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Hawaii’s licensure requirements protect practitioners, especially those on smaller islands who serve sparse populations. For this reason, Hawaii isn’t a part of any interstate health compacts, although it does allow telehealth and telemental appointments. It has also expanded telemedicine access during emergencies, but in ways that benefit patient needs without hurting small practices, which could lead to a shortage of doctors.
Hawaii law, established by HRS 453, requires medical care providers to be licensed in the state to provide services to its citizens and demands you establish a doctor-patient relationship in person on the first visit. Exceptions to this rule include out-of-state radiologists and virtual consultations. Executive Order 20-02 suspended HRS 453 during the COVID-19 emergency and has been extended to April 13, 2021, by the Eighteenth Proclamation issued by the governor.
During the emergency period and any further extensions, you can establish a relationship with any doctor virtually and can have telemedicine appointments with an out-of-state provider who’s not currently licensed in Hawaii. Once the emergency period has ended, HRS 453 allows temporary and limited licenses to be issued to out-of-state practitioners in the event of a shortage of doctors.
HRS 453 requires a doctor to first see you face-to-face before prescribing medications during any subsequent virtual visits unless another physician who saw you in person has referred them. Some telehealth appointments may not require an in-person visit before prescribing medications, such as when a medical provider is on call or when a follow-up visit is arranged. Prescriptions for opiates or cannabis require an in-person visit to establish the doctor-patient relationship. The COVID-19 emergency proclamation has temporarily suspended most of these prescription requirements.
Hawaii has adopted standard telehealth services outlined by Medicaid, with the additional requirement that you have the first appointment in person. This restriction protects physicians with practices on smaller islands from losing patients to larger practices on more populated islands or the mainland.
Hawaii law permits reimbursement for four telemedicine modalities, as defined by Medicaid:
This includes, but is not limited to:
Covered telehealth services in Hawaii do not include fax, e-mail, text, or audio-only telephone communication. Confirmation of incidences of reimbursement for Medicaid store-and-forward technologies is still outstanding.
According to HRS 453, telehealth services may be provided by, or under the direction of in the case of a physician’s assistant, a physician or an osteopathic physician. There are no stated restrictions on what medical professionals may provide telehealth services, as long as they are licensed to practice. This includes any telehealth services conducted for the treatment of disease, including hypnosis and any telemental services you may need.
Normally, you must start a physician-patient relationship in person before having telehealth appointments. The suspension of this requirement during the COVID-19 emergency makes it possible for you to have your first visit with a medical provider virtually.
To find out more about telehealth policies in Hawaii or for additional information about how to find a provider who offers telehealth services, please review the following sources.
The Hawaii Department of Health is a resource for information about telehealth services and provides updates about COVID-19. You may also find information about Medicaid eligibility and what telehealth services are covered.
Contact Information: Website | 808-586-4400
This is Hawaii’s main website for information about Medicaid eligibility and coverage. You can click on the provider directory to find physicians who offer telehealth services.
Contact Information: Website | 800-316-8005
Contact Information: Website | 808-956-2897