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Alaska

Counselors

Source

New Rules and Regulations as of October 11, 2019, in effect November 20, 2019

12 AAC 62.400. Distance professional service

b) Before providing distance professional services, a licensee must:

  1. be licensed in good standing under AS 08.29;
  2. have completed a minimum of six continuing education hours from a National Board for Certified Counselors (NBCC) approved continuing education provider pertaining to distance professional services….
  3. determine that the client is intellectually, emotionally, and physically capable of using distance professional services and that the delivery method for providing distance professional services is appropriate for the client's needs.

(e) Before providing distance professional services, a licensee must develop a safety plan with the client to identify local resources in the client’s community should emergency care become necessary…”

The Alaska Board of Professional Counselors provides the following guidelines as resources: 

Guidelines

ACA Code of Ethics, Section H

Social Workers

Source

Info Packet

"Social workers must provide follow-up care if physically separated from patient, request consent to provide a copy of records to the primary provider and comply with other regulations adopted by the Board regarding qualifications and restrictions pertaining to evaluation, diagnosis, supervision, and treatment (AS 08.95.050(b)(c)) In addition businesses (including sole proprietor) engaged in telemedicine are required to register for placement in Telemedicine Business Registry through the Professional Licensing Section."

Marriage and Family Therapists

Source

Statutes and Regulations for Marital and Family Therapy: effective June 2019

ARTICLE 4. TELETHERAPY PRACTICE. 

  1. SCOPE OF TELETHERAPY PRACTICE. 

“Services offered by licensees of the board across a distance by electronic means fall within the jurisdiction of the board to the same degree as traditional face-to-face services described in AS 08.63. The provisions of AS 08.63 and this chapter apply to these services. Teletherapy or technology-assisted services refers to the scope of marital and family therapy practice of diagnosis, evaluation, consultation, intervention, and treatment of behavioral, social, and interpersonal disorders through synchronous or asynchronous two-way electronic communication, including telephone, videoconferencing, electronic mail, text messaging, instant messaging, and social media. The practice of technology-assisted distance professional services does not include functions or practices that are not within the training required for licensure under this chapter in accordance with AS 08.63.240. Authority: AS 08.63.050 AS 08.63.110 AS 08.63.210 AS 08.63.100 12 AAC 19.”

  1. ELIGIBILITY TO PRACTICE TELETHERAPY. 

“To be eligible to practice teletherapy with clients physically present in this state, an individual must 

(1) be licensed in good standing under AS 08 63.100 as a marital and family therapist or AS 08.63.110 as a marital and family therapy associate; and 

(2) complete initial training in the following topics regarding teletherapy, totaling a minimum of four hours:

(A) appropriateness of teletherapy; 

(B) teletherapy theory and practice; 

(C) modes of teletherapy delivery; 

(D) legal and ethical issues; 

(E) handling online emergencies; 

(F) best practices and informed consent.

Authority: AS 08.63.050 AS 08.63.110 AS 08.63.210 -11- AS 08.63.100 12 AAC 19.

  1. PROVIDING TECHNOLOGY-ASSISTED DISTANCE PROFESSIONAL SERVICES. 

(a) The provision of any service as the practice of marital and family therapy defined under AS 08.63.900 to a client physically present in this state through digital, telephonic, electronic, or other means, regardless of the location of the provider of the service, constitutes the practice of marital and family therapy in this state and requires licensure of the service provider under AS 08.63 and this chapter. 

(b) The provision of any service defined under AS 08.63.900 as the practice of marital and family therapy by a provider of the service in this state through digital, telephonic, electronic, or other means, regardless of the location of the client receiving the service, constitutes the practice of marital and family therapy in this state and requires licensure of the provider under AS 08.63 and this chapter. 

(c) When providing technology-assisted distance professional services, a licensee shall determine that the client is intellectually, emotionally, and physically capable of using the application and that the application is appropriate for the needs of the client. 

(d) When technology-assisted distance professional services are determined inappropriate by the licensee or client, the licensee may consider referral to a clinician local to the client for in-person services. If the client refuses the referral, the licensee shall document the rationale for continuing to provide distance professional services. 

(e) Each time a technology-assisted distance professional services session takes place, the licensee shall verify the client’s identity and shall note the client’s identity in the progress note. 

(f) Regarding the delivery of distance professional services, a licensee shall follow the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) Teletherapy Guidelines, dated September 2016, and adopted by reference. 

(g) At the onset of services, licensees shall develop a safety plan identifying local resources in the community of the distance client should emergency care be required. The safety plan must include contact telephone numbers for local resources. Local resources may include family members, law enforcement, health aides, religious leaders, or tribal leaders trusted by the client to be available during distance professional services.”

“Authority: AS 08.63.050 AS 08.63.110 AS 08.63.210 AS 08.63.100 Editor’s note: A copy of the Association of Marital and Family Therapy Regulatory Boards (AMFTRB) Teletherapy Guidelines, dated September 2016, adopted by reference in 12 AAC 19.410, may be obtained from the Department of Commerce, Community, and Economic Development, Division of Corporations, Business and Professional Licensing, P.O. Box 110806, Juneau, AK 99811-0806; phone (907) 465-2551, or website.  12 AAC 19.

  1. SAFETY AND CONFIDENTIALITY OF COMMUNICATIONS. (a) All forms of communications with clients, including electronic communications, must comply with the requirements of 45 C.F.R. Parts 160 and 164 regarding privacy, security, and breach for purposes of P.L. 104-191 (Health Insurance Portability and Accountability Act of 1996). (b) Licensees must endeavor to protect clients from unwanted interruptions during sessions involving synchronous distance professional services.”

“Authority: AS 08.63.050 AS 08.63.110 AS 08.63.210 AS 08.63.100 12 AAC 19.

  1. INFORMED CONSENT. To provide, by digital, telephonic, or other electronic means, any service defined under AS 08.63.900 as the practice of marital and family therapy, a licensee shall secure informed consent from a client. Informed consent must be written and clearly set out the benefits and risks of entering into distance professional services. The informed consent must identify the means of contact with the client, including the use of a telephone, online synchronous counseling, electronic billing, text messaging, or electronic mail.”

“The informed consent must also 

(1) identify issues related to the difficulty of maintaining the confidentiality of electronically transmitted communications; 

(2) inform clients of all colleagues, supervisors, and employees, such as information technology (IT) administrators, who might have authorized or unauthorized access to electronic transmissions; 

(3) inform clients of the risks of access, including by family members and employees who have access to technology used in the counseling process; 

(4) inform clients of pertinent legal rights and limitations governing the practice of a profession over state lines or international boundaries; 

(5) inform clients that, whenever possible, encrypted websites and electronic mail communications will be used to help ensure confidentiality; 

(6) when the use of encryption is not possible, inform clients of this limitation and limit electronic transmissions to general communications that are not client-specific; -12- 

(7) inform clients if and for how long archival storage of transaction records is maintained; 

(8) discuss the possibility of technology failure and alternate methods of service delivery during a failure; 

(9) inform clients of emergency procedures, such as calling 911 or a local crisis hotline, when the licensee is not available; 

(10) inform clients of the limits of confidentiality under AS 08.63.200; 

(11) identify, as applicable, time zone differences, local customs, and cultural or language differences that might impact services delivery; 

(12) inform clients when technology-assisted distance professional services are not covered by insurance; and 

(13) fully disclose the licensee’s licensing, credentials, and areas of expertise.”

Authority: AS 08.63.050 AS 08.63.110 AS 08.63.210 AS 08.63.100

Psychologists

Source

12 Alaska Admin. Code 60.035 - Courtesy license

"(a) A courtesy license authorizes the licensee to practice psychology for no more than 30 days in a 12-month period. An applicant will only be issued one courtesy license in that person's lifetime. A courtesy licensee shall submit a report to the board each month

during the period of courtesy licensure indicating the number of days practiced under the courtesy license during the month. A

courtesy license does not authorize the licensee to conduct a general psychology practice or to perform services outside the scope of practice of psychology that is specified on the courtesy license.

(b) The board or its designee will issue a one-time courtesy license to an applicant who meets the requirements of this section."

Psychiatrists

Source

“All businesses engaged in or planning to engage in telemedicine services must register with our Department.

Please note, telemedicine and telehealth services are often used synonymously, however, the definition of telemedicine services is given in general government statute, AS 44.33.381 and is provided below for your reference:

"Telemedicine services" means the delivery of health care services using the transfer of medical data through audio, visual, or data communications that are performed over two or more locations by a provider who is physically separated from the recipient of the health care services. AS 44.33.381

If you provide telemedicine services to Alaska-based clients a valid Alaska business license is required. To register with our Department, please provide your Alaska Business License number on the Telemedicine Business Registry License application. Applications for a business license may be obtained through the Business Licensing Section.

Refer to the source provided for all requirements and limitations.

 

Alaska Professional Regulations/Health & Safety Online Prescribing

“The guiding principles for telemedicine practice in the American Medical Association (AMA), Report 7 of the Council on Medical Service (A-14), Coverage of and Payment for Telemedicine, dated 2014, and the Federation of State Medical Boards (FSMB), Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, dated April 2014, are adopted by reference as the standards of practice when providing treatment, rendering a diagnosis, prescribing, dispensing, or administering a prescription or controlled substance without first conducting an in-person physical examination.”

“During a disaster emergency declared by the Governor, an appropriate licensed health care provider need not be present with the patient to assist a physician or physician assistant with the examination, diagnosis, and treatment if the physician or physician assistant is prescribing, dispensing or administering buprenorphine to initiate treatment for opioid use disorder and the physician or physician assistant:

  • Is a Drug Addiction Treatment Act (DATA) waivered practitioner;
  • Documents all attempts to conduct a physical examination and the reason why the examination cannot be performed; and
  • Requires urine or oral toxicology screening as part of the patient’s medication adherence plan.”

“A physician is not subject to disciplinary sanctions for rendering a diagnosis, treatment or prescribing a prescription drug (except a controlled substance) without a physical examination if the physician or another health care provider or physician in the physician’s group practice is available for follow up care and the physician requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider.”

“If the above requirements are met, a physician may also prescribe a controlled substance or botulinum toxin when an appropriate licensed health care provider is present with the patient to assist the physician with the examination, diagnosis, and treatment.”

Source:

“Physicians are prohibited from prescribing medications based solely on a patient-supplied history received by telephone, FAX, or electronic format.”

Source:

Refer to the source provided for all requirements and limitations.

Nurses

Source

12 AAC 44.925. STANDARDS OF PRACTICE FOR TELEHEALTH. 

“(a) The guiding principles for telehealth practice in the American Telemedicine Association (ATA), Core Operational Guidelines for Telehealth Services Involving Provider-Patient Interaction, dated May 2014, and the American Psychiatric Association (APA) and the American Telemedicine Association (ATA), Best Practices in Videoconferencing-Based Telemental Health, dated April 2018, are adopted by reference as the standards of practice when providing treatment, rendering a diagnosis, prescribing, dispensing, or administering a prescription or controlled substance without first conducting an in-person physical examination under this section. (b) An advanced practice registered nurse (APRN) may practice telehealth, including prescribing, dispensing, or administering a prescription drug that is not a controlled substance if (1) the APRN is licensed by the board; (2) the APRN, or another licensed health care provider in a group practice, is available to provide follow-up care; and -51- (3) the APRN requests that the person consent to sending a copy of all records of the encounter to the person's primary care provider if the prescribing APRN is not the person's primary care provider and, if the person consents, the APRN sends the records to the person's primary care provider. (c) An APRN may prescribe, dispense, or administer a prescription drug that is a controlled substance if the requirements under (b) of this section and AS 08.68.705 are met and the APRN prescribes, dispenses, or administers the controlled substance when an appropriate health care provider is present with the patient to assist the APRN with an examination, diagnosis, and treatment. (d) Notwithstanding (c) of this section, during a disaster emergency declared by the governor, an appropriate health care provider need not be present with the patient to assist an APRN with an examination, diagnosis, and treatment, if the APRN is prescribing, dispensing, or administering buprenorphine to initiate treatment for opioid use disorder and the APRN (1), is a waived practitioner under 21 U.S.C. 823(g)(2) (Drug Addiction Treatment Act (Data)); (2) documents all attempts to conduct a physical examination under this section and the reason why the examination cannot be performed; and (3) requires urine or oral toxicology screenings as part of the patient’s medication adherence plan. (e) Notwithstanding (b) and (c) of this section, an APRN may not prescribe, dispense, or administer a prescription drug in response to an Internet questionnaire or electronic mail message to a person with whom the APRN does not have a prior APRN-patient relationship. (f) For a telehealth encounter, an APRN must complete and document (1) the patient’s informed consent to use telehealth technologies; (2) a clinical history and review of systems establishing diagnoses and identifying conditions and contraindications to recommended treatment; and (3) a plan of care that lists all recommendations and prescriptions issued by electronic means. (g) An APRN practicing telehealth must ensure compliance with P.L. 104-198 (Health Insurance Portability and Accountability Act of 1996 (HIPAA)) and medical record retention rules, and transmissions, including patient electronic mail, prescriptions, and laboratory results must be secure within existing technology to include password-protected, encrypted electronic prescriptions, or other reliable authentication techniques. (h) In this section, (1) an "APRN-patient relationship" is established when there is an in-person health examination or examination by telehealth technology of the patient by the APRN or another APRN, physician, or physician assistant in the same group practice and the patient record is available to the treating APRN; (2) "controlled substance" has the meaning given in AS 11.71.900; (3) "health care provider" has the meaning given in AS 18.15.395; (4) "prescription drug" has the meaning given in AS 08.80.480; (5) "primary care provider" has the meaning given in AS 21.07.250. Authority: AS 08.68.100”

Refer to the source provided for all requirements and limitations.

Alaska Professional Regulations/Health & Safety Online Prescribing

“The guiding principles for telemedicine practice in the American Medical Association (AMA), Report 7 of the Council on Medical Service (A-14), Coverage of and Payment for Telemedicine, dated 2014, and the Federation of State Medical Boards (FSMB), Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, dated April 2014, are adopted by reference as the standards of practice when providing treatment, rendering a diagnosis, prescribing, dispensing, or administering a prescription or controlled substance without first conducting an in-person physical examination.”

“During a disaster emergency declared by the Governor, an appropriate licensed health care provider need not be present with the patient to assist a physician or physician assistant with the examination, diagnosis, and treatment if the physician or physician assistant is prescribing, dispensing or administering buprenorphine to initiate treatment for opioid use disorder and the physician or physician assistant:

  • Is a Drug Addiction Treatment Act (DATA) waivered practitioner;
  • Documents all attempts to conduct a physical examination and the reason why the examination cannot be performed; and
  • Requires urine or oral toxicology screening as part of the patient’s medication adherence plan.”

“A physician is not subject to disciplinary sanctions for rendering a diagnosis, treatment or prescribing a prescription drug (except a controlled substance) without a physical examination if the physician or another health care provider or physician in the physician’s group practice is available for follow up care and the physician requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider.”

“If the above requirements are met, a physician may also prescribe a controlled substance or botulinum toxin when an appropriate licensed health care provider is present with the patient to assist the physician with the examination, diagnosis, and treatment.”

Source:

“Physicians are prohibited from prescribing medications based solely on a patient-supplied history received by telephone, FAX, or electronic format.”

Source:

Refer to the source provided for all requirements and limitations.

Medicaid Telehealth Parity Law

 

Will Medicaid reimburse for telehealth/telemental health services?

Yes. Read the following:

7 AAC 110.620. Scope

(a) The department will pay for medical services furnished through telemedicine applications as an alternative to traditional methods of delivering services to Medicaid recipients.

(b) For a provider to receive payment under 7 AAC 110.620 - 7 AAC 110.639, the provider's use of telemedicine applications must comply with the standards set out in AS 47.07 and 7 AAC 105 - 7 AAC 160 for the medical service provided by the type of provider, including

(1) provisions that affect the efficiency, economy, and quality of service; and

(2) coverage limitations.

7 AAC 110.625. Telemedicine applications; limitations

(a) The department will pay a provider for a telemedicine application if the provider provided the medical services through one of the following methods of delivery in the specified manner:

(1) live or interactive; to be eligible for payment under this paragraph, the service must be provided through the use of a camera, video, or dedicated audio conference equipment on a real-time basis; medical services provided by a telephone that is not part of a dedicated audio conference system or by a facsimile machine are not eligible for payment under this paragraph;

(2) store-and-forward; to be eligible for payment under this paragraph, the service must be provided through the transference of digital images, sounds, or previously recorded video from one location to another to allow a consulting provider to obtain information, analyze it, and report back to the referring provider;

(3) self-monitoring or testing; to be eligible for payment under this paragraph, the services must be provided by a telemedicine application based in the recipient's home, with the provider only indirectly involved in the provision of the service.

(b) The department will only make a payment for a telemedicine application if the service is limited to

(1) an initial visit;

(2) a follow-up visit;

(3) a consultation made to confirm a diagnosis;

(4) a diagnostic, therapeutic, or interpretive service;

(5) a psychiatric or substance abuse assessment;

(6) psychotherapy; or

(7) pharmacological management services on an individual recipient basis.

Source

Refer to the source provided for all requirements and limitations.

Payment Parity

Sec. 21.42.422.   Coverage for telehealth and mental health benefits. 

A health care insurer that offers, issues for delivery, or renews in the state a health care insurance plan in the group or individual market that provides mental health benefits shall provide coverage for mental health benefits provided through telehealth by a health care provider licensed in this state and may not require that prior in-person contact occur between a health care provider and a patient before payment is made for covered services.

Resource

Permission for the Temporary Practice of Clinicians Licensed Outside the State

We are not aware of any permission that allows for services delivered by out-of-state providers.

Note: As this is a free resource and Rules and Regulations regarding Telehealth are always changing, we appreciate any updates or corrections. They can be emailed to us at This email address is being protected from spambots. You need JavaScript enabled to view it. with a link to the source or a citation of the rule or regulation.

THTC Program Button

Telemental health is not a separate service from mental health services. All state licensing boards require that licensed clinicians follow all the regulations for practicing under their license no matter what medium of communication is used. All licensing boards also require that clinicians only practice within the boundaries of their competence. This usually requires education, continuing education, and/or supervision in telemental health. Complete our telehealth training program to cover all the essential competencies of providing telemental health services and earn the THTC (Telemental Health Training Certificate).

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