBME has decided not to move forward with the proposal concerning "specialists." Additionally, the prohibition against physicians from prescribing controlled substances to themselves or their immediate family member was amended and now contains an exception for "cases of emergency." The rule now reads:
(11) Self-treatment; Treatment of Immediate Family Members - Except in cases of emergency, physicians shall not prescribe controlled substances from themselves or immediate family members. As respects a physician, immediate family members include the physician's spouse, children, parents or siblings.
Telemedicine
In response to comments received following the initial publication, the LSBME has proposed several substantive changes to the telemedicine rules. An annotated version of the rules can be viewed here.
A few of the highlights from the proposed changes include:
- The board removed to the requirement of disclosing a physician's email address to the patient prior to utilizing telemedicine. The physician must still disclose their name, Louisiana medical license number, address and telephone number to the patient and the disclosure shall be documented in the medical record.
- The board removed the absolute prohibition of prescribing Schedule II medication or an amphetamine or opioid of any schedule.
- Physicians are allowed to authorize or order the prescription, dispensation or administration of any controlled substance of any controlled substance as long as the following conditions are met:
- The physician has had at least one in-person visit with the patient at a physical practice location in this state within the past year
- The prescription is issued for a legitimate medical purpose
- The prescription is in conformity with the same standard of care applicable to an in-person visit, and
- The prescription is permitted by and in conformity with applicable state and federal laws and regulations
- Any physician can be granted an exception to the prohibitions on an individual basis as long as it is supported by a physician's written application as to why an exception should be granted.
- Any application for a telemedicine permit must contain an affirmation that the applicant has an arrangement with one or more physicians, who maintain a physical practice location in this state, to accept patients on referral or and for follow-up care.
All questions and comments should be directed to LSMS Vice President of Legal Affairs, Wes Hataway, at wes@lsms.org.
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