“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:
- Refund Requirements
- Professional Standards
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Final legislation and rulemaking
- Iowa The Physical and Occupational Therapy Board amended two rules, Chapter 201, which relates to physical therapists, and Chapter 208, which relates to occupational therapists. These rules establish standards for physical therapy and occupational therapy telehealth visits and allow the use of audio or video equipment, or both, at the licensee’s discretion. In connection with adopting the revised rules, the Board noted that the expansion is in response to public comments from ATA Action, the American Telehealth Association’s affiliated trade group, which urged the Board to expand the modalities that can be used for telehealth appointments to ensure Iowa patients have access to affordable, high-quality health care.
- Maryland Enacted HB 1127. This bill would allow certain health care providers to provide sexual assault forensic examinations at no cost to victims through “peer-to-peer telehealth” and make those services eligible for reimbursement by the Crime Victims Compensation Board (CICB). Peer-to-peer telehealth methods allow forensic examinations to be conducted using interactive audio, video, or other communications or electronic technology, where the forensic nurse is in one location and the patient is with a qualified health care provider in another location to assist the forensic nurse in conducting the forensic examination.
- Maryland HB 1078 was also enacted, requiring Medicaid to offer remote ultrasounds and remote fetal non-stress testing under certain circumstances.
- South Carolina Enacted S 858. This bill adds the home-based acute hospital care program as exempt from the South Carolina Department of Health and Environmental Control’s Certificate of Need review. “Home-based acute hospital care” includes the use of technology to provide continuous remote patient monitoring and connectivity to patients.
Proposed Legislation and Rulemaking Activity
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- in ColoradoSB 24-054 has passed the House. The bill requires all private insurers to cover chronic obesity treatment and pre-diabetes treatment, including intensive behavioral and lifestyle therapy, bariatric surgery, and FDA-approved anti-obesity medications. The definition of intensive behavioral and lifestyle therapy includes telehealth interventions.
- in MichiganHB 4580 and HB 4213 have passed the second chamber. If enacted, HB 4580 would require telehealth services to be covered by Medicaid if the point of origin is within the home or school, in addition to other points of origin permitted in the Medicaid Provider Manual. HB 4213 would also require Medicaid to cover telehealth services, but would further clarify Medicaid coverage requirements. First, HB 4213 mandates Medicaid coverage parity for telehealth services. In addition, HB 4213 mandates coverage of telehealth services both when the remote provider’s synchronous interaction is conducted using audio and video electronic media and when audio-only electronic media is used. Under HB 4213, telehealth services are permitted as an appropriate method of care at a federally qualified health center, rural health clinic, or tribal health center.
- in Michigan, Both HB 4579 and HB 4131 have passed the Second House. If enacted, HB 4579 would require health insurance plans to provide equal coverage for telehealth. Similarly, HB 4131 would amend the state’s private payer law to require equal payment for telehealth services. However, HB 4131 also prohibits health insurance plans from requiring providers to provide services via telehealth unless there is a contract for a telehealth-preferred or telehealth-only product.
- in AlaskaHB 126 has passed the second chamber, and if enacted, the bill would allow associate counselors to provide certain services via telehealth.
- New Hampshire SB 403 has passed the Second House. The bill establishes requirements for community health workers, including allowing certified community health workers to provide services via telehealth.
- of Washington The Office of the Insurance Commissioner has published a rulemaking agenda that includes proposed rules to establish uniform standards for establishing relationships for purposes of audio-only telehealth services. The rules address the implementation of SB 5821, which will take effect on June 6, 2024.
- Several states have seen activity related to interstate compacts.
- in AlaskaSB 75 has passed both chambers and would establish the Audiology and Speech-Language Pathology Compact.
- in AlabamaSB 207 has passed the second chamber and would establish the Dietitian Licensure Compact.
- in LouisianaHB 888 has passed the second chamber and would establish the Social Work Licensure Compact.
Why is this important:
- States continue to evaluate reimbursement criteria related to the provision of care delivered through telehealth. Michigan’s bill is an example of state efforts to promote access to telehealth by implementing Medicaid and health insurance reimbursement parity for telehealth services. In addition to reimbursement parity, Maryland HB 1078, South Carolina S 858, and Colorado 24-054 reflect an increased focus on expanding coverage for various types of telehealth services.
- States continue to amend and clarify professional practice standards regarding telehealth. States are continually adopting and revising standards governing the practice of telehealth in various health professions. Some states require the authorization of additional types of telehealth providers, such as associate counselors and certified community health workers, under Alaska HB 126 and New Hampshire SB 403. Other states, such as Iowa, have clarified standards for which specific types of providers, such as physical therapists and occupational therapists, can provide telehealth services.
Telehealth is an important development in healthcare delivery, but the patchwork of regulations is complex. McDermott’s Digital Health team works with leading providers, payers and technology innovators to help them enter new markets, break down barriers to accessible healthcare delivery, and mitigate enforcement risk through proactive compliance.
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