Can out-of-state patients do telemedicine?

Posted by Beachcomber20 @itsaquarter23, Dec 9 7:56am

I'm located in Oregon, and I'm in the process of deciding where and how to get treated for prostate cancer. I'll probably need to travel out-of-state to get the best radiation treatment. Last week I called FredHutch Cancer Center in Seattle to get further information about their services. During that conversation, I asked whether out-of-state patients could keep in touch with their doctors via telemedicine for follow-ups. I was told that the doctors there do provide telemedicine consultations. But because their medical licenses are specific to Washington State, I'd have to drive to the nearest place in Washington State and be physically in Washington in order for the doctors to be able to do the telemedicine consultation legally. Because I'm in Portland, Oregon, driving to Washington State would only be a five-mile drive. But what if I want to be treated in another state farther away from home, such as UCSF, Stanford, or UCLA? I easily can't drive across the Oregon-California border; it's too far. Question: how do patients maintain contact with their doctor located in another state? Or do those patients travel for the primary treatment and then transfer their follow-up care to a local doctor? Also, do the doctors at places like UCSF, Stanford, and UCLA do the initial consultation via telemedicine? Or would I need to travel there for the initial consultation and evaluation? And then travel there again for the treatment?

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

callibaetis | @callibaetis | Dec 9 8:35am

I believe that the physician needs to be licensed in the state that the patient resides in for the consultation (this may vary by state). Once the relationship is established the patient/physician can maintain contact via MyChart (if available), phone, etc. Obviously, full evaluation/treatment would require travel.

In my case, I travelled to Huntsman for brachytherapy and followed up with IMRT at home in Montana.

callibaetis | @callibaetis | Dec 9 10:00am

I'll have to add that in my case I was able to do an initial consultation via Zoom as my physician was licensed to do so. Since this was a second opinion situation, my records (MRI, biopsy, PSMA, etc.) had already been forwarded for evaluation.

bjroc | @bjroc | Dec 9 10:05am

A rare few states disallow second opinions from out of state doctors, one is Utah I believe. Otherwise it is generally a second opinion that assumes you got a local opinion already and is allowed.

jeffmarc | @jeffmarc | Dec 9 11:05am

It’s not just whether the doctor has a license in a different state that is a problem. Taxes are another issue, If the person does work in another state, then they have to pay that state taxes on those calls an extra expense for their accountant and they would nee A 4 1/2 hour drive for mid Manhattan NYPD detectives are on their way right now.

When telehealth is used, it is considered to be rendered at the physical location of the patient, and therefore a provider typically needs to be licensed in the patient’s state. Some states allow temporary licenses, Other states allow it to be done without a license for that state.

I know a few people who have gone from Oregon To California to get treatment, They have come to Ancan.org Advanced prostate cancer meetings to find a better doctor than is found in Oregon. I know that some people have gone there for recommendations and then had the treatment near where they live, It does require having the correct equipment near you.. Going in person isn’t really necessary if you think about it, What they need to see is all of your cancer documentation, And they will have that before your personal visit. Call the different places and find out what their requirements are.

callibaetis | @callibaetis | Dec 9 1:04pm

In case anyone is interested, here is a link regarding cross state licensing.
https://www.cchpca.org/topic/cross-state-licensing-professional-requirements/

jeffmarc | @jeffmarc | Dec 9 4:58pm

In reply to @jeffmarc "It’s not just whether the doctor has a license in a different state that is a..." + (show)

I use voice recognition and apparently voice from my TV got put in my message.

There was what I was supposed to say.

If the person does work in another state, then they have to pay that state taxes on those calls, an extra expense for their accountant, and they would need enough clients to make it worthwhile to pay an accountant for that state. Some medical companies may not want to get involved with this.

scottbeammeup | @scottbeammeup | Dec 9 5:03pm

Hypothetically, someone in Oregon could use a VPN that would show their IP address as being in Washington State and receive a telemedicine call that would show as going from one IP address in Washington state to another IP address in Washington state. Purely hypothetically.

scottbeammeup | @scottbeammeup | Dec 9 5:04pm

Helen, Volunteer Mentor | @naturegirl5 | Dec 9 6:18pm

@itsaquarter23 This is something that is rather complicated. I live in Michigan and I’ve had virtual appointments (telemedicine) with doctors and other medical providers from Mayo Clinic in Rochester, MN. I have been told by doctors here in Michigan that when I have a virtual appointment from another state that the medical provider must be licensed in Michigan. Each state controls their own licensing boards and the requirements for how to get licensed.

1. I would call my health insurance company and ask the question. My husband and both have Original Medicare and so we do not have a network of medical providers and can see anyone who takes Medicare.

2. I would ask the facility where the virtual appointment originates which in your case is Oregon. It could very well be different from one facility to the next.

What do you think you will do?