Just as policy is changing at the federal level to allow – and even encourage – greater use of telehealth and telemedicine programs, states, too, have been active. A number of states are in the process of updating telehealth laws and regulations, modernizing definitions to keep pace with available technology and services and setting rules for providers and plans.
There are as many as 90 bills now pending this year before state lawmakers, according to the Center for Connected Health Policy. They address a variety of topics, including “regulatory, licensing and advisory board oversight of telehealth laws.”
Most bills have the effect of expanding reimbursement, improving the environment for all stakeholders. Historically, many health insurers have been skeptical of the financial and clinical benefits of telehealth programs. As a result, the federal government, and now the states, have begun to adopt legislation and regulations that mandate reimbursement for telehealth and telemedicine services in the commercial marketplace and in public programs like Medicaid and Medicare.
Other issues addressed in pending state legislation/regulation include promoting multistate provider licensing, funding for telehealth pilot projects, establishing guidelines for online prescribing, defining provider-patient relationships through virtual communications, and expanding broadband coverage.
In New Mexico, for example, the Senate passed SB354 “Health Coverage for Telemedicine” on February 26, 2019 and the House adopted the bill on March 15, 2019. The legislation impacts payer coverage in several ways by:
In addition, Virginia just signed into law legislation (SB 1221 and HB 1970) that makes several important policy changes governing telehealth by:
Other state activity includes Arizona’s consideration of a bill that parallels work in New Mexico on telehealth and legislation in North Dakota being amended to add “store and forward” as a reimbursable service. Also, Maryland’s Board of Physicians is reported to be completing new telehealth regulations. Content is expected to include “ground rules for telemedicine in establishing a doctor-patient relationship.”
Florida may be going further than most states to meet its goal to “kick start” telehealth in the state. Legislation (HB23), passed by Florida’s House Health Quality Subcommittee, would offer tax breaks – worth as much as $30 million – and the ability to use out-of-state providers, among other changes. The tax credit would be available to “insurers and HMOs willing to reimburse health providers for telehealth services and…could be applied against corporate income taxes or insurance premium taxes.”
There are clear trends in state action to improve the climate for telehealth technology, services and reimbursable coverage. The pace of such modernization is one of the strongest – signaling that telehealth policy is a priority at the both the state and federal level. We’ll continue to keep track for you.