Application & Instructions for Initial Licensure - Telemedicine

 

CLICK HERE TO BEGIN THE ONLINE APPLICATION PROCESS

     Click HERE to complete a previously started (and saved) online initial application.
     Click HERE to check the status of your completed online initial application.

To access a paper application, click HERE (available for a limited time)

 

The items listed below MUST be completed and mailed to the LSBME as part of the initial application process.

 

A telemedicine permit is required when a physician does not maintain a physical practice location in this state to engage in the practice of medicine in this state via telemedicine. Telemedicine is define as the practice of health care delivery, diagnosis, consultation, treatment and transfer of medical data by a physician using interactive telecommunication technology that enables a physician and patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously per §7503 of the rules .  Once permit is granted, it must be renewed annually.

 

Note: Interpretation of diagnostic studies/testing including pathology, echocardiograms, ultra sounds, intraoperative monitoring, radiological procedures, radiology or nuclear medicine requires a full Louisiana medical license only.

 

OVERVIEW

The Louisiana State Board of Medical Examiners (the “Board”) annually processes hundreds of applications for licensure. This process involves the collection of credentials from the applicant as well as other sources.  The Board conducts a thorough evaluation of credentials, employment or work history, malpractice history and disciplinary history.  This process takes time - anywhere from a few weeks to several months, depending upon how quickly the applicant complies with what is requested and the nature of any problems requiring closer attention.  A permit is not guaranteed.  As such, each applicant is advised not to make commitments on loans, practice start dates, home purchases, etc. The Board will not accelerate one application at the expense of another nor will it waive any requirements in the screening process.  Once the application is received and reviewed, the analyst prepares and sends out a missing document report to request additional information and/or to return items that need corrections or clarifications.  Please wait at least ten days before calling to check on the status of the application.  The Board has no control over materials that must be requested from other agencies.  The Board shall have a reasonable period of time to collect and assimilate all required documents and information necessary to issue a permit.  If after submitting an application for a permit, an applicant has failed to respond or make an effort to pursue this permit for a period of six months, the application will be null and void and the applicant must reapply.  If you have been named in a malpractice suit, been sanctioned by another state or agency or have answered “yes” to any of the questions on the oath or affirmation page of the application, you must provide a detailed notarized narrative of the incident and anticipate a delay in the application process.  This includes offenses that may have occurred as a juvenile and that may have been expunged from your record.  The criminal background check can take months to process.  As such, it is suggested that you request the criminal background materials as soon as possible in the application process.

 

QUALIFICATIONS FOR PERMIT

  • Be of good moral character and be at least 21 years of age.
  • Be a citizen of the United States or possess valid and current legal authority to reside and work in the United States duly issued by the commissioner of the Immigration and Naturalization Service.
  • Possess an unrestricted license to practice medicine issued by a State medical authority. The Board may deny a TMED permit if the applicant has had prior actions subject to investigation or has had actions involving staff privileges.
  • Is not enrolled in a medical residency or other post graduate medical training program.
  • Has attended the board’s “Physician Orientation Program” or completed online (visit our website at www.lsbme.la.gov to view requirements for online completion), and telemedicine rule review.
  • Pay the appropriate fee. Credit/Debit card only:$150.00 Note:  Fees are not refundable. Renewal fee is $100.00 if paid prior to the expiration date, if not, the application fee of $150.00 is due.
  • Possess a Doctor of Medicine degree duly issued by a medical school approved by the board.  This diploma must be in English; if not, must be accompanied by a certified translation into English.
  • Applicant must have completed one year of ACGME approved residency training in the United States or Canada in the same specialty;
  • Have taken and passed FLEX/USMLE Steps 1, 2, and 3, state board examination, National Boards Parts 1, 2, and 3, COMLEX-USA, NBOME or a combination thereof.  (There is no limit on step 1, four on Step 2 and four on step 3).
  • If a medical competency examination has not been taken within 10 years of application, the applicant must be board certified or re-certified through the American Board of Medical Specialties within the past ten years or the applicant must take and pass SPEX (Special Purpose Examination) administered through the Federation of State Medical Boards, Inc.

Online Education Course and Quiz- Take and successfully complete the Online Education Course & Quiz. The course will review the Rules pertaining to the practice of telemedicine in the state of Louisiana. Instructions will be provided upon receipt of application.

 

GENERAL INFORMATION

Criminal Background Check  - The state of Louisiana does criminal background checks as part of the application process through the state -Louisiana Department of Public Safety and Corrections-DOC and Federal Bureau of Investigations-FBI.  Applicants with criminal history may expect delays in the application process.  Materials can be obtained on our website by clicking on Licensure then on the Criminal Background Check link. Applicants with criminal history may expect delays in the application process.

Mail: LSBME, Attn: CBC, 630 Camp Street, New Orleans, LA 70130 
E-Mail: lsbmecbc@lsbme.la.gov 
Phone: (504) 568-6820

Certified Birth Certificate - The applicant must submit either a certified birth certificate (a certified document can only be obtained from the issuing agency and must bear the official seal or stamp and signature of an authorized representative) or an original passport (expired passports are acceptable).  The certified birth certificate becomes a permanent part of the applicant’s file and is not returned.  If the applicant submits a passport, the applicant must include a written explanation of the reason the birth certificate is not available. 

Valid Visa -Applicants who are not native-born citizens of the United States must show proof of legal entry into the United States to work and reside by presenting either:

  • An original certificate of Naturalization
  • Certified birth certificate establishing birth to U.S. citizens traveling abroad
  • Valid Visa issued by the department of Immigration and Naturalization (INS).(Acceptable visas – J-1, H-1B, Immigrant

 

OTHER INFORMATION

Verification of Application/Licensure Status - Visit our website at www.lsbme.la.gov and log on to your account to verify the progress/status of your application.

 

Communication with the Board

Mailing address - LSBME, 630 Camp Street, New Orleans, LA 70130

Questions - Contact Barbara Bender at (504) 568-7190 or bbender@lsbme.la.gov

 

Third Party Authorization- Read and have this form notarized.

 

Oath or Affirmation - Read, answer and have this form notarized.  Any “yes” answer(s) must be accompanied by a notarized affidavit.  The applicant must explain in detail the incident(s) in which he/she is answering yes to and have the explanation typed written and notarized.  This includes offenses that may have occurred as a juvenile and that may have been expunged from your record. 

NOTE: If criminal history is found that you did not disclose, you will be required to submit a new Oath or Affirmation, a notarized affidavit as to why you did not disclose the information and a new processing fee equal to the initial licensure fee. It is important that you answer question 3 accurately and truthfully. Do not take the advice of friends, lawyer, etc.

 

Verification/Endorsement – Use this form ONLY if the LSBME staff cannot verify your license online.  If the license cannot be verified online, you will be notified. If you named any state (including District of Columbia, Puerto Rico, Guam, Canada) on page 2 of the application, send a copy of this form to each of those states for completion whether the license issued was permanent, temporary or is now expired.  It is suggested that you contact each state to inquire as to whether or not that state has any requirements that must be fulfilled before it will complete our form.  Most states charge a fee and will not complete the form until that fee is paid.  You may make as many machine copies of this form as is necessary.

 

Statement of Legal Name - Record your name as it appears on each document listed that applies to you.  This form must also be completed by any person whose name is not the same as the name on the birth certificate.  This form must be notarized.