Why This Course Matters

Malpractice risk is a real concern for any physician, but in telemedicine, the risks and liabilities shift in ways providers don't anticipate. A misstep in documentation, licensing, or patient communication could mean legal action, lost income, or worse-losing your license.

The good news? Malpractice doesn’t have to be inevitable. This course is designed to arm you with practical strategies to protect yourself, reduce liability, and ensure compliance so you can practice confidently and securely.

What You'll Gain from This Course

• Understand the true cost of malpractice (financial, career, and legal impacts).
• Recognize common telemedicine malpractice risks and how to mitigate them.
• Master documentation best practices that protect you in legal situations.
• Learn risk mitigation strategies that proactive physicians use.
• Identify and avoid the most common pitfalls that lead to malpractice claims.

Learning Objectives

By the end of this course, you will:

1. Understand the true cost of malpractice – Learn the financial, career, and legal consequences of malpractice claims and how they impact telemedicine providers.
2. Recognize common telemedicine malpractice risks – Identify the specific vulnerabilities in virtual care that increase liability and how to mitigate them effectively.
3. Master documentation best practices – Learn how to structure patient notes, informed consent, and follow-up documentation to protect yourself in a legal dispute.
4. Apply risk mitigation strategies used by proactive physicians – Implement step-by-step techniques to prevent misdiagnosis, licensing violations, and telemedicine compliance failures.
5. Identify and avoid common malpractice pitfalls – Recognize frequent provider mistakes in virtual care and how to eliminate them before they lead to a claim.

Why This Matters:
Most malpractice claims in telemedicine aren’t caused by blatant medical errors—they happen because of poor documentation, unclear patient communication, or missing legal safeguards. This course ensures you’re prepared, protected, and confident in your telemedicine practice.

How to Prepare for This Course

Before diving into the content, it’s helpful to assess where you currently stand in terms of malpractice risk. Below are some quick preparation steps that will help you get the most out of this course:

Step 1: Review Your Malpractice Insurance Policy

🔲 Does your current malpractice policy explicitly cover telemedicine?
🔲 Does it include coverage for multiple states if you practice across state lines?
🔲 Do you have tail coverage in case of delayed malpractice claims?

If you're unsure, contact your insurance provider to verify your coverage before proceeding.

Step 2: Evaluate Your Current Documentation Practices

🔲 Do you use a telemedicine-specific documentation template?
🔲 Do your patient notes clearly state the mode of the visit (video, phone, chat)?
🔲 Do you document informed consent for every telemedicine visit?

If you’re missing any of these elements, this course will help you strengthen your documentation strategy.

Step 3: Identify Your State’s Telemedicine Regulations

🔲 Are you properly licensed in every state where you treat patients?
🔲 Do you know your state’s telehealth prescribing laws (especially for controlled substances)?
🔲 Are you compliant with HIPAA security rules for telemedicine visits?

This course will guide you through risk reduction strategies to keep you fully compliant in every state where you practice.

Step 4: Consider Your Patient Interaction Process

🔲 Do you set clear patient expectations upfront about what telemedicine can and cannot do?
🔲 Do you have a policy for escalating cases to in-person care when needed?
🔲 Do you provide follow-up instructions in writing after each visit?

Why This Matters:
Many malpractice claims arise from patient misunderstandings about telemedicine limitations. We’ll cover best practices for communication, consent, and follow-up to minimize liability.

Why Malpractice Coverage is Different for Telemedicine

Traditional malpractice insurance was built for brick-and-mortar practices, but telemedicine introduces new risks related to state licensing, prescribing, documentation, and patient privacy. Many physicians assume their existing policy covers virtual care, only to find gaps that expose them to major liability.

A well-structured malpractice policy for telemedicine should cover both clinical and regulatory risks, ensuring physicians are protected from lawsuits, board complaints, and compliance violations.

Key Coverage Areas for Telemedicine Malpractice Insurance

1. Clinical Errors – Covers misdiagnosis, delayed diagnosis, and failure to meet the standard of care.
2. Licensing Violations – Protection in case of unintentional practice in an unlicensed state.
3. Telemedicine-Specific Exclusions – Some policies don’t cover virtual prescribing—know what’s excluded.
4. HIPAA & Data Security Issues – Liability for breaches, unauthorized disclosures, or compliance failures.
5. Defense Costs & Settlements – Covers legal fees, court costs, and malpractice settlements.

Key Takeaway: Not all malpractice insurance automatically covers telemedicine—physicians need to confirm specific policy details to avoid gaps in protection.

Understanding the Core Types of Malpractice Coverage

Claims-Made vs. Occurrence-Based Coverage

Claims-Made Policies

• Covers incidents only if the policy is active when a claim is filed.

• If a patient sues after the policy ends, you’re NOT covered.

• Requires tail coverage to protect against future claims.

Occurrence-Based Policies

• Covers any incident that happened while the policy was active, even if the claim is filed later.

• More expensive but offers permanent protection.

• Best choice for physicians who may change jobs, contracts, or practice settings.

Best Practice: If using a claims-made policy, tail coverage is essential to avoid gaps in protection.

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Tail & Nose Coverage: What Happens If You Change Jobs?

Tail Coverage: Protecting Yourself After a Policy Ends

If you leave a job or switch insurance providers, patients can still file claims for past visits. Tail coverage extends malpractice protection beyond your policy's expiration date.

Who Needs Tail Coverage?

• Physicians moving to a new telemedicine employer.

• Providers transitioning from a claims-made to a new policy.

• Anyone with a risk of delayed malpractice claims.

Cost of Tail Coverage:

• Typically 150-250% of your annual premium.

• Some employers include tail coverage in their contracts—always confirm.

Nose Coverage: Covering Prior Acts When Switching Providers

Instead of paying for tail coverage, some new malpractice policies offer nose coverage—which covers previous claims under your new policy.

Who Should Consider Nose Coverage?

• Physicians switching malpractice carriers who want continuous coverage.

• Providers moving between telehealth platforms with different insurers.

Best Practice: If leaving a telemedicine job, negotiate tail coverage or ensure your new policy includes nose coverage.

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What’s Typically Excluded from Telemedicine Malpractice Policies?

Many general malpractice policies don’t fully cover virtual care—here’s what may be excluded from standard plans:

1. Practicing Across State Lines Without Licensure

• If you treat a patient in a state where you’re not licensed, malpractice insurance may not cover related lawsuits.

2. Prescribing Controlled Substances via Telemedicine

• Some policies exclude prescribing Schedule II-IV drugs without an in-person evaluation.

3. Non-HIPAA-Compliant Communication Platforms

• If a malpractice claim results from a data breach via an unsecured app (e.g., FaceTime, WhatsApp), your policy may not cover it.

4. Employment-Related Lawsuits

• Most malpractice policies don’t cover wrongful termination, discrimination, or contract disputes with telemedicine employers.

Best Practice: Request a detailed policy review to identify hidden exclusions before assuming you’re covered.

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How to Choose the Right Telemedicine Malpractice Insurance

Key Questions to Ask Before Purchasing Coverage

• Does my policy explicitly cover telemedicine visits?

• Am I covered for treating patients in multiple states?

• Are there restrictions on telehealth prescribing?

• Is tail coverage included or available as an add-on?

• Am I protected against HIPAA violations or data security breaches?

• Does the policy cover regulatory board complaints?

Best Practice: Work with an insurance broker specializing in telemedicine malpractice policies to ensure full protection.

Building a Bulletproof Malpractice Strategy

• Verify that your malpractice policy explicitly includes telemedicine coverage.
• Understand claims-made vs. occurrence-based coverage—and secure tail/nose coverage if needed.
• Check for state licensing restrictions—malpractice insurance may not protect against out-of-state violations.
• Ensure compliance with HIPAA, prescribing laws, and telehealth consent regulations.
• Negotiate coverage terms when signing new contracts with telemedicine employers.

• Review your malpractice policy TODAY and identify any gaps in coverage.
• If you’re switching telemedicine jobs, ensure you have tail or nose coverage to avoid legal risks.
• If unsure about coverage details, schedule a policy review with an insurance expert.

By taking these proactive steps, you’ll secure the right malpractice coverage, minimize liability risks, and practice telemedicine with confidence.

Avoid These Costly Mistakes

Many telemedicine providers assume their malpractice insurance fully protects them, only to discover gaps and exclusions when it’s too late. From licensing violations to documentation failures, improper prescribing, and lack of tail coverage, small mistakes can lead to massive legal and financial consequences.

This section outlines the most common pitfalls physicians make with telemedicine malpractice coverage—and how to avoid them.

Mistake #1: Assuming Your Traditional Malpractice Policy Covers Telemedicine

Why This is a Problem:

Many physicians transitioned into telemedicine during the pandemic without reviewing their malpractice coverage. Standard malpractice policies were written for in-person care and may not extend coverage to virtual visits.

What Can Go Wrong?

• If your policy excludes telemedicine, you may be personally liable for any lawsuits.
• Some policies restrict coverage to a specific location—meaning out-of-state virtual visits might not be covered.
• Prescribing limitations in your policy may leave you exposed to claims related to telehealth medication errors.

How to Fix It:

• Call your malpractice carrier today and ask:
• Does my policy explicitly cover telemedicine visits?
• Are there any location-based or prescribing restrictions?
• Do I need additional coverage for virtual practice?

Best Practice: If your insurer offers an add-on telemedicine rider, get it in writing to ensure you’re covered.

Mistake #2: Not Having Tail or Nose Coverage When Switching Jobs or Insurers

Why This is a Problem:

Malpractice claims can be filed months or even years after a telemedicine visit. If you change jobs, switch insurers, or let a claims-made policy lapse, you may have zero protection for past patient encounters.

What Can Go Wrong?

• You leave a telemedicine job and a patient sues you for a past virtual consult. If you don’t have tail coverage, you’re on the hook personally for legal fees and settlements.
• You switch malpractice providers and assume you’re covered—but your new policy doesn’t protect past services.
• You move from a claims-made policy to a new job and don’t secure proper transition coverage.

How to Fix It:

• If using a claims-made policy, make sure tail coverage is in place before leaving a job.
• Negotiate tail coverage into your contract before starting a new telemedicine role.
• If switching insurers, ask your new provider if they offer nose coverage to cover past claims.

Best Practice: Always confirm if your policy has tail or nose coverage BEFORE switching jobs or insurers.

Mistake #3: Failing to Verify Multi-State Licensing Protection

Why This is a Problem:

Malpractice policies are often state-specific—just because you have coverage in one state doesn’t mean you’re covered in another. If you see patients across state lines without multi-state malpractice coverage, you could face board complaints, fines, or denial of claims.

What Can Go Wrong?

• Seeing a patient in a state where you aren’t licensed can void malpractice coverage.
• Some states have stricter telemedicine rules, requiring additional approvals before coverage applies.
• Your policy may only cover states listed on your licensing profile.

How to Fix It:

• Confirm which states your policy covers before seeing out-of-state patients.
• If practicing in multiple states, request multi-state coverage options.
• Consider IMLC (Interstate Medical Licensure Compact) participation to streamline licensing approvals.

Best Practice: Always verify patient location at the start of each telemedicine visit to ensure licensing compliance.

Mistake #4: Overlooking Exclusions for Telemedicine Prescribing

Why This is a Problem:

Not all malpractice policies cover virtual prescribing, and many exclude controlled substances or certain medication classes.

What Can Go Wrong?

• Prescribing without an in-person visit—violating federal or state telemedicine prescribing laws.
• Being unaware of state-specific prescription regulations—leading to board complaints.
• Your malpractice policy excluding coverage for medication-related claims in telemedicine.

How to Fix It:

• Check your state’s prescribing rules—some require in-person evaluations for controlled substances.
• Confirm with your insurer whether telemedicine prescribing is covered under your malpractice policy.
• Avoid prescribing controlled substances via telehealth unless explicitly permitted under federal and state laws.

Best Practice: If prescribing, always document medical necessity and include follow-up care instructions.

Mistake #5: Relying on Employer-Provided Malpractice Insurance Without Reviewing the Details

Why This is a Problem:

Some telemedicine companies offer malpractice insurance for contracted physicians, but these policies often have limitations that providers don’t realize until a claim arises.

What Can Go Wrong?

• Employer-provided insurance may not include tail coverage if you leave.
• Your policy might not cover board complaints or HIPAA violations.
• Coverage may only apply to patients seen through that specific platform—meaning you’re unprotected for outside consults.

How to Fix It:

• Request a full copy of the employer-provided malpractice policy.
• Check for tail coverage, policy limits, exclusions, and scope of protection.
• Consider a personal malpractice policy for additional coverage.

Best Practice: Never assume employer malpractice insurance is enough—always verify the fine print.

Mistake #6: Not Covering HIPAA & Data Security Risks in Your Policy

Why This is a Problem:

Telemedicine introduces additional liability for data breaches, unauthorized access, and improper storage of patient information. If your malpractice policy doesn’t include cyber liability protection, you could be held personally responsible for HIPAA violations.

What Can Go Wrong?

• Using non-HIPAA-compliant platforms (e.g., FaceTime, WhatsApp) and having a breach.
• Accidental disclosure of PHI (Protected Health Information).
• Cyberattacks or ransomware affecting patient data.

How to Fix It: 

Use HIPAA-compliant telehealth platforms like Zoom for Healthcare, Doxy.me, or AthenaTelehealth.

Ensure your malpractice policy includes cyber liability coverage.

Encrypt patient records and avoid storing PHI on unsecured personal devices.

Best Practice: If your malpractice policy doesn’t include cyber coverage, add a separate cybersecurity rider.

Final Takeaways: How to Avoid Malpractice Coverage Mistakes in Telemedicine

• Verify that your malpractice policy explicitly includes telemedicine visits.
• Check for multi-state licensing protection before seeing out-of-state patients.
• Secure tail or nose coverage when switching jobs or insurers.
• Understand prescribing limitations—especially for controlled substances.
• Review employer-provided malpractice policies for gaps.
• Ensure cyber liability & HIPAA violations are covered under your policy.

Next Steps:

• Schedule a policy review with your malpractice carrier to check for coverage gaps.
• If switching telemedicine jobs, confirm tail or nose coverage to prevent liability gaps.
• Review your prescribing and licensing compliance to ensure you’re fully protected.

By proactively addressing these common malpractice pitfalls, you’ll minimize liability risks, close coverage gaps, and ensure your telemedicine practice is fully protected.

Action Plan Development

Use this template to create a structured action plan to strengthen your malpractice protection and minimize telemedicine risks.

Section 1: Malpractice Policy Review

Current Malpractice Carrier: ________________________

Policy Type: ☐ Claims-Made ☐ Occurrence-Based

Does My Policy Cover Telemedicine? ☐ Yes ☐ No ☐ Not Sure

Does My Policy Include Multi-State Coverage? ☐ Yes ☐ No ☐ Not Sure

Does My Policy Cover HIPAA Violations? ☐ Yes ☐ No ☐ Not Sure

Does My Policy Include Tail or Nose Coverage? ☐ Yes ☐ No ☐ Not Sure

Action Steps:

1. Contact my insurance provider to confirm telemedicine-specific coverage.
2. If coverage is insufficient, request a telemedicine rider or explore alternative providers.
3. If I don’t have tail/nose coverage, discuss options for adding it to my policy.
4. Negotiate malpractice coverage terms in my employment contract (if applicable).

Target Completion Date: ________________________

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Section 2: Licensing & Compliance Strategy

States Where I Currently Practice Telemedicine: ________________________

Am I Licensed in All States Where My Patients Are Located? ☐ Yes ☐ No ☐ Not Sure

Have I Verified My State’s Telehealth Prescribing Rules? ☐ Yes ☐ No ☐ Not Sure

Action Steps:

1. Review all state licensing requirements where I provide telemedicine services.
2. Ensure I have active licenses in every state where I see patients.
3. Create a compliance tracker to monitor state-specific rules & renewal deadlines.

Target Completion Date: ________________________

____________________________________________________________________________________________________________

Section 3: Documentation & Risk Mitigation Improvements

Do I Document Patient Location in Every Visit? ☐ Yes ☐ No ☐ Needs Improvement

Do My Notes Clearly Show Clinical Decision-Making? ☐ Yes ☐ No ☐ Needs Improvement

Do I Collect Informed Consent for Every Visit? ☐ Yes ☐ No ☐ Needs Improvement

Action Steps:

1. Adopt a telemedicine documentation template to standardize my visit notes.
2. Ensure my EHR or telehealth platform has an informed consent workflow.
3. Train my team on proper documentation and compliance best practices.

Target Completion Date: ________________________

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Section 4: Patient Communication & Prescribing Protections

Do I Provide Patients with Clear Telehealth Expectations? ☐ Yes ☐ No ☐ Needs Improvement

Am I Fully Aware of State Prescribing Rules for Telemedicine? ☐ Yes ☐ No ☐ Not Sure

Am I Using HIPAA-Compliant Telemedicine Platforms? ☐ Yes ☐ No ☐ Needs Improvement

Action Steps:

1. Set up a telehealth onboarding process that includes patient consent & education.
2. Ensure my telemedicine prescribing practices align with state & federal laws.
3. Conduct a HIPAA compliance audit to verify data security measures.

Target Completion Date: ________________________

Self-Assessment Checklist: Telemedicine Malpractice Coverage

Use this checklist to evaluate your malpractice coverage, risk exposure, and compliance strategy in telemedicine. If you can’t check all the boxes, it’s time to adjust your approach to reduce liability risks.

Step 1: Verify Your Malpractice Coverage

🔲 My malpractice insurance explicitly covers telemedicine visits.

🔲 I have confirmed multi-state coverage for every state where I treat patients.

🔲 My policy includes protection for HIPAA violations and cyber liability risks.

🔲 My policy covers telemedicine prescribing, including any limitations on controlled substances.

🔲 I understand the difference between claims-made vs. occurrence-based coverage.

🔲 I have tail or nose coverage in place in case I switch insurers or telehealth platforms.

Step 2: Ensure Licensing & Compliance Protection

🔲 I verify patient identity and location before every telehealth visit.

🔲 I practice only in states where I hold an active medical license.

🔲 I keep records of informed consent for every telemedicine visit.

🔲 I follow state-specific telehealth laws regarding prescribing and supervision requirements.

🔲 I maintain HIPAA compliance by using secure, encrypted platforms for video and messaging.

Step 3: Review Documentation & Risk Mitigation Practices

🔲 I use standardized telemedicine documentation templates to ensure completeness.

🔲 My patient notes always include:

• Patient location & identity verification
• Visit modality (video, phone, asynchronous)
• Informed consent statement
• Clinical decision-making rationale
• Treatment plan & follow-up instructions

🔲 I have a structured process for referring high-risk cases to in-person care.

🔲 I routinely educate patients on the limitations of telemedicine to set proper expectations.

Step 4: Action Plan for Strengthening Malpractice Protection

🔲 Review my malpractice policy and request clarification on any gaps in coverage.

🔲 Consult a medical malpractice attorney or insurance broker for a policy review.

🔲 Set up a compliance tracker to monitor state-specific telehealth requirements.

🔲 Create a malpractice response plan outlining next steps if a claim is filed.

🔲 Ensure my employment contract includes tail coverage or negotiate for additional protection.

🔲 Develop a telehealth workflow checklist to prevent compliance or documentation mistakes.

If you have unchecked boxes, take immediate steps to address those gaps before you encounter a malpractice claim.

Research and Evidence-Based Sources

These references provide research-backed insights, legal guidelines, and compliance strategies for telemedicine malpractice coverage, risk mitigation, and best practices.

Legal & Compliance Guidelines for Telemedicine Malpractice

1. American Medical Association (AMA). Telehealth Implementation Playbook. AMA, 2022.
2. Cavicchiolo ME, Guerra L, Rampazzo F, et al. Legal implications in telemedicine: Mitigating risks while embracing innovation. Journal of Telemedicine and Telecare. 2023. doi:10.1177/1357633X231045172
3. Kruse CS, Lee K, Watson JB, Lott L. Factors influencing the adoption of telemedicine in healthcare: Legal and compliance considerations. Health Policy and Technology. 2023;12(2):129-139. doi:10.1016/j.hlpt.2023.10023
4. Spangenberg Shibley & Liber LLP. Telemedicine and medical malpractice: Emerging issues. Published February 1, 2024.

Informed Consent & Patient Safety in Telemedicine

1. Henry TA, Gilchrist V, Kohli N, et al. Informed consent in telemedicine: A best practices guide. Annals of Family Medicine. 2022;20(3):214-219. doi:10.1370/afm.2800
2. Navigating Informed Consent Requirements in Telehealth: A Provider’s Guide. Health Law Alliance.
3. McLean S, Sheikh A, Cresswell K, Nurmatov U, Mukherjee M. The impact of telemedicine on patient safety: A scoping review. BMC Medicine. 2021;19(1). doi:10.1186/s12916-021-02109-z

Liability Risks & Malpractice Trends in Digital Health

1. Mehta SJ, Wilensky GR. Telemedicine and liability risks: What physicians need to know. American Journal of Medicine. 2022;135(5):567-570. doi:10.1016/j.amjmed.2022.01.015
2. Rowland SP, Fitzgerald JE, Lungren M, Lee E, Harned Z, McGregor AH. Digital health technology-specific risks for medical malpractice liability. Npj Digital Medicine. 2022;5(1). doi:10.1038/s41746-022-00698-3
   
   
   

Telemedicine Company Evaluation Checklist

This checklist provides a comprehensive evaluation framework for clinicians considering telemedicine positions, covering key aspects such as compensation, working conditions, patient care standards, billing, legal compliance, and CPOM regulations. It ensures transparency by addressing critical factors like contract terms, malpractice insurance, quality assurance, and regulatory adherence, helping clinicians make informed decisions before joining a telemedicine practice.

Telemedicine Documentation Best Practices

Telemedicine documentation best practices ensure accurate, complete, and compliant records for remote patient consultations. These practices include clear note-taking, maintaining confidentiality, and adhering to legal and regulatory standards for telehealth services.

Telemedicine Informed Consent Checklist

A Telemedicine Informed Consent Checklist is a concise guide that ensures patients understand the unique aspects, benefits, limitations, and potential risks of receiving healthcare services remotely. It covers key elements such as privacy, security, technical requirements, and legal considerations, promoting transparency and safeguarding patient rights during virtual consultations.

Overview of ATA & Joint Commission Best Practices in Telemedicine

The ATA and Joint Commission have established best practices in telemedicine to ensure high-quality, patient-centered care that is both safe and compliant with regulatory standards. These guidelines emphasize secure technology, rigorous provider training and credentialing, effective communication, and continuous quality improvement to support reliable virtual care delivery.

Case Study Examples of Malpractice Claims in Telemedicine & Their Resolutions 

This case study explores real-life examples of malpractice claims in telemedicine, highlighting key legal and ethical issues such as misdiagnosis, data breaches, and inadequate patient care. It also examines the resolutions of these cases, including settlements, policy changes, and legal precedents that shape the future of telehealth practices.