PART 3 OF 4: Prescribing, Reimbursement, and Practice Structure

The operational rules that shape a telehealth practice.

Telehealth compliance extends into how providers prescribe, how services are paid for, and how the practice itself is organized. Each of these areas carries requirements that differ from, or add to, those of a traditional in-person practice. This post addresses the operational rules that govern a California telehealth practice.

Prescribing via telehealth

California generally permits prescribing based on a telehealth encounter, provided an appropriate provider-patient relationship and examination support the prescription. Controlled substances carry additional constraints under both federal law and California law, and the rules in this area have evolved significantly in recent years. Providers prescribing controlled substances via telehealth should confirm the current federal and state requirements before doing so.

Reimbursement and payer rules

California requires health plans and insurers to cover telehealth services on terms comparable to in-person care, and Medi-Cal reimburses a range of telehealth services. Coverage and payment rules nevertheless vary by payer and by service, and they continue to change. Practices should verify current coverage, coding, and documentation requirements for each payer rather than assuming uniformity.

Corporate Practice of Medicine still applies

A telehealth practice is still a medical practice, and California's Corporate Practice of Medicine doctrine applies with full force. A practice backed by investors or a management company must be structured so that licensed physicians retain clinical control and ownership, typically through a management services organization arrangement. Delivering care remotely does not change these ownership rules.

Multi-state and platform considerations

Telehealth practices frequently operate across state lines and through technology platforms. Each state where patients are located may impose its own licensure, consent, and prescribing rules, and platform vendors must be brought within the practice's compliance framework through appropriate agreements.

How West Coast Health Law Can Help

We advise telehealth practices on compliant prescribing protocols, payer and reimbursement questions, and CPOM-compliant structuring — including multi-state and platform arrangements.

This article is provided for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Laws change and every situation is different; consult a qualified attorney about your specific circumstances.

West Coast Health Law offers a FREE consultation which you may schedule by clicking the button on our website.