-
Subchapter 001: OUT-OF-STATE TELEHEALTH LICENSURE AND REGISTRATION
§ 3051. Scope
(a) This chapter shall apply to the following health care professions regulated by the
Office of Professional Regulation:
(1) alcohol and drug abuse counseling;
(2) allied mental health professions, including mental health counseling, marriage and
family therapy, and services provided by nonlicensed and noncertified psychotherapists;
(3) applied behavior analysis;
(4) athletic training;
(5) audiology;
(6) chiropractic;
(7) dentistry;
(8) dietetics;
(9) midwifery;
(10) naturopathy;
(11) nursing;
(12) nursing home administration;
(13) occupational therapy;
(14) optometry;
(15) osteopathy;
(16) pharmacy;
(17) physical therapy;
(18) psychoanalysis;
(19) psychology;
(20) respiratory care;
(21) social work;
(22) speech language pathology; and
(23) veterinary medicine.
(b) This chapter shall apply to the following health care professions regulated by the
Board of Medical Practice:
(1) physicians;
(2) physician assistants; and
(3) podiatrists. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3052. Definitions
As used in this chapter:
(1) “Board” means the Board of Medical Practice.
(2) “Health care professional” means an individual who holds a valid license, certificate,
or registration to provide health care services in any other U.S. jurisdiction in
a health care profession listed in section 3051 of this chapter.
(3) “Health care services” means services for the diagnosis, prevention, treatment, cure,
or relief of a health condition, illness, injury, or disease.
(4) “In good standing” means that a health care professional holds an active license,
certificate, or registration from another U.S. jurisdiction; the health care professional
is not subject to a disciplinary order that conditions, suspends, or otherwise restricts
the professional’s practice in any other U.S. jurisdiction; and the health care professional
is not affirmatively barred from practice in Vermont for any reason, including reasons
of fraud or abuse, patient care, or public safety.
(5) “Mandatory disclosure” means the information that the health care professional must
disclose to the patient at the initial telehealth visit or consultation, as determined
by the relevant regulatory body by rule.
(6) “Office” means the Office of Professional Regulation.
(7) “Store and forward” means an asynchronous transmission of medical information, such
as one or more video clips, audio clips, still images, x-rays, magnetic resonance
imaging scans, electrocardiograms, electroencephalograms, or laboratory results, sent
over a secure connection that complies with the requirements of the Health Insurance
Portability and Accountability Act of 1996, Pub. L. No. 104-191 to be reviewed at a later date by a health care provider at a distant site who is
trained in the relevant specialty. In store and forward, the health care provider
at the distant site reviews the medical information without the patient present in
real time and communicates a care plan or treatment recommendation back to the patient
or referring provider, or both.
(8) “Telehealth” means health care services delivered by telemedicine, store and forward,
or audio-only telephone.
(9) “Telemedicine” means the delivery of health care services, such as diagnosis, consultation,
or treatment, through the use of live interactive audio and video over a secure connection
that complies with the requirements of the Health Insurance Portability and Accountability
Act of 1996, Pub. L. No. 104-191. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3053. Telehealth licensure or telehealth registration required
(a) A health care professional who is not otherwise licensed, certified, or registered
to practice in Vermont but is licensed, certified, or registered in good standing
in all other U.S. jurisdictions in which the health care professional is or has been
licensed, certified, or registered and who wishes to provide health care services
to a patient or client located in Vermont using telehealth shall obtain a telehealth
license or telehealth registration from the Office or the Board in accordance with
this chapter.
(b) A telehealth license or telehealth registration issued pursuant to this chapter shall
authorize a health care professional to provide services to a patient or client located
in Vermont using telehealth only. Telehealth licensure or telehealth registration
does not authorize the health care professional to open an office in Vermont or to
provide in-person health care services to patients or clients located in Vermont.
(c) A health care professional who is not otherwise licensed, certified, or registered
to practice in Vermont and provides health care services in Vermont using telehealth
without a telehealth registration or telehealth license, or provides services beyond
the limitations of the telehealth registration or telehealth license, is engaged in
unauthorized practice as defined in 3 V.S.A. § 127 and section 1314 of this title and is subject to the penalties set forth in those sections. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3054. Scope of telehealth license and telehealth registration
(a) Telehealth license.
(1) A health care professional who is not otherwise licensed, certified, or registered
to practice in Vermont may obtain a telehealth license to provide health care services
using telehealth to a total of not more than 20 unique patients or clients located
in Vermont during the two-year license term.
(2) To be eligible to obtain a telehealth license under this chapter, a health care professional
shall:
(A) complete an application in a format and with such content as prescribed by the Office
or the Board;
(B) hold an active, unencumbered license, certificate, or registration in good standing
in any other U.S. jurisdiction to practice the health care profession that the professional
seeks to practice in Vermont using telehealth and provide verification of the license,
registration, or certificate to the Office or the Board if required by the profession;
(C) if required by the rules adopted by the Office or the Board pursuant to section 3061
of this chapter, submit a copy of a mandatory disclosure that conforms to the requirements
established by rule;
(D) if required by the rules adopted by the Office or the Board pursuant section 3061
of this chapter, provide documentation of professional liability coverage or financial
responsibility that includes coverage or financial responsibility for services provided
by telehealth to patients or clients not located in the health care professional’s
home state in an amount established by rule;
(E) provide any other information and documentation of qualifications required by the
Office or the Board by rule; and
(F) pay the required telehealth licensure fee, which shall be 75 percent of the renewal
fee for the profession as set forth in 3 V.S.A. § 125 or in the applicable chapter of this title.
(3) A health care professional may renew a telehealth license every two years upon application
and payment of the required fee. A license that has expired shall be reinstated upon
payment of the biennial renewal fee and the late renewal penalty, which shall be 75
percent of the late renewal penalty established in 3 V.S.A. § 127 or in section 1401a of this title, as applicable.
(b) Telehealth registration.
(1) A health care professional who is not otherwise licensed, certified, or registered
to practice in Vermont may obtain a telehealth registration to provide health care
services using telehealth:
(A) for a period of not more than 120 consecutive days from the date the registration
was issued; and
(B) to a total of not more than 10 unique patients or clients over the 120-day period
that the registration is in effect.
(2) To be eligible to obtain a telehealth registration under this chapter, a health care
professional shall:
(A) complete an application in a format and with such content as prescribed by the Office
or the Board;
(B) hold an active, unencumbered license, certificate, or registration in good standing
in any other U.S. jurisdiction to practice the health care profession that the professional
seeks to practice in Vermont using telehealth and provide verification of the license,
registration, or certificate to the Office or the Board if required by the profession;
(C) if required by the rules adopted by the Office or the Board pursuant to section 3061
of this chapter, submit a copy of a mandatory disclosure that conforms to the requirements
established by rule; and
(D) pay the required telehealth registration fee, which shall be the lesser of:
(i) 50 percent of the renewal fee for the profession as set forth in 3 V.S.A. § 125 or in the applicable chapter of this title; or
(ii) the application fee for a full license for the profession as set forth in 3 V.S.A. § 125 or in the applicable chapter of this title.
(3) A health care professional may only reactivate a telehealth registration once every
three years. A telehealth registration shall not be renewed or reactivated upon expiration.
(c) Other license or registration. A health care professional seeking to provide health care services to a patient or
client located in Vermont using telehealth may register or apply for a full license
to practice the profession in this State in accordance with the applicable provisions
of this title. Nothing in this section shall be construed to prohibit a qualified
health care professional from registering or obtaining a full license to practice
in Vermont in accordance with relevant laws.
(d) Transition to licensure; fee credit.
(1) If a health care professional holding a telehealth registration issued pursuant to
this chapter elects to apply for a telehealth license or a full license while the
professional’s telehealth registration is in effect or within three years following
the effective date of the professional’s telehealth registration, the amount of the
fee paid by the health care professional for the telehealth registration pursuant
to subdivision (b)(2)(D) of this section shall be credited and applied toward the
amount of the relevant telehealth license under subdivision (a)(2)(F) of this section
if the professional is seeking a telehealth license or the application fee for a full
license for the profession as set forth in 3 V.S.A. § 125 or in the applicable chapter of this title.
(2) If a health care professional holding a telehealth license issued pursuant to this
chapter elects to apply for a full license while the professional’s telehealth license
is in effect, the amount of the fee paid by the health care professional for the telehealth
license pursuant to subdivision (a)(2)(F) of this section shall be credited and applied
toward the amount of the application fee for a full license for the profession as
set forth in 3 V.S.A. § 125 or in the applicable chapter of this title. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3055. Scope of practice; standard of practice
(a) In order to be eligible for a telehealth license or telehealth registration under
this chapter, a health care professional shall hold a license, certificate, or registration
in another U.S. jurisdiction that authorizes the provider to engage in the same or
a broader scope of practice as health care professionals in the same field are authorized
to engage pursuant to a license, certificate, or registration issued in accordance
with the relevant provisions of this title.
(b) While practicing in Vermont using telehealth, a health care professional holding a
telehealth license or telehealth registration issued pursuant to this chapter shall:
(1) practice within the scope of practice established in this title for that profession;
and
(2) practice in a manner consistent with the prevailing and acceptable professional standard
of practice for a health care professional who is licensed, certified, or registered
in Vermont to provide in-person health care services in that health care profession. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3056. Records
A health care professional holding a telehealth license or telehealth registration
issued pursuant to this chapter shall document in a patient’s or client’s medical
record the health care services delivered using telehealth in accordance with the
same standard used for in-person services and shall comply with the requirements of
18 V.S.A. §§ 9361 and 9362 to the extent applicable to the profession. Records, including video, audio, electronic,
or other records generated as a result of delivering health care services using telehealth,
are subject to all federal and Vermont laws regarding protected health information. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3057. Effect of disciplinary action on out-of-state license, certificate, or registration
(a) A health care professional shall not obtain a telehealth license or telehealth registration
under this chapter if the health care professional’s license, certificate, or registration
to provide health care services has been revoked or is subject to a pending disciplinary
investigation or action in any other U.S. jurisdiction.
(b) A health care professional holding a telehealth license or telehealth registration
under this chapter shall notify the Office or the Board, as applicable, within five
business days following a disciplinary action that places a warning, reprimand, condition,
restriction, suspension, or any other disciplinary action on the professional’s license,
certificate, or registration in any other U.S. jurisdiction or of any other disciplinary
action taken or pending against the health care professional in any other U.S. jurisdiction. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3058. Jurisdiction; application of Vermont laws
A health care professional holding a telehealth license or telehealth registration
in accordance with this chapter is subject to the laws and jurisdiction of the State
of Vermont, including 18 V.S.A. §§ 9361 and 9362 and laws regarding prescribing, health information sharing, informed consent, supervision
and collaboration requirements, and unprofessional conduct. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3059. Exemptions from registration and licensure requirements
A health care professional is not required to obtain a telehealth registration or
licensure solely to provide consultation services to another health care professional
regarding care for a patient or client located in Vermont, provided the consulting
health care professional holds a license, certificate, or registration to practice
the profession in one or more U.S. jurisdictions and the consultation is based on
a review of records without in-person or remote contact between the consulting health
care professional and the patient or client. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3060. Venue
Venue for a civil action initiated by the Office, the Board, or a patient or client
who has received telehealth services in Vermont from an out-of-state health care professional
holding a telehealth license or telehealth registration shall be in the patient’s
or client’s county of residence or in Washington County. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)
§ 3061. Rulemaking
The Office or the Board may adopt rules in accordance with 3 V.S.A. chapter 25 to
carry out the purposes of this chapter, including, in consultation with the appropriate
boards and advisor appointees for professions regulated by the Office, rules regarding
any profession-specific requirements related to telehealth licenses and telehealth
registrations. (Added 2021, No. 107 (Adj. Sess.), § 1, eff. July 1, 2023.)