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On Tuesday, February 21, 2023, the State Medical Board of Ohio released its final telehealth rules to implement Ohio’s telehealth statute (O.R.C. 4743.09) for physicians, physician assistants, dieticians, respiratory care professionals and genetic counselors. Ohio’s advanced practice registered nurses (“APRNs”) should also take note of these rules. While the Medical Board does not govern APRNs directly, those APRNs who are required to have a collaborating physician and standard care arrangement (namely nurse practitioners, certified nurse midwives, and clinical nurse specialists) are still affected by the rules. Generally, if an APRN’s collaborating physician is limited in their practice, then the APRN will also be limited. 

Here is a quick summary of the new telehealth rules: 

 

General Telehealth Provisions (OAC 4731‐37‐01): 

1. Applies to Ohio Patients Only 

The rules only govern providers who are serving patients located in Ohio. The provider must meet the applicable standard of care. Additionally, if the patient is located outside of Ohio, providers should remember to follow the laws and regulations of the state where the patient is located.  

2. Telehealth and In-Person Standard of Care Parity 

The same standard of care applies to both telehealth and in-person visits.  

3. Synchronous and Asynchronous Technology Allowed 

If the same standard of care as an in-person visit can be met, then providers may use synchronous or asynchronous technology. All elements of a bona fide healthcare visit standard of care must be met in order to use telephone calls.  

4. In-Person Visit Required if Standard of Care is Not Met 

The rules provide direction on when an in-person visit or referral of the patient to another provider is required.  

5. Required Consultations 

In certain circumstances, formal consultations with another healthcare provider are required.  

6. Permits Use of Remote Patient Monitoring Devices 

If the patient consents, physicians and physician assistants may provide telehealth services through FDA-approved remote monitoring devices. 

7. Non-Controlled Prescribing Through Telehealth 

The rules set forth the requirements for a physician or physician assistant to prescribe, personally furnish, or otherwise provide a non‐controlled prescription through telehealth.

 

Controlled Substance and Telehealth Prescribing (OAC 4731‐11‐09): 

1. All Ohio and federal laws and rules governing controlled substances must be followed, including OAC 4731-37-01 (governing non-controlled substances). 

2. A physician exam must be done prior to prescribing a schedule II drug unless one of the following requirements is met:
   1. New patient receiving hospice or palliative care
   2. Substance use disorder patients being treated through FDA-approved medication-assisted treatment (MAT) or for opioid use disorder
   3. The drug is prescribed to treat a mental health condition
   4. The patient is in an emergency situation (Provider may only prescribe the amount of schedule II drug needed to cover the duration of the emergency or up to a 3-day supply – whichever is less. When the emergency ends, the provider must do a physical examination before further prescribing a schedule II drug.) 

3. Controlled substance prescribing through telehealth must be done in accordance with an exception permitted under federal law. 

If you have any questions concerning the new Ohio Medical Board rules or regarding telehealth in general, please don’t hesitate to contact BMD Health Law Group Member Jeana M. Singleton at jmsingleton@bmdllc.com or 330-253-2001.