Legislation of telehealth laws in the Sunshine State rather came late compared to other states in the country. In 2019, providers, practitioners, insurers, and patients had an established rule book to render, receive, and reimburse telehealth services.
The state has established a Telehealth Advisory Council responsible for making recommendations that would improve both the practice and delivery of this type of service. Its first job was to survey and research how insurers and providers perceived the state’s telehealth status, the existing issues that need to be addressed, and how the state can provide assistance. However, the current telehealth law House Bill No. 23, does not provide an extensive and in-depth discussion on every aspect of telehealth, not even in the much-limited concept of telemedicine.
Telehealth has since then been defined under Florida laws as the utilization of telecommunications technology to conduct either a synchronous or asynchronous delivery of health care services between providers and patients located at different sites. This is a broad term that encompasses telemedicine and seldom uses to refer to this type of service.
Through this, administration, assessments, consultations, diagnosis, monitoring, transfer of medical information, patient and professional health-related education, public health services, and treatment can now be done remotely. However, according to state law, this does not include such services rendered through audio-only telephone calls, fax transmissions, US mail or other parcel services, or e-mail messages, but these modalities can still be used by providers whenever necessary.
The standard of care expected of telehealth providers is the same as that in in-person consultations. The requirement of conducting a physical examination and researching of patient’s medical history can be forgone if evaluations can be done through telehealth means without compromising an accurate diagnosis and corresponding treatment plan.
It is to be noted that the patient’s location at the time of rendering any telehealth service is considered the venue and is governed by that state’s laws. If any civil or administrative case is to be filed due to the virtual interaction, the same should be filed at the county where the patient was at the time, at his or her residence, or in Leon County.
Learn more about telemedicine and telehealth in Florida:
Unmatched Feature of Telemedicine in Florida
Florida has published an online resource solely dedicated to Florida Telehealth where you can verify a physician’s license, get answers to frequently asked questions, subscribe to e-mail updates, and where out-of-state health care providers can register to be able to practice telehealth within the state.
One can also access the main statute that governs the practice of telehealth in the state. This has helped individuals located in Florida and health care practitioners alike when it comes to better understanding and utilizing this platform made possible by modern technology.
Florida State Telemedicine Laws and Policies
Who can practice telemedicine in Florida?
Any health care professional who belongs in any of the following fields are allowed to render services and expertise through telehealth:
Advanced Practice Registered Nurse
Certified Nursing Assistant
ChiropractorClinical Lab Personnel
Clinical Social Worker
Emergency Medical Technician
Hearing Aid Specialist
Licensed Practical Nurse
Marriage and Family Therapist
Mental Health Counselor
This is a non-exclusive list, and other professions may be allowed to practice under amendments or later legislation that lawmakers may deem fit and necessary. These are all governed by their respective boards but are generally subjected to the same rules and regulations when it comes to the practice of telemedicine.
Out-of-State Telehealth Provider
There is no move on the part of the government and legislative to become a member state of the Interstate Medical Licensure Compact. However, existing laws govern out-of-state telehealth providers who want to provide such services within Florida. The rule is that only those with active, valid, and unencumbered licenses in another US state or territory may be allowed to practice telehealth in the state, subject to approval upon registration.
This means that one must not have any pending cases concerning his or her license privileges within the last five years and maintain a liability coverage or bond in the same amount or greater than what the state law requires. Hence, provisional licenses are not acknowledged. If there are any restrictions or pending disciplinary actions on your license after being approved as an out-of-state health provider, you should inform the Department of Health within five business days after the same has been placed.
Approval of your application to practice telehealth out-of-state will be reflected on an approval letter together with your corresponding registration number. Your name will then appear in a published list together with your basic information and medical background where patients can verify and review them.
However, this does not equate to a permit to open an office in Florida, nor does it give you the privilege to provide in-person services. Electronically prescribed medications can only be forwarded and dispensed by Florida-licensed pharmacies.
There are only two exemptions wherein non-state medical licensees who are also not out-of-state licensees can provide in-actual health care services to individuals residing or temporarily located in Florida as long as they possess active licenses from their home state. These are:
- Emergency medical conditions wherein failure to render immediate attention would cause serious jeopardy to the patient, especially pregnant women and including fetuses, serious impairment or dysfunction to any bodily functions and organs
- Professional medical consultations by a Florida-licensed practitioner who oversees the treatment of a patient
As for nurses who are holders of a multi-state License through the enhanced Nurse Licensure Compact (eNLC), they are no longer required to register and can readily provide telehealth services within Florida since it is a member state.
Standard of Care
Telehealth practitioners must observe the same prevailing standard of care in their delivery of services as they are mandated to provide in-person health care services. Their practice is limited to the scope of their field of expertise and individuals located within Florida.
Non-physician telehealth providers are likewise expected to render services within their respective scope of practice and the same standard of care as determined by Florida law.
No explicit rules or regulations govern the requirement of getting informed consent from patients before rendering any type of telehealth service.
The establishment of a physician-patient relationship is also allowed in telemedicine. This means that new patients’ initial consultation can be done directly through telehealth modalities.
Like in in-person services, telehealth practitioners must record their patient’s medical information, whether they are strangers, friends, or family. All services received by the patient through telehealth must likewise be included in his or her medical records. Failure to do so has corresponding monetary fines and penalties such as submitting a letter and taking a medical record-keeping course.
The same standard of confidentiality and privacy must be maintained as practiced in clinics and offices regardless of the type of file and modalities on how the patient transmitted the information to the provider. This could be in audio, video, or electronic format.
The general rule is that an in-person visit is required before one can be prescribed a controlled substance for medical purposes. Florida is one of the country’s six states that allows the prescription of such substances even in the absence of an in-person consultation provided that any of the following circumstances is present:
- When it is for a psychiatric disorder
- When the patient to be treated is currently confined in a licensed hospital
- When it is prescribed in connection with hospice services
- When the patient being treated is a nursing home resident
The presence of the following circumstances should be coupled with a DEA registration authorizing the practitioner to prescribe controlled substances.
Making electronic medical questionnaires the sole basis for prescribing any medications online is an outright violation of the standard of diligence required of practitioners. A documented evaluation of the patient, accurate diagnosis, and informing the patient of the risks and benefits of taking such prescription must be complied with.
Although a face-to-face visit is no longer required, proper patient evaluations and taking of medical history must be always be done first before any online prescribing. One must note that the issuance of a prescription already establishes a physician-patient relationship. Physicians are also prohibited from self-prescribing.
Child Protective Team Services
In rural and remote areas, medical evaluation and monitoring of children who might be victims of abuse or neglected by their families or guardians can now be conducted through telemedicine by the Child Protective Team (CPT) with the assistance of registered nurses and the supervision of a physician.
Substance Abuse Services
For telehealth services addressing substance abuse, they must first comply with these regulations:
- Submit a detailed outline of the procedures for each service they will be offering via telemedicine.
- Comply with federal and state-required laws regarding keeping the confidentiality and security of their patient’s medical information.
- Utilize high-quality two-way, real-time equipment and communications technology in delivering their services.
- Observe the same standard of care as they would when rendering health care services in person.
The only services delivered via telehealth by providers in substance abuse cases are assessments, clinical screenings, counseling, and medication management.
State Reimbursement Policy
What services are reimbursed in Florida?
The AHCA or Agency for Health Care Administration is responsible for Medicaid in the state of Florida. Through the Statewide Medicaid Managed Care (SMMC) programs implemented by the state government, most Medicaid members now enjoy the benefits of a health plan.
The cost for the purchase and maintenance of equipment used by the provider in delivering telehealth services is not reimbursed under any health care plans or insurance, public or private.
By FL Medicaid:
- Live Video
X Remote Patient Monitoring
X Standalone or combination e-consults through e-mail, text message, or facsimile
What is explicitly indicated in state law is reimbursement for live video or interactive telemedicine. Store-and-forward and remote patient monitoring modalities were not mentioned as reimbursable by FL Medicaid. There is likewise no reimbursement for chart reviews under the program.
The live video involves a real-time and two-way interaction through communication technology between a healthcare provider and a patient. This is the modality of telehealth service that Medicaid covers.
The one being reimbursed is the practitioner rendering the service who is not located in the same area as the recipient.
By Private Payer or other health care service plan providers:
No parity laws are providing for coverage and payment of telehealth services in the state of Florida. When it comes to health insurers and telehealth providers, voluntary contracts with terms and conditions mutually agreed upon by both parties shall govern their reimbursement policies.
If there are any differing provisions between reimbursable in-person services and telehealth service rates and methodologies stipulated in the contract, the telehealth provider must sign his initials on said variations.
The same law applies to health maintenance organizations that issue major medical coverage.
Who can avail of these reimbursements?
All providers who are enrolled and registered with the Florida Medicaid are eligible for reimbursements under the program as long as they perform within the scope of their practice under their license. The same is also true for those who deliver services under the fee-for-service system.
For Child Protective Team rendered services to be reimbursed, the CPT must be recognized and approved by the Centers for Medicare and Medicaid Services (CMS) to be reimbursed.
Public Health Emergency (PHE)
Florida’s Department of Health, through the State Surgeon General, released several Emergency Orders dealing with the suspension of statutes, regulations, and orders during this public health emergency. These were promulgated to remove any possible circumstances that would hinder the delivery of health care services to the public in this kind of time when it is most needed.
- Renewals for professional licenses are being extended from time to time, and all matters relating to licensing, such as disciplinary hearings, can be conducted through teleconferencing.
- Out-of-state health care practitioners who have valid and unrestricted licenses in their respective states are temporarily permitted to provide telehealth services to individuals located within the state of Florida without the need to register with the state’s Department of Health. These professionals can be any of the following:
- Advanced Practice Registered Nurses
- Clinical Social Workers
- Life Support Professionals
- Marriage and Family Therapists
- Mental Health Counselors
- Osteopathic Physicians
- Physician Assistants
- All health benefit plans, pharmacy benefits plans, and state group insurances are mandated to provide coverage for telehealth services.
- Under exceptional circumstances, Florida licensed physicians are temporarily allowed to prescribe controlled substances electronically.
- Medical marijuana cardholders can be re-certified through telehealth if they qualify.
The Florida Medical Clinic has released a list of their Covid-19 providers who deliver healthcare services through telemedicine. The application of the issuances is constantly being extended better to address the needs of its constituents during this pandemic.
10 Best Online Doctors and Telemedicine Providers in Florida
Florida houses some of the country’s top-quality telehealth care providers. If you are residing or temporarily staying in Florida, you can expect to receive the best service. Below is a list of state-licensed providers who can diagnose, treat, and prescribe medications along with other telemedicine services:
- HIPAA Compliant
- Board Certified Psychologists, Psychiatrists, Physicians, and Therapists
Peace Medical is an addiction and mental health clinic. They also provide primary care and pain management services. They deliver telemedicine services which they refer to as Tele-Med either through synchronous or interactive modalities, online communication, or phone conversation.
Some of the mental health issues they address and the corresponding programs they offer are as follows:
- Anxiety Control
- Detox Programs
- Hormone Level Control
- Pain Control
- Urgent Care: Respiratory Illnesses, Skin Conditions, Minor Injuries, and other conditions
- Weight Control
They have set forth rules and guidelines which patients must strictly observe for their welfare. For Tele-Med, the initial visit must be face-to-face as the patient must be physically examined and his or her medical history reviewed. All required medical records and documentation before engaging in Tele-Med must also be provided. There is a mandatory in-office consultation every six months or whenever the doctor deems it necessary.
- Secure systems and patient portal
- Board Certified Physicians and Emergency Medicine Doctors
Urgent Care has different locations in Palm Beach County, and each caters to its respective areas. They have one in Palm Beach Gardens, West Palm Beach, and Palm Springs. Below is an exclusive list of medical conditions they treat through telemedicine:
- Asthma Exacerbation
- Cold and Flu
- Erectile Dysfunction
- Puncture Wounds
- Skin Conditions
- Sinus Infection
Those who have weak immune systems, immunocompromised, or have disabilities can get the most benefit from their services. They also address workmen’s compensation injuries in the state of Florida. However, you cannot be prescribed any controlled substances through their telemedicine services.
A review of your family and medical history will help them identify factors that contribute to the medical condition subject of the consultation. Their staff and physicians can also do limited physical examinations. If they assess that you would need to see a specialist for your medical case, they will help you set an appointment with them at the earliest time possible.
They are in-network with most major insurance providers such as Aetna, Humana, Cigna, all workmen’s compensation insurance companies, and many others. If you cannot find your insurance provider in their list, you can still avail of their services, and they will directly bill them.
- Secure Video Sessions
- Licensed Counselors, Psychiatrists, Therapists, and Nurses with Specialized Training
Brave Health provides psychiatric services such as counseling, medication management, therapy, and medication-assisted treatment (MAT) virtually. Their expertise is in behavioral health, mental health, and substance use disorder. They have an evidence-based approach when it comes to treating their patients.
Each patient receives a well-researched customized treatment according to their own needs and what the provider thinks would be the most effective course to take. You are constantly being re-evaluated along the way so that necessary changes and adjustments to your treatment plan can be made. The treatment period could be anywhere from six months to one and a half years.
You can also access educational resources on their website, which can provide you with a background on your current condition or a loved one. It can help you understand and find ways of giving support for their treatment. The topics usually revolve around addiction and other substance use disorders – how to battle them, tags to support groups, and many others. They also provide links to informational government-run sites that may offer free services like HIV Testing in the state of Florida.
- HIPAA Compliant
- Board Certified Obstetrician-Gynecologist, Physicians, Midwife, Nurse
They offer two options on how you want to avail of their telemedicine services, either through FaceTime or Healow. The latter is their Patient Portal system. They cover subspecialties in women’s health, specifically in gynecologic oncology, gynecologic pathology, and urogynecology. Engaging the services of a clinic that offers telemedicine services that focuses only on women’s health would make your consultations worth your time. If your case is special, they can just simply refer and forward your records to another specialist within their network that covers your condition.
Consultations and questions regarding the matters listed below are entertained through their telemedicine services:
- Bladder Issues
- Family Planning
- Genetic Counseling
- Hormone Replacement Therapy
They also have a clinic where you can go if your provider requires you to take tests, ultrasounds, and physical exams. If further and in-person follow-up consultation is likewise necessary for your medical care, they can directly give you an appointment during your virtual visit. To make accessing their services easier, you can download the Healow app from the App Store or Google Play. The provider has recently released the Healow Mom which is a pregnancy app.
- HIPAA Compliant
- Board Certified Psychologist, Psychiatrist, Neurologist, Psychiatric-Mental Health Nurse Practitioner, Certified Family Nurse Practitioner, Physician Assistants, Licensed Clinical Social Worker
LifeStance was formerly known as Florida Behavioral Health. They specialize in treating and managing Attention Deficit Hyperactivity Disorder (ADHD). However, they do not accommodate first-time patients directly through their telehealth service. You must first be seen in person by one of their doctors for a proper assessment, examination, and determination whether treatment through telehealth will work and is best for you.
Aside from ADHD, they also address the following mental health issues and conditions:
- Adjustment Disorder
- Anger Management
- Anxiety Disorders
- Autism Spectrum Disorders
- Bipolar Disorders
- Eating Disorders
- Grief Counseling
- Healthy Behavioral Changes
- Obsessive-Compulsive Disorder
- Panic Attack
- Personality Disorders
- Post-traumatic Stress Disorder
- Stress Management
You can also find educational resources on their website about these conditions so that you have an understanding or background about them before your consultation. This can also be very helpful when you are living with or know someone who is experiencing any symptoms or suffering any of these mental health issues.
They offer medication-assisted treatment (MAT) and can issue prescription refills as medically necessary. The patient portal they utilize is AdvancedMD.
- HIPAA Compliant
- Board-Certified Pediatricians
Whether you want to consult an illness or simply have questions about the growth and development of your child, you can rely on the pediatricians at Blueberry Pediatrics to take away all your worries. They can provide medical and proven facts about breastfeeding and sleep training. Every concern involving your child is never too minor, not to be given any expert attention. Their pediatricians can give you medical advice and treatment even after-hours for these common illnesses:
- Ear Infections
- Gastrointestinal Issues
- Runny Nose
They offer what they call the medical kit, which they phrase as an exam room in a box. It consists of an ear infection kit with an HD Digital Smart Otoscope, a finger pulse oximeter, and a digital oral thermometer. These tools can be very helpful in getting a full and accurate examination of your child, especially the otoscope, as it is illegal for doctors to provide treatment for any ear infection without having any visuals of the tympanic membrane.
All your children can be covered in just one membership. You can download their app from Google Play or the App Store. If your child has an existing pediatrician, they can coordinate and forward your consultation records with him or her to be updated.
- HIPAA Compliant
- Board Certified Advanced Family Nurse Practitioners, Physicians, Physician Assistants, Medical Assistants
They cover a wide array of medical illnesses that fall within primary care, family medicine, women’s health, and parasitic infectious disease. They also do clinical research and provide school health services. However, only a few are available online or through telemedicine. The TeleHealth Department at SFFHRC treats the following conditions:
- Burning with Urination
- Eye Swelling, Irritation, Redness
- Gastroesophageal Reflux Disease (GERD)
- Mild Asthma
- Minor Burns
- Sinus Pain
- Sore Throats
- Wound Care
They also offer medication management for those taking multiple medicines, complicated medication regimen, or have been taking their medications for a long time. If you speak Spanish or Mandarin, SFFHRC can match you with one of their bilingual health care practitioners.
They are affiliated with Memorial Hospital West and West Kendall Baptist Hospital. According to their medical judgment, if they believe that your medical condition requires to be checked by a doctor in-person or a trip to the emergency room altogether, they can help you book or set an appointment.
- Board Certified Adult and Child Psychiatrist
Children, teens, and adults are all accommodated at NowPsych in their online psychiatry services. They also do autism evaluations, dual diagnosis, medication management, review consultation, and address peer, school, and relationship issues. Their psychiatrist is verified by Psychology Today and can see patients for any of the following conditions:
- Addiction: Substance, Internet, Video Game
- Asperger’s Syndrome
- Bipolar Disorder
- Chronic Impulsivity
- Developmental Disorder
- Intellectual Disability
- Learning Disability
- Mood Disorders
- Obsessive-Compulsive Disorder
- Post-traumatic Stress Disorder
- Teen Violence
- Traumatic Brain Injury
They observe different treatment approaches at NowPsych depending on what best suits the patient. It can either be psychodynamic, dialectical, cognitive-behavioral, interpersonal, or parent-child interaction. You can choose to be treated individually or as a family.
They also post blog articles on their website that tackle different mental health issues, symptoms, treatment plans, recommendations, and many more if you can’t decide just yet as to how to go about with your course of treatment or how to deal with a loved one suffering from a mental health condition, reading their articles would be a good first step to take.
- HIPAA Compliant
- Board-Certified Physicians, Cardiologists, Oncologists
The virtual care they offer at Orlando Health can be categorized into three:
- Virtual Care: This is where regular telemedicine consultations fall. You can be a new patient or an established physician with the Orlando Health Medical Group. The department of Pediatric Specialty Practices, Cancer Institute, Surgical Specialties, Heart and Vascular Institute, Primary Care Services, Women’s Services, and Orthopedic Institute accommodates this type of telehealthcare.
- On-Demand Virtual Care: If you have minor medical problems that would require the immediate attention of a doctor, you should book under this category. They treat minor conditions like abrasions, allergies, colds, conjunctivitis, diarrhea, flu, insect bites, moles, respiratory infections, skin rashes, sore throats, sprains, strains, and warts. You can download the app from the App Store or Google Play which is powered by Teladoc.
- Rehabilitation Virtual Care: They provide physical, occupational, and speech therapy in their outpatient rehabilitation virtual visits. If you have lymphedema, neurological, orthopedic, pelvic health, or speech difficulties and issues, doctors at Orlando Health can help you recover and optimize them again.
All clinical notes can be accessed through their accounts and can be readily downloaded to be presented to your established physician. Currently, all virtual visit services are available only for those located in Central Florida. If you do not speak English, they will provide a third-party medical translator during the virtual consultation.
- HIPAA Compliant
- Board Certified Orthopedic Physician, Physician Assistants, Nurse Practitioners
They accept both existing and new patients through the Florida Orthopaedic Institute Telemedicine Services. Said services can be used for consultations, queries, or discussions for treatment plans to be undergone by the patient. They have physicians who are specialists in Hip and Thigh, Interventional Spine, Knee and Leg, and Sports Medicine. Some of the conditions they specialize in includes:
- Achilles Tendinitis
- ACL Injuries
- Bicep Tendon Tear
- Carpal Tunnel Syndrome
- Charcot Joint
- De Quervain’s Tenosynovitis
- Ganglion Cysts
- Hallux Rigidus
- Heat Injury
- Hip Muscle Strains
- Muscle Spasms
- Pinched Nerve
- Rheumatoid Arthritis
The above-mentioned are just some of the medical conditions they treat. There are still other and more complicated conditions that they address and explain through infographics on their website. They currently utilize FaceTime for iOS users and Zoom for Android users. If you have any bandages or dressings at present, be sure to have them removed before your telemedicine appointment so that your doctor can remotely examine them right away and save time during consults. They have clinics all over Florida, so if your online doctor might advise you to seek an in-office consult or get tests done, you can easily schedule one during your session.
Telemedicine Resources in Florida
The existence of telehealth laws in Florida has only been concretely established in 2019. The laws governing this type of health care service can be found in various government sites with the common goal of educating the general public and professionals alike about the advantages and restrictions attached to them. Check out the following links to have a well-informed background about telehealth in Florida:
- Florida Telehealth: Whether you are a provider or a patient, anything you need to know about telehealth laws and services in Florida can be found on this official government website. One can verify a license, sign up for updates, access registration documents, and get answers to frequently asked questions on this resource.
- Center for Connected Health Policy – Florida: This the National Telehealth Policy Resource Center funded by the Public Health Institute. It publishes up-to-date information about each state, including Florida, laws, and reimbursement policies on telehealth.
- Florida Medical Association: On this site, you can find under their Telehealth Information section the latest issuances, payment resources, initiatives, and toolkits. You can also find links to financial assistance and other resources related to public health.
- Agency for Health Care Administration: This agency is responsible for handling the state Medicaid program and licensing healthcare facilities. If you want to learn about reimbursement policies and the extent of your coverage, you can find these pieces of information here.
- Southeast Telehealth Resource Center: Florida belongs in the southeastern region where SETRC serves as an extension to the existing telemedicine programs in the covered states. They offer clinical support, educational resources, and technical support.