The telemedicine laws and rules have gone through major changes since the COVID-19 Pandemic, and the laws and rules continue to be in a state of flux. The federal rules govern prescribing controlled substances, but the majority of telemedicine rules are governed by state law. Generally, before a provider can prescribe any drug, the provider must have an established patient-provider relationship. An open question in many states we’ve continued to research is-Can you create a patient-provider relationship through telemedicine? This updated post dives into this question with updated insight, with a focus on Georgia rules. If you need assistance integrating telemedicine into your practice or would like to discuss this blog post, you may contact our healthcare law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.
Each state is going to answer this question differently. Let’s dive into the rules in Georgia as an example of how to think through this question.
First, it’s important to understand what telehealth modalities are permitted in a given state. In Georgia, for instance, the definition of telemedicine is found within the insurance code. Georgia Code Section 33-24-56.4 (“Ga. Telehealth Act”) defines telemedicine as “a form of telehealth which is the delivery of clinical health care services by means of real-time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or store and forward transfer technology . . . .”
Second, it’s also important to understand if a given state’s Medical Practice Act dictates when telehealth is permitted. Among many other requirements, the baseline standard for when a provider can provide care through telehealth in Georgia is that the provider “[i]s able to examine the patient using technology or peripherals that are equal or superior to an examination done personally by a provider within that provider’s standard of care.” Rule 360-3-.07(a)(3.d.).
Third, just because a modality is permitted does not mean it can be used to establish a patient-provider relationship. A state’s medical practice laws and/or medical board may provide specific guidance on how to create a patient-provider relationship through telemedicine. Often times, however, the rules permit provider discretion. As an example, in Georgia, it’s unclear whether a video call and/or whether store and forward technologies can create a patient-provider relationship, but the Georgia Medical Board provided clarity in April 2025 in this answer on what may not be sufficient to establish a patient-provider relationship:
Question: A training company in Atlanta plans to offer neurotoxin injection courses under the supervision of an off-site MD. They want me to review model history forms and photographs to determine suitability for treatment and prescribe appropriate dosing for trainees to administer. I’m seeking clarification on whether this process meets the Board’s requirement for a medical history and physical exam.
Response: The scenario presented, asynchronous telehealth/store-and-forward telemedicine, would not comply with the requirement for an examination of the patient prior to the issuance of the prescription. The examination must be a dynamic assessment. At a minimum, a telehealth appointment with real-time live video would be required. See Board Rule 360-3-.07 and Board of Nursing Position Statement: Cosmetic/Aesthetic Procedures.
The Georgia Medical Board confirmed a questionnaire or audio-only call is likely not typically going to be sufficient to establish a patient-provider relationship, and a real-time two-way audio and video call is likely the safest and most appropriate way to establish such a relationship. Our firm has worked with many different medical practices to provide guidance with the provider’s input on how to properly integrate telemedicine into their practice.
If you need assistance integrating telemedicine into your practice or would like to discuss this blog post, you may contact our healthcare law firm at (404) 685-1662 (Atlanta) or (706) 722-7886 (Augusta), or by email, info@littlehealthlaw.com. You may also learn more about our law firm by visiting www.littlehealthlaw.com.