W. Va. Code R. § 5-16-4 - Delivery of Teledentistry

4.1. To deliver teledentistry services in this state, one must hold a current, valid dental or dental hygiene license or registration issued by the Board. The practice of dentistry occurs where the patient is located at the time teledentistry services are provided.

4.2. No person shall practice teledentistry unless a bona fide practitioner-patient relationship is established. A bona fide practitioner-patient relationship shall exist if the dentist has (i) obtained or caused to be obtained a health and dental history of the patient; (ii) performed or caused to be performed an appropriate examination of the patient, either physically, through use of instrumentation and diagnostic equipment by which digital scans, photographs, images, and dental records are able to be transmitted electronically, or through use of face-to-face interactive two-way real-time communications services or store-and-forward technologies; (iii) provided information to the patient about the services to be performed; (iv) initiated additional diagnostic tests or referrals as needed; or (v) through audio only calls or conversations that occur in real time. In cases in which a dentist is providing teledentistry, the examination required by clause (ii) shall not be required if the patient has been examined in person by a dentist licensed by the board within the twelve months prior to the initiation of teledentistry and the patient's dental records of such examination have been reviewed by the practitioner providing teledentistry.

4.3. No person shall deliver dental services in this state through teledentistry unless he or she has established written or electronic protocols for the practice of teledentistry that include (i) methods to ensure that patients are fully informed about services provided through the use of teledentistry, including obtaining informed consent; (ii) safeguards to ensure compliance with all state and federal laws and regulations related to the privacy of health information; (iii) documentation of all dental services provided to a patient through teledentistry, including the full name, address, telephone number, and state license number of the dentist providing such dental services; (iv) procedures for providing in-person services or for the referral of patients requiring dental services that cannot be provided by teledentistry to another licensed dentist who actually practices dentistry in an area the patient can readily access; and (v) provisions for the use of appropriate encryption when transmitting patient health information via teledentistry. A dentist who delivers dental services using teledentistry shall, upon request of the patient, provide health records to the patient or a dentist of record in a timely manner in accordance with applicable federal or state laws or regulations. All patients receiving dental services through teledentistry shall have the right to speak or communicate with the licensed dentist providing such services upon request.

4.4. Nothing in this section shall be construed to alter the scope of practice of any licensed dentist or dental hygienist or to authorize the delivery of health care services in a setting, or in a manner, not authorized by law. Licensees or registrants delivering teledentistry services in this State shall comply with all rules of professional conduct and state and federal statutes and regulations relevant to dentistry and dental hygiene. Teledentistry encounters shall be held to the same standard of care as a traditional in-person patient encounter.

4.5. A patient in this State may be treated via teledentistry by (i) a dentist licensed or registered by the Board; (ii) a dental hygienist who is licensed or registered by the Board and is either supervised by, and has delegated authority from, a dentist licensed or registered by the Board; or (iii) a dental hygienist who is licensed by the Board and holds a General Supervision or Public Health Practice Permit.

4.6. In providing teledentistry serivces, a licensee or registrant shall, to the extent possible:

4.6.1. Confirm the identity of the requesting patient;

4.6.2. Collect the patient's health history;

4.6.3. Disclose the licensee's or registrant's identity, applicable credentials, and contact information including a current phone number; and

4.6.4. Obtain an appropriate informed consent from the requesting patient after disclosures have been made regarding the delivery models and treatment methods and limitations, to include any special informed consents regarding the use of teledentistry services. At a minimum, the informed consent shall inform the patient or legal guardian and document acknowledgment of the risk and limitations of:

4.6.4.a. The use of electronic and communications in the provision of care;

4.6.4.b. The potential for breach of confidentiality, or inadvertent access, of protected health information using electronic and digital communication in the provision of care;

4.6.4.c. The potential disruption of electronic and digital communication in the use of teledentistry;

4.6.4.d. The types of activities permitted using teledentistry services;

4.6.4.e. The patient or legal guardian's understanding that it is the role of the licensee or registrant to determine whether the condition being diagnosed or treated is appropriate for a teledentistry encounter; and

4.6.4.f. A requirement for explicit patient or legal guardian consent to forward patient-identifiable information to a third party.

4.7. The licensee or registrant shall ensure that any electronic or digital communication used in the practice of teledentistry is secure to maintain confidentiality of the patient's medical information as required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all other applicable laws, administrative regulations, and guidance. Confidentiality shall be maintained through appropriate processes, practices and technology, including the disposal of electronic and digital equipment and data.

4.8. Any dental record made through teledentistry shall be held to the same record retention standards as a record made through a traditional in-person dental encounter. An informed consent obtained in connection with teledentistry services shall be filed in the patient's dental record. The patient record established during the use of teledentistry services shall be accessible to both the licensee or registrant and the patient or legal guardian, consistent with all established laws and administrative regulations governing patient healthcare records. The licensee shall document or record in the file:

4.8.1. The patient's presenting problem;

4.8.2. The licensee's or registrant's chief concern;

4.8.3. The patient's diagnosis;

4.8.4. The patient's treatment plan; and

4.8.5. A description of all services provided by teledentistry.

4.9. The indication, appropriateness, and safety considerations for each prescription for medication, laboratory services, or dental laboratory services provided through the use of teledentistry services shall be evaluated by the licensee or registrant in accordance with applicable law and current standards of care, including those for appropriate documentation. A licensee's or registrant's use of teledentistry carries the same professional accountability as when a prescription is issued in connection with an in-person encounter. A licensee or registrant shall not prescribe schedule II drugs via teledentistry.

4.10. A licensee or registrant who provides teledentistry services in this State shall not:

4.10.1. Directly or indirectly engage in false, misleading, or deceptive advertising of teledentistry services;

4.10.2. Allow fee-splitting for the use of teledentistry services; or

4.10.3. Charge for a general consultation or giving advice without a definitive diagnosis.

Notes

W. Va. Code R. § 5-16-4