Telehealth practice questions

[bobby pen]

I am currently gearing up to start a telehealth, private pay practice with licenses in multiple states. I have everything in place except for a few logistical issues. If anyone can share their experience or knowledge about these subjects/answer these questions I would be very appreciative.
1. If I have a license in another state & see patients there via telehealth, do I have to register as a foreign entity or can I see patients w/o a business license/registering with the Secretary of State if I am seeing them as an individual and not as an LLC or sole proprietor?
2. Do taxes have to be paid to each in state I see patients, or do I only have to pay taxes in my state of residency?

TIA!

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[dl2dp2]

I discussed this with my accountant--the answer is there's no clear answer at the moment as this is all so new. There are several different ways to do this.

What I would do is start with a professional LLC in your home state where you have a physical presence. This process alone can take 3-6 months depending on where you are. Then consult your accountant on these contingencies once this is set up. It also depends on whether you choose to tax as a C-corp vs. S-corp vs. Sole.

 

[bobby pen]

Thank you for your response.
I heard something similar From my CPA. They weren’t sure if I should do quarterly taxes in each state due to being telehealth or if I would have to pay taxes only in certain states. Example: California collects taxes on all income earned in California. But then i read it was above 500,000. Or if paying in my home state w cover it. I planned on starting my solo LLC and taking it from there.

Any idea about seeing patients? I have licenses in these states already along w my website, malpractice and EMR ready to go. Do I need to wait till the LLC is up and running and register with the secretary or can I start practice as an individual practitioner at anytime? I consulted 2 lawyers, one who works w risk management for medical practitioners, and neither could really give me a straight answer. I’ve read telemedicine laws in each state and they don’t mention this. If you have any suggestions about resources I would very much appreciate it.

 

[dl2dp2]

You can start practicing any time. I transferred my sole accounts to LLC once it's done. Just file Schedule C on LLC TIN whenever ready.

Ask your CPA to give you one or several final answers. Then run your taxes on that final answer. Asking me (or the internet) doesn't help. I'm not going to help you draft a response to IRS/State finance div at a time of audit. Your CPA has experience in this.

 

[Sushirolls]

Need to also consult with lawyer, more than the CPA.

Also need to consult with medical board for each state (or is it nursing board?).

 

[nexus73]

If you're in New York and your patient is in Chicago, and you get sued, do you have to fly to Chicago for all the depositions, etc?

 

[Sushirolls]

Most likely

 

[bobby pen]

You can start practicing any time. I transferred my sole accounts to LLC once it's done. Just file Schedule C on LLC TIN whenever ready.

Ask your CPA to give you one or several final answers. Then run your taxes on that final answer. Asking me (or the internet) doesn't help. I'm not going to help you draft a response to IRS/State finance div at a time of audit. Your CPA has experience in this.

I appreciate the response. I agree asking other on the internet is not the greatest but the fact that others have experienced the same issue and have had similar experiences and were able to move forward helps ease the anxiety with the unknown aspects. I will be following my CPAs advice once they give me a solid answer.

In response to the second comment . I have consulted a lawyer. 2 who could not give me a straight answer on the LLC, seeing patients etc. one was med risk management. I have talked to my med mal who also was unable give me a full answer. I could contact the medical board and maybe they could give me some clarity. I also appreciate the private practice thread. It was very helpful.

 

[nexus73]

Most likely

well that would be inconvenient