Telehealth Regulatory and Legal Considerations: Frequently Asked Questions

Jana Cason, Janice A. Brannon


As telehealth gains momentum as a service delivery model in the United States within the rehabilitation professions, regulatory and legal questions arise. This article examines the following questions:
1. Is there a need to secure licenses in two states (i.e., where the practitioner resides, and where the client is located), before engaging in telehealth?
2. Do state laws differ concerning if and how telehealth can occur?
3. Do any states expressly disallow telehealth?
4. Can services delivered through telehealth be billed the same way as services provided in-person?
5. If practitioners fulfill the requirements to maintain licensure (e.g., continuing education obligations) in their state of residence, do they also need to fulfill the requirements to maintain licensure for the state in which the client resides?
6. Will professional malpractice insurance cover services delivered through telehealth?
7. Does a sole practitioner need to abide by HIPAA regulations?
Responses to these questions are offered to raise awareness of the regulatory and legal implications associated with the use of a telehealth service delivery model


American Speech-Language-Hearing Association. (2011). State licensure telepractice provisions. Retrieved from

Delaware General Assembly Title 24 Professional Regulation. (2006). 3700 Board of Examiners of Speech/Language Pathologists, Audiologists & Hearing Aid Dispensers, Section Retrieved from

Thompson, G. (2011). Thompson STEP Act passes U.S. House of Representatives. Retrieved from

Watzlaf, V., Fahima, R., Moeini, S., & Firouzan, P. (2010). VoIP for telerehabilitation: A risk analysis for privacy, security, and HIPPA compliance. International Journal of Telerehabilitation, 2(2), 3-14. doi:10.5195/IJT.2010.6056

Watzlaf, V., Fahima, R., Moeini, S., Matusow, L. & Firouzan, P. (2011). VoIP for telerehabilitation: A risk analysis for privacy, security, and HIPPA compliance – Part II. International Journal of Telerehabilitation, 3(1), 3-10. doi: 10.5195/IJT.2011.6070

Telehealth Resources

American Occupational Therapy Association. (2010). Telerehabilitation Position Paper. American Journal of Occupational Therapy, 64, S92-S102. doi: 10.5014/ajot.2010.64S92. Retrieved from

American Physical Therapy Association. (2009). Telehealth - definitions and guidelines. Retrieved from

American Speech-Language-Hearing Association. (2011). Telepractice for SLPs and audiologists. Retrieved from

American Telemedicine Association – * Telerehabilitation Special Interest Group (SIG) i4a/pages/index.cfm?pageID=3328 * American Telemedicine Association’s, A Blueprint for Telerehabilitation Guidelines –

Center for Telehealth and e-Health Law (CTel) –

Regional Telehealth Resource Centers -




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