Purpose of Review This article provides an overview of the legal and regulatory requirements that providers engaging in teledermatology must consider when structuring telemedicine arrangements and developing a telehealth strategy. Recent Findings The numerous state and federal legal and regulatory considerations applicable to teledermatology offerings are rapidly changing: new laws and regulations are proposed and adopted every year. Summary At the state level, requirements are often state specific and address a wide variety of topics such as establishing the physician-patient relationship, technology-specific requirements, and practice and prescribing standards when delivering care through telemedicine. At the federal level, laws and regulations address federal health care program reimbursement, digital devices, and data privacy, among other topics.

The primary means of ensuring EMTALA compliance while implementing emergency telemedicine programs include incorporating critical clinical details into the services contracts and implementing robust written policies that anticipate division of labor issues, the need for backup coverage, triaging, patient transfer protocols, and credentialing issues. With adequate up-front due diligence and meaningful contracting, hospitals and telemedicine providers can avoid common EMTALA liability pitfalls.

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The expansion of health care services delivered through telehealth is impacted by numerous legal, regulatory, and reimbursement frameworks. Standard medical practices for consent, privacy, credentialing, and licensing apply to telehealth; however, the opportunity for cross-state practice complicates their application. Hospital-specific rules for credentialing and emergency stabilization must also be considered. Delivery of medical services is often driven by reimbursement, which for telehealth is governed by a complicated web of rules that vary by service, payer, and location. Temporary changes to these rules in association with the public health emergency (PHE) declared in response to the COVID-19 pandemic has rapidly reshaped the telemedicine regulatory landscape. Advocacy for smart legislation that improves and simplifies access to care is important to ensure equity of telehealth services.