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adamnyc

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I have a 2 part posting here. Does anyone know if a medical resident or practicing physician can prescribe home medical equipment to a patient in another state? Assume you've never had an in person evaluation, and its only over the phone getting medical history and possible receiving email of pictures of their condition. The patients would be NON-Medicare. Only private insurance patients.

I am a working with a medical supply company thinking of recruiting flex time physicians for this type of phone consult. The product is a home compression boot commonly prescribed for lymphedema and venous insufficiency and/or stasis ulcers.

Is this legal? If so, is it something a physician might be interested in.
 

PADPM

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I'm not an attorney, but I wouldn't have respect for any doctor who became involved with the "scheme". In essence, in MY opinion, it's simply an unethical way to bill insurance for expensive equipment.

To prescribe lymphedema pumps based on photos, phone conversations, etc., is beyond my comprehension. Just docs looking for a quick buck and a company looking for a quick way to "sell" their products, whether they are even indicated/justified or not.

If the product is beneficial AND the patient needs the product, why not just get a prescription from the patient's OWN physician who actually knows the patient, knows the patient's medical history and has actually TREATED the patient.

This is exactly why insurance rates are so high.
 

NotAProgDirector

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If I work in state X and a patient comes to my office in state X and I write a prescription, then they can (usually) take that prescription to any other state and have it filled. This also allows a patient to turn in a prescription to any Walgreens, and then fill that prescription at another Walgreens.

If I see a patient in my office in state X, but they live in state Y and call me after hours for help, that's also fine. But I can't do a home visit to their house without a license from State Y.

In the situation you're suggesting, the actual "visit" would happen over the phone. This seems most akin to "Nighthawks" -- radiologists who work in one state (or even another country) and read films sent to them from elsewhere. They all need state licenses for every state they read films in. So, I'm pretty sure that you'd need a license for every state where you planned to do this.
 
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MaxillofacialMN

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No idea, but I would guess no. If they can prescribe a boot, couldn't they prescribe drugs and everything else?

States have different laws and you aren't registered there....

No idea though.
 

gutonc

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In the situation you're suggesting, the actual "visit" would happen over the phone. This seems most akin to "Nighthawks" -- radiologists who work in one state (or even another country) and read films sent to them from elsewhere. They all need state licenses for every state they read films in. So, I'm pretty sure that you'd need a license for every state where you planned to do this.

This....

And while many states have specific licenses for teleradiology (in my state, it costs the same but is much less of a hassle to get than a regular license), I don't know of any that have special licenses for tele-insurance scams. But I could be wrong.
 
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