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Telemedicine in Michigan A Policy Report Addressing Legal and Regulatory Barriers Prepared by Pamela Whitten Ph D In Cooperation with the State Telehealth Working group Michigan State University Acknowledgements This report is made possible by State of Michigan funding allocated to Michigan State University s Institute for Public Policy and Social Research IPPSR for applied public policy research projects 1 Contents I Introduction 4 A Rationale for this Project 5 II An Overview of Telemedicine 6 III Barriers to Diffusion of Telemedicine 9 A Licensure Credentials and Certification 10 1 Physician Licensure 11 2 Nursing Licensure 13 3 Credentialing and Privileging 14 4 Certification 14 B Payment and Reimbursement 16 C Safety Standards of Care and Liability 19 1 Practice Guidelines 19 2 Technical Standards 21 3 Liability Insurance 21 D Infrastructure 23 E Privacy Security and Confidentiality 26 1 HIPAA 26 IV Telemedicine in Michigan 29 V Recommendations to Advance Telemedicine in Michigan 33 A Coordination Mechanism 33 2 B Licensure Credentials and Certification 34 1 Issues Presented 34 2 Recommendations 35 C Payment and Reimbursement 37 1 Issues Presented 37 2 Recommendations 37 D Liability 39 1 Issues Presented 39 2 Recommendations 40 E Infrastructure 42 1 Issues Presented 42 2 Recommendations 42 F Privacy Security and Confidentiality 44 1 Issues Presented 44 2 Recommendations 44 VI Summary 46 VII Conclusion 47 References 49 3 Tables and Appendix Table 1 Roster of the Working Group on Telemedicine Policy for Michigan 52 Table 2 Telemedicine Related State Licensure Laws 53 Table 3 States that Adopted the Interstate Nurse Licensure Compact 57 Table 4 States Where Medicaid Reimbursement of Services Utilizing Telemedicine is Available 58 Table 5 Additional State Laws addressing Telemedicine 64 Appendix 1 Sample Professional Liability Application 66 4 Telemedicine in Michigan A Policy Report To Address Legal and Regulatory Barriers I Introduction The Office for the



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