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I. What are the licensure requirements in Alabama for telehealth mental health care?

Alabama’s licensure requirements for telemedicine are quite lenient. Medical professionals only need a standard Alabama medical license to practice telemedicine within the state. Clinical social workers must meet the conventional professional standards set by the Board of Social Work Examiners to provide telehealth counseling and psychotherapy services.

Requirements for out-of-state treatment

Alabama is part of the Interstate Medical Licensure Compact, which permits the practice of telemedicine across multiple states and establishes licensing requirements and regulations to do so. Alabama physicians must carry a State of Principle Licensure to obtain a license in a participating IMLC state and provide telehealth services to patients outside of the state. Alabama physicians may practice medicine across state lines by getting a special purpose license from the Commission.

Emergency licensure

During a state of emergency, qualifying physicians may obtain temporary emergency certificates of qualifications, emergency medical licenses, and controlled substances certificates. Licensed nurses may work without an Alabama nursing license for up to 30 days, and licensed marriage and family therapists can provide telemedicine services before completing traditional telehealth training requirements. Emergency licensing is available to physician assistants for up to 120 days during a health emergency, and they can forgo the standard immediate physician supervision requirement.

II. What are the online prescribing regulations in Alabama?

The Medical Examiner’s Board in Alabama has no established rules and regulations regarding medication prescriptions via telehealth. However, the Drug Enforcement Administration states that typically, you must have examined your patient in-person previously before you can prescribe a controlled substance via a telehealth appointment. Exceptions apply during a declared health emergency.

Medical providers may not prescribe scheduled drugs via telemedicine visits for nonmalignant pain unless the patient is in a palliative care program or a qualified multidisciplinary hospice. Optometry service providers must establish a doctor-patient relationship before prescribing controlled substances via telehealth.

III. What are other common telehealth restrictions in Alabama?

Documented, informed patient consent is required before providing telehealth services. Medical practitioners must ensure patient confidentiality and HIPAA compliance via the electronic means of providing telehealth services. Special purpose licensees can’t go into practice with nurse practitioners or midwives, supervise PAs, or act as a covering physician in a medical practice.

Types of telehealth services allowed

  • Consultations and treatment for medical conditions
  • Services related to End-Stage Renal Disease treatment
  • Psychiatric diagnostic services
  • Medication management
  • Clinical social work services, including diagnostic assessments, psychotherapy, and counseling
  • Optometry services, including diagnosis and treatment

When a patient presents with new symptoms unrelated to a previously known existing condition during a telehealth visit, they must see a provider in person within 72 hours. Failure to do so disallows continuing telehealth care for the new symptoms.

Types of providers allowed to offer telehealth services

  • Doctors and psychiatrists
  • Physicians assistants
  • Clinical nurse specialists
  • Certified registered nurse practitioners
  • Certified registered nurse anesthetists
  • Nurse midwives
  • Clinical psychologists
  • Clinical social workers
  • Registered nutrition professionals and dietitians
  • Licensed marriage and family therapists

Emergency allowances

Per the DEA, physicians may prescribe controlled substances via telehealth venues during the current COVID-19 health emergency even if they haven’t previously examined their patient in person, with conditions.

Throughout the duration of the COVID-19 health emergency, the Alabama Medical Board and the Medical Licensure Commission encourage practitioners to provide their services via telemedicine whenever it’s possible, safe, and sensible to do so.

Blue Cross and Blue Shield of Alabama has expanded available telehealth services in response to the COVID-19 pandemic.

IV. Telehealth provider resources in Alabama

It’s important to stay abreast of changes and new rules and regulations in telehealth. It’s a fast-evolving field, and the COVID-19 health emergency has prompted even more unpredictability. Security and data protection are key to ensure HIPAA compliance over secure telecommunications channels. The following resources are helpful in these areas.

Alabama Board of Medical Examiners & Medical Licensure Commission

The ALBME provides lots of helpful information about telehealth regulations, licensing requirements, rules regarding prescribing medication, and telemedicine service reimbursement for physicians and physician assistants. Available links support further research to learn more about these topics and recent changes to the laws.

Contact Information: Website | 800-227-2606

Southeastern Telehealth Resource Center

The SETRC is one of 12 regional and two national federally funded telehealth resource centers. This southeastern center provides information and support for Alabama, Florida, Georgia, and South Carolina.

Program planning and development of local telemedicine programs are some of the services SETRC offers to individuals and organizations throughout the region. It serves as a data-rich source of state-relevant information about the provision of telemedicine. Visit the Alabama page for detailed telehealth tools, resources, and information.

Contact Information: Website | 888-738-7210

Rural Health Information Hub – Alabama Partnership for TeleHealth

RHIhub APT is a nonprofit organization committed to providing telehealth services to patients in rural regions of Alabama. Members pay a monthly partnership fee to use established telehealth infrastructure and receive staff training and education. The services include valuable telemedicine technology tools, such as a telehealth delivery platform, a cloud-based portal, and tele-stethoscope apps.

Contact Information: Website | 866-754-4325

V. Sources