COVID-19 Accelerates Telehealth Adoption Triggering New State Compliance Requirements
ComplianceFebruary 01, 2021

COVID-19 accelerates telehealth adoption triggering new state compliance requirements

Telehealth has been building momentum for several years, connecting patients to vital healthcare services through video conferencing, remote monitoring, and more.

In a matter of months, the use of telehealth services has skyrocketed. Driven by the COVID-19 pandemic and spurred by the imperative to keep patients away from crowded medical facilities, healthcare providers are increasingly rolling out telemedicine programs. In March 2020 alone, the Cleveland Clinic logged more than 60,000 telehealth visits, compared to a typical month which would average 3,400 virtual visits. Telehealth claim lines jumped 3,060 percent from October 2019 to October 2020, according to the healthcare research organization Fair Health.

Actions by Congress and the Department of Health and Human Services (HHS) are also encouraging greater access to telehealth services. As a result, a number of states have or are in the process of implementing new telehealth rules and requirements.

In this article we explore important licensing and other compliance considerations for healthcare professionals as they adopt and participate in telehealth programs.

What is telehealth?

Telehealth is a commonly accepted umbrella term for a wide range of clinical diagnosis and management, education, and other aspects of everyday healthcare.

Telemedicine is another term that creeps into the conversation. It’s traditionally reserved for diagnosis and monitoring delivered via technological means.

Mobile health (mHealth) is often used interchangeably with telehealth, but it refers to a service that is delivered exclusively over a mobile device.

Telehealth adoption trends

Before the coronavirus crisis, telehealth adoption was already widespread — up 340% in 2019, according to a survey by American Well.

Since the pandemic took hold, government leaders have urged citizens to leverage telehealth services resulting in a surge in demand. Telehealth protects patients and reinforces social distancing, but it also frees up healthcare and front-line providers to focus on those in most need by encouraging patients with un-related conditions to get care online. Today, almost 80% of hospitals offer some form of telehealth service.

Telehealth license requirements during COVID-19

Telehealth may sound like a straightforward connection between a patient and their provider, but licensing can be a challenge for many telehealth programs. Typically, most states require that physicians are licensed in the state where the telehealth site or “visit” is provided. (I.e. the location of the patient, even if that provider is not a resident of that state.)

If a telehealth appointment takes place or medication is prescribed across state lines, then healthcare providers are required to establish licensure in that state.

At least, this was the case until COVID-19. As healthcare providers practice telehealth during the pandemic, they must consider several important licensing considerations.

First, what hasn’t changed? Telehealth licensing continues to vary from state to state. Furthermore, if a provider is licensed in the state where the patient is located, no additional licensing is required.

However, as part of their emergency declarations, many states have temporarily relaxed licensure requirements or issued expedited licenses for out-of-state physicians. It’s a fluid and dynamic situation. For up-to-date information, providers should refer to the latest information from the American Medical Association (AMA). Another useful resource is the Federation of State Medical Boards (FSMB), which is tracking executive orders related to licensure.

Registered Agent requirements for telehealth practitioners

Other telehealth regulatory developments include new out-of-state registration requirements. For example, in Florida a relatively new law permits out-of-state health care professionals without a license in that state to deliver telehealth care services, but only if they designate a Registered Agent for service of process in that state.


During this time of crisis, telehealth is an important lifeline for patients and healthcare professionals, breaking down distance barriers, and ensuring access to care is provided to those who need it most by triaging low-risk urgent care and follow-up appointments.

As the pandemic landscape continues to evolve, healthcare professionals can anticipate that telehealth rules and regulations will also change. It pays to have one eye on the licensing and regulatory landscape environment at this time.