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Whether a healthcare practitioner is permitted to provide telephonic professional services to a client in a state where the practitioner is unlicensed is unresolved. Public policy of states and risk management policy of practitioners would seem to militate against it. States wish to have jurisdiction by means of licensure over healthcare practitioners who provide services to their residents. Although it has not occurred to my knowledge, there is the possibility that a practitioner might be accused of unlicensed practice by the state in which the client resides (and in which the practitioner is unlicensed); unlicensed practice is a crime. Additionally, there is the possibility that, should the practitioner be sued for malpractice, insurance coverage might be questioned by the practitioner’s malpractice carrier for services rendered out-of-state on the basis of the practitioner having engaged in unauthorized practice.
LEGAL BRIEFS
communication? Presumably, you will be lacking information that you might otherwise glean from face-to-face encounters with patients. Resolution of these questions require recourse to professional research and ethical and community standards. You might address them additionally in an informed consent document, in which you label as experimental the telephonic aspect of treatment, and if possible, offer patients alternative non-telephonic referrals if and when exigent circumstances arise.
purposes the site of delivery of all services shall be considered New York State and subject exclusively to the laws of this State might provide a technical solution to these issues, but is as yet untested also. Having initial and then some ongoing regular contact in New York State, i.e., an in-person intake and occasional face-to-face sessions, would bolster a position that New York is properly considered the situs of the services. Out-of-state telephonic "coaching" presents significantly less exposure than telephone therapy because coaching usually does not require a license, is not necessarily a professional activity, and has standards of care that are looser and vaguer.
Bruce Hillowe practices law in the state of New York, USA , Emphasizing Mental Healthcare Law, Healthcare Law and Mediation and has served his Community for 29 Years. This article is a reprint from his quarterly newsletter in which he offers a Health Law Supplement in each issue. Visit his website at: www.BruceHillowe.com
Having an out-of-state patient sign an agreement that for all
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