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Comment by zetazzed | Hacker News Reader

I have a very conscientious friend who used to drive across state lines to do a video visit from their car with an out of state provider. It's pretty wild to think about what a waste and time sink this is for families with complex illnesses.

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Is there anything that stops patients from lying that they are in a different state (just temporarily)?

No but insurance might not cover it

If the telemedicine app can geolocate your IP address it can independently determine what state you are in.

You can just trust IP geo databases to be accurate down to the country* - and that's only most of them time and not even considering VPNs exist.

Sure, if something looks fishy you could then go through the appropriate legal channels to get a more exact location from the ISP, but false positives are going to happen so often, eventually everyone involved might get a bit cranky.

* Only the likes of Google have the scale and requisite information to keep more accurate and up-to-date databases, and even those are fallible.

> You can just trust IP geo databases to be accurate down to the country*

You can't trust even that. There's an ISP which shares the IP pool between its child companies (? or some similar arrangement) in Crimea and Poland. We found out when Polish subscribers got affected by sanctions on business with Crimea.

My home IPs get placed into another country by geolocation all the time (it's probably more wrong than right). My VPN IPs (for which I always use either Finland or the Netherlands) have been geolocated to: three states in the US, Dubai, and several other EU countries.

Don't trust it for anything important ever.

At one point during the pandemic, I lived in a different state than two doctors who I saw virtually every few months (due to moving during the pandemic to a nearby city that happened to be just across the border). The state I lived in put fairly short deadlines on how long they'd allow out of state telemedicine, and whenever it came within a few weeks, they reiterated to the doctors I saw that they would _not_ extend the deadline...only to extend it at the last minute anyhow. By the time it finally didn't actually get extended, I had moved back, so I didn't need to actually make this decision, but the sense I got is that the ones who would have gotten in trouble would be the doctors, not the patients, and considering that I knew and liked these doctors (and obviously had a vested interest in them continuing to practice), I wouldn't have risked it for their sakes, despite the inconvenience.

I regularly see an out-of-state provider via telemedicine and no, nothing stops me from lying and saying that I'm in the same state as the provider. (He knows and doesn't care.)

The telemedicine visits themselves are conducted through MyChart. It's definitely not checking my IP or it would've caught me a long time ago, especially since I have to check the "I am currently in <x state>" checkbox every single time I see him :P

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