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State Telehealth Laws and Reimbursement Policies

James Custer

Director, Telehealth Products and Operations at Yorktel

Latest posts by James Custer (see all)

Telehealth adoption is accelerating across the United States. According to the American Telemedicine Association, more than half of U.S. hospitals now use some form of telemedicine.
 
One very important factor for its rapid ascension is the emergence of favorable reimbursement policies that ensure healthcare providers are paid for telehealth-enabled patient care. Federal legislation such as The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), is rightfully credited for this increased success by aligning access and quality of care to reimbursements. To satisfy consumers’ demand for efficient, high-quality care, (as well as meeting the federal reimbursement provisions under MACRA) doctors and hospitals are forced to think outside the box, making telehealth an attractive addition to their portfolio.

Individual states must also be acknowledged as a key enabler for increased adoption. Last month, The National Law Review reported that, “31 states plus the District of Columbia now have telehealth commercial insurance laws on the books. Continued expansion in coverage and reimbursement means providers can enhance telemedicine offerings, both for the immediate cost savings and growing opportunities for revenue generation, to say nothing of patient quality and satisfaction.”

Below, I’ve highlighted recent legislation that has either taken effect or will take effect in the near future.

Louisiana: Louisiana’s governor signed into law, HB 570, (the “Act”), eliminating a prior requirement that physicians practicing telemedicine maintain an office in Louisiana or contract with in-state providers. The Act also changes the telemedicine modality required for a patient encounter from “two-way video” technology to “interactive audio” (provided the modality is sufficient to meet the same standard of care as an in-person encounter). The Act requires telemedicine providers make referrals to, or arrangements for, follow-up care when necessary. The Act became effective on June 17, 2016. – Health Care Law Today

Hawaii: Governor David Ige signed a bill into law on July 7, 2016, which expands coverage in Hawaii for telemedicine services. Senate Bill 2395, Relating to Telehealth, requires the state’s Medicaid managed care and fee-for-service programs cover services provided through telehealth, stating that these programs “shall not deny coverage for any service provided through telehealth that would be covered if the service were provided through in-person consultation between a patient and a health care provider.”

The law takes effect on January 1, 2017 – Healthcare Informatics

Rhode Island: Rhode Island marks the 31st state to enact a telemedicine commercial reimbursement statute. The Telemedicine Coverage Act (HB 7160B) was signed into law by Rhode Island Governor Gina Raimondo on June 28, 2016, representing a forward step for telehealth providers in a state that historically has held one of the lowest-rankings in the nation for telehealth coverage policy. The new law requires commercial health insurers in the Ocean State to cover treatment provided via telemedicine to the same extent the services are covered via in-person care. The law takes effect January 1, 2018 and applies to all policies delivered, issued, or reissued in the State after that date. – Health Care Law Today

Alaska: Enacts New Telemedicine Law – Alaska Governor Bill Walker signed SB 74 into law on June 21, 2016, expanding the use of telemedicine in the Last Frontier state. Specifically, SB 74 removes Alaska’s previous in-state presence requirements for prescribing via telemedicine, and authorizes the use of telemedicine in certain clinical practices, including licensed audiologists, speech language pathologists, counselors, marriage and family therapists, psychologists, social workers, physical therapists, and occupational therapists. – Office of the Governor

Arizona: SB 1363: Removes restrictions in Arizona’s telemedicine private payer law which previously required telemedicine coverage only when it was provided to an enrollee in a rural region, as defined in law. The bill also adds pulmonology to the list of health care services that are required to be reimbursed when delivered through telemedicine. The bill will apply to contracts issued, delivered or renewed after January 1, 2018. – Center for Connected Health Policy

South Carolina: SB 1035, signed by South Carolina Governor, Nikki Haley, allows a patient-provider relationship to be established via telemedicine, however does not allow for the prescription of medication when an in-person physical exam is necessary for diagnosis. The bill went into effect June 3, 2016. – State Scoop

Connect with Yorktel at the ATA Fall Forum next month in New Orleans to see how we can help you capitalize on these emerging health trends.

Please click here to view all State legislation regarding telemedicine.