Telehealth rules in Kentucky

1. 01 · First visit

   A form cannot carry a refill

   KRS 311.597 treats it as dishonorable conduct to prescribe in response to a communication transmitted or received by computer or other electronic means without verification that the person requesting medication is in fact who the patient claims to be, establishment of a documented diagnosis through accepted medical practices, and maintenance of a current medical record. The same provision then states that an electronic, on-line or telephonic evaluation by questionnaire is inadequate for the initial evaluation of the patient or for any follow-up evaluation, which places a tenth prescription under exactly the test that governed the first.

   Source: KRS 311.597

   Across the border

   • Indiana

     Indiana attaches its conditions to the drug class, requiring a real-time audio-video visit and a check of the state monitoring program before any controlled substance, and allowing opioids only for opioid use disorder.

     Source: IC 25-1-9.5-8

   • Ohio

     Ohio accepts an asynchronous first encounter under the ordinary standard of care and saves its hard requirement for Schedule II, which needs an in-person examination when the patient is new.

     Source: Ohio Admin. Code 4731-11-09

   • West Virginia

     West Virginia bars the questionnaire at the front door only, demanding a real-time encounter to begin treatment and then an in-person visit within twelve months of starting remote care.

     Source: W. Va. Code 30-3-13a

   • Virginia

     Virginia lets a store-and-forward review stand where an existing history is available and an examination or testing is added when the standard of care calls for it, reserving audio-only contact for follow-ups.

     Source: Center for Connected Health Policy: Virginia

   • Tennessee

     Tennessee halts an asynchronous review only when the transmitted material cannot support a diagnosis, at which point the physician must declare as much and send the patient for data, an examination or local care.

     Source: Tenn. Comp. R. & Regs. 0880-02-.16

   • Missouri

     Missouri moved in the opposite direction, permitting treatment based on an intake form where a state-licensed entity delivers it and a report reaches the patient's regular physician inside fourteen days.

     Source: RSMo 191.1146

   • Illinois

     Illinois leaves the modality open and puts its prescribing gate elsewhere, calling for a state controlled substance license, electronic transmission for Schedules II through V, and a monitoring check before a first narcotic.

     Source: 720 ILCS 570/311.6

2. 02 · Prescribing

   A weight drug starts from numbers

   201 KAR 9:016 puts a measured floor under controlled weight-loss prescribing: a body mass index of twenty-seven or more, or twenty-five to twenty-seven alongside a comorbid condition such as cardiovascular disease, diabetes mellitus, dyslipidemia, hypertension or sleep apnea. The same regulation asks for a history emphasizing cardiovascular illness, a complete physical examination, and laboratory work covering a complete blood count, fasting blood sugar, thyroid function, a lipid profile, serum potassium, and liver and renal function. A monitoring report for the twelve months before the encounter comes first, and carrying a Schedule III or IV amphetamine-like drug past three months has to be justified in the patient record.

   Source: 201 KAR 9:016

   Across the border

   • Indiana

     Indiana names no numerical threshold and asks instead for a thorough examination plus a documented, unsuccessful course of diet and exercise before an anorectic drug goes out.

     Source: IC 35-48-3-11

   • Ohio

     Ohio sets the entry point higher, at a body mass index of thirty or twenty-seven with a comorbid condition, and stops treatment unless the patient sheds five percent of starting weight inside the first three months.

     Source: Ohio Admin. Code 4731-11-04

   • West Virginia

     West Virginia carries no obesity drug series in its board rules and draws its remote prescribing line by schedule instead, refusing Schedule II to a patient treated only by telemedicine.

     Source: W. Va. Code 30-3-13a

   • Virginia

     Virginia applies the same test to a weight medication as to any other scheduled drug, asking whether the prescriber keeps a practice location in the state or can refer the patient locally for an examination.

     Source: Va. Code 54.1-3303

   • Tennessee

     Tennessee fixes no body mass threshold for anorectic drugs and holds the remote prescriber to the same standard of professional practice as a similar licensee working face to face.

     Source: T.C.A. 63-1-155

   • Missouri

     Missouri legislates no weight threshold and has spent its recent lawmaking instead on opening an intake-form pathway supervised by a licensed entity.

     Source: RSMo 191.1146

   • Illinois

     Illinois governs the same medications through registration and reporting, asking for a state controlled substance license and electronic transmission, with stimulants joining the monitoring check duty from January 1, 2027.

     Source: 720 ILCS 570/311.6

3. 03 · Practice

   One telehealth rule for every profession

   900 KAR 12:005 applies a single set of telehealth duties to health care providers across the licensed professions rather than leaving each board to draft its own. The regulation calls for non-public-facing technology products that comply with federal privacy law, and it lists live audio-video, asynchronous store-and-forward, remote patient monitoring, audio-only systems and clinical text chat among the secure ways a service may be delivered.

   Source: 900 KAR 12:005

   Across the border

   • Indiana

     Indiana writes its telehealth duties into the professions title and conditions remote care on a relationship the prescriber has already established, with notice to the patient's primary care provider where the patient agrees.

     Source: IC 25-1-9.5-7

   • Ohio

     Ohio runs its duty through one statute covering the treating professions and requires patient identity and location to be verified and telehealth consent documented before treatment starts.

     Source: Ohio Rev. Code 4743.09

   • West Virginia

     West Virginia locates its rule in the chapter shared by the licensing boards and makes a live encounter the gateway, with an in-person visit expected inside the first year of remote treatment.

     Source: W. Va. Code 30-1-26

   • Virginia

     Virginia leans on board guidance rather than one cross-profession regulation, and that guidance confines audio-only encounters to follow-up care and conditions store-and-forward on an available history.

     Source: Center for Connected Health Policy: Virginia

   • Tennessee

     Tennessee splits the work between a statute carrying the definitions and a medical board rule that pushes ordinary telephone calls, email and fax outside telemedicine altogether.

     Source: Tenn. Comp. R. & Regs. 0880-02-.16

   • Missouri

     Missouri aims its newest provision at the delivery organization, allowing intake-form treatment where a licensed entity provides it and a report goes to the patient's usual physician.

     Source: RSMo 191.1146

   • Illinois

     Illinois counts a telephone call as a telehealth encounter while leaving text messaging outside the definition, and it demands a state license to treat a patient located there.

     Source: 225 ILCS 150/10

1. 01

   Identity comes first

   Before a prescription follows an electronic request, the licensee verifies that the person asking for medication is in fact the patient, a step that lives in the chart as much as in the clinical judgment.

   Source: KRS 311.597

2. 02

   A documented diagnosis

   A diagnosis established through accepted medical practices has to be recorded in a current medical record, so the file shows the reasoning behind the prescription rather than the outcome alone.

   Source: KRS 311.597

3. 03

   Follow-ups are not exempt

   Because the questionnaire language covers any follow-up evaluation, a repeat cycle built on a short re-check form needs a genuine exchange with the provider, with photographs or a live encounter where the condition calls for them.

   Source: KRS 311.597

4. 04

   No in-person precondition

   Nothing in the framework requires a prior consultation in an office, and reimbursement may not be refused merely because a practitioner and a patient never met face to face.

   Source: Center for Connected Health Policy: Kentucky

1. 01

   Compacts count

   A state agency may not prohibit telehealth delivered to a person located here by a provider practicing under a recognized interstate compact, and membership spans compacts covering physicians, nurses, psychologists and several therapy professions.

   Source: Center for Connected Health Policy: Kentucky

2. 02

   Two agreements before prescribing

   An advanced practice registered nurse executes a written collaborative agreement with a physician before prescribing nonscheduled legend drugs, and a second, separate agreement before prescribing anything in Schedules II through V.

   Source: KRS 314.042

3. 03

   Four years, then release

   After four years of prescribing, the nonscheduled agreement falls away once the board has been notified, while the controlled substance agreement ends only where the board approves a written request, and either may be kept voluntarily.

   Source: KRS 314.042

4. 04

   Coursework follows the database

   Controlled substance prescribers devote four and a half of their sixty continuing education hours each three-year cycle to the monitoring system, pain management or addiction disorders.

   Source: 201 KAR 9:310

5. 05

   A state office for telehealth

   Telehealth policy has a division of its own inside the Office of Inspector General, which is where operating guidance is published rather than in a single licensing board's newsletter.

   Source: Center for Connected Health Policy: Kentucky

How Tessic Health's providers are licensed in Kentucky