“Telehealth Trends” focuses on state legislative and regulatory developments that impact healthcare providers, telehealth and digital health companies, pharmacists and technology companies involved in delivering and facilitating virtual care.
Past week trends:
- Professional Standards
- Refund Requirements
- Interstate Compact
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Final legislation and rulemaking
- Connecticut Enacted HB 5197, which establishes the Social Services Licensing Agreement.
- South Carolina Enacted H 5183 to add certain nursing tasks, including performance of non-clinical tasks via telehealth, to the representative list of nursing tasks that a physician, physician assistant, or advanced practice nurse may delegate to unlicensed ancillary personnel.
- South Carolina Also enacted was S610, which establishes the counseling agreement.
- of Wisconsin The Board of Psychology Examiners amended its rules to align with the state’s establishment as a member of the Psychology Interjurisdictional Compact. Specifically, the adopted rules provide that the Standards of Practice and Professional Conduct apply to both telehealth and telepsychology services.
Proposed Legislation and Rulemaking Activity
highlight:
- in CaliforniaIn November 2015, AB 2339 passed the First Chamber. The bill expands existing Medi-Cal definitions and exceptions that currently limit the establishment of new patient relationships through telehealth. Specifically, the bill allows new patient relationships to be established using asynchronous telehealth modalities when related to sensitive services or when requested by the patient. For Medi-Cal purposes, the bill expands the definition of “asynchronous store and forward” to include asynchronous electronic transmissions that are directly initiated by the patient, such as through a mobile phone application.
- in IllinoisHB 5087 passed the Second House. The bill amends the Illinois Physical Therapy Act to provide that physical therapy via telehealth services may be used to address access to care issues, enhance care delivery, and increase a physical therapist’s ability to assess and direct patient performance within the patient’s environment. The bill also provides that a physical therapist or a physical therapist assistant working under the general supervision of a physical therapist may provide physical therapy via telehealth services, subject to certain limitations.
- in IllinoisSB 2586 also passed the Second House. The bill amends the Illinois Dental Practice Act to include patient diagnosis and treatment planning services in the definition of teledentistry. The bill also establishes standards of practice for dentists to perform teledentistry, including that dentists may only perform or utilize teledentistry with patients of record and that dentists must obtain informed consent from patients before providing teledentistry services.
- in OhioSB 95 has passed the House. The bill allows telepharmacy entities to dispense medications and provide patient counseling and other pharmacist care through a telepharmacy system. The bill also sets out the requirements for a pharmacy to qualify to operate as a telepharmacy.
- in Pennsylvania, SB 739 has passed the First Chamber. The bill amends Title 40 (Insurance) of the Pennsylvania Consolidated Code to require insurers, Medicaid, and Children’s Health Insurance Program (CHIP) managed care plans to reimburse health care providers for covered services provided to patients via telehealth, which is defined to include synchronous and asynchronous interactions and remote patient monitoring.
- of Tennessee The Board of Optometry has proposed rules to update the standards of practice that would allow optometrists to provide telehealth services.
- Several states have seen activity related to interstate compacts.
- in New HampshireSB 218, a bill establishing the social work compact, has passed both chambers.
- in Rhode IslandSB 2184, a bill establishing the Social Work Licensure Compact, has passed the First House.
- in CaliforniaAB 2566, which would establish the counseling agreement, passed the First House.
- in Rhode IslandSB 2183, a bill that would establish counseling agreements, passed the First House.
- in CaliforniaAB 2051, a bill to establish psychology interjurisdictional compacts, has passed the First House.
Why is this important:
- States continue to amend and clarify professional practice standards regarding telehealth. States continue to propose, adopt, and revise standards governing the practice of telehealth in various health professions. South Carolina’s HB 5183 recognizes that certain delegated nursing tasks can be performed via telehealth, while Illinois’ HB 1087 and SB 2586 seek to amend professional practice standards to allow physical therapists and dentists to provide telehealth services. Additionally, Ohio’s SB 95 sets the stage for telepharmacy operations through telepharmacy systems.
- States continue to evaluate coverage and reimbursement for the provision of care delivered through telehealth. Proposals in Pennsylvania and California are examples of state efforts to increase access to telehealth by mandating Medicaid coverage for telehealth services. California AB 2339 seeks to provide additional flexibility for Medicaid patients by allowing health care providers to establish new Medicaid patients through telehealth under certain circumstances. Pennsylvania SB 739 not only mandates Medicaid coverage, but also requires health insurance coverage for medically necessary health care services provided through telehealth by participating network providers.
- States continue to increase activity regarding licensure agreements for various health care professionals. These state initiatives demonstrate a willingness to ease the burden of the licensure process and facilitate practice in multiple jurisdictions without giving up professional licensure authority. This week, states advanced legislation on an interstate compact on the practice of social work, counseling, and psychology.
Telehealth is an important development in healthcare delivery, but it is complicated by regulatory inconsistencies.
