Out-of-State Telehealth Provider Treating Florida Clients
Dr. Priya Kim holds a Georgia psychology license and a Georgia address. She has never applied for a Florida license or Florida telehealth registration. Her website states: Online therapy for Florida residents-licensed psychologist. She has provided 12 video sessions to six clients who live in Miami, Orlando, and Jacksonville; one client is a 16-year-old whose mother pays. Dr. Kim is physically in Atlanta for every session. She keeps records in Georgia, uses a HIPAA-compliant platform, and says she follows Georgia law. One Florida client, a 42-year-old with bipolar disorder, sends a message saying he has stopped lithium and feels unstoppable. Dr. Kim calls the Florida Department of Health to ask whether she can continue while she works on paperwork. A DOH investigator tells her a complaint has been opened. Her website lists no Florida registration number.
1. Was Dr. Kim required to obtain a Florida license or registration before treating Florida clients by telehealth? Analyze under Florida law.
Read the worked answer
Yes. Under s. 456.47, Fla. Stat., an out-of-state health care practitioner who provides telehealth services to Florida patients must either hold a Florida license or register with the Florida Department of Health as an out-of-state telehealth provider. Registration requires an active, unencumbered license in another state, an application and fee, and agreement to be bound by Florida law and jurisdiction. The provider must include the registration number in advertisements and may not open a Florida office or physically practice in Florida. Dr. Kim had only a Georgia license and no registration, so her six Florida treatment relationships were unauthorized. Her website statement that she serves Florida residents is evidence of the violation.
2. What should Dr. Kim do now for existing clients, including the client in crisis?
Read the worked answer
She should immediately stop providing psychotherapy to Florida clients until she is registered or licensed. Stopping abruptly creates an abandonment risk, so she should give each client written notice, explain the reason at an appropriate level, offer several Florida-licensed referrals, provide records upon authorization, and document the transition. For the client who stopped lithium and feels unstoppable, she must treat the situation as a possible psychiatric emergency: arrange a local emergency evaluation through 911, mobile crisis, or an emergency department; contact a family member only as necessary to protect him; and document. She should not continue weekly therapy while unregistered. She may consult with Florida counsel about registration.
3. If Dr. Kim registers as an out-of-state telehealth provider, what limits remain?
Read the worked answer
Registration is limited to telehealth and does not authorize practicing while physically in Florida. Dr. Kim would remain subject to Florida statutes and Board rules, including mandatory reporting of child and vulnerable-adult abuse, confidentiality and privilege rules, record-retention requirements, and disciplinary jurisdiction. She must keep her registration current, report any discipline in Georgia, and include the registration number in advertising. She also must meet the Florida standard of care and maintain appropriate emergency protocols for distant patients. Registration is not a substitute for a Florida license if she wants to see patients in person in Florida.