Telehealth trends focus on state legal and regulatory developments impacting health care providers, telemedicine and digital health companies, pharmacists, and technology companies that provide and facilitate virtual care.
Trends over the past week:
- interstate highway compact
- Professional standards and licenses
- Refund requirements and payment parity
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Enactment of final laws and regulations
- michigan Consent to telehealth, referrals to in-person health care providers (if necessary), delegation of controlled substance prescribing to advanced practice registered nurses, and training standards related to human trafficking, licensure, and continuing education. Established a final rule outlining telehealth practice standards.
- Delaware Established a final rule regarding social work practice. This amendment changes the requirement for direct supervision in post-degree supervised clinical social work experience for licensure applicants and specifies that supervision will be conducted 100% via live video conferencing at the discretion of the supervisor. Telemedicine requirements have been revised to exempt individuals practicing through the Delaware Interstate Telemedicine Registry from the prerequisite of holding a Delaware license.
- tennessee Enacts SB 1674 to direct the Department of TennCare to amend existing regulations or promulgate new regulations for fee-for-service and Medicaid managed care plans for reimbursement no later than December 31, 2024 ( Specifically, to allow for reimbursement) remote ultrasound and remote fetal nonstress testing if the patient is at a residence or other off-site location separate from the patient’s provider and meet the same standard of care. (using established CPT codes).
Proposal-level legislation and rulemaking activities
highlight:
- in new jersey, A 2803 passed through the first chamber. If enacted, this bill would require certain out-of-state medical professionals and graduates of medical training programs to apply for in-state licensure and certification and practice in the state before being licensed. will be recognized.
- in texas, HB 1771 passed through one chamber. This bill, if enacted, would require agencies with regulatory authority over telehealth medical services, teledentistry, or telemedicine providers to standardize the format and retention of records regarding patient consent to: will be required to adopt the necessary regulations. (i) Treatment; ii) Data Collection; and (iii) Data Sharing.
- in minnesota, SF 4399 passed through both chambers. If enacted, this bill would provide that, subject to Federal approval, substance use disorder services covered as in-person services may be provided through telehealth, as defined in Section 256B.0625, subdivision 3b. It turns out. The use of telehealth to provide services must be medically appropriate to the condition and needs of the person receiving the services. Refunds will be made at the same rates and under the same terms that apply to in-person services.
- in Alabama, SB 207 passed through one chamber. If this bill becomes law, a dietitian licensing agreement will be adopted.in tennesseeHB 1863 (versus SB 1862) also passed one chamber and, if enacted, would adopt the Dietitian Licensing Compact.
- Many states have advanced legislation related to social work compacts.
- in maineLD 2140 passed through both chambers
- in AlabamaSB 208 passed through one chamber
- in new hampshireHB 1190 passed in one chamber.
- in new jerseyA 2813 passed through one chamber.
- in tennesseeSB 2405 passed both chambers
- in coloradoHB 24-1002 Passed One Chamber.
- in vermont stateH 543 passed through both chambers
Why it’s important:
- States continue to increase activity around licensing agreements for various medical professionals. These states’ efforts demonstrate a desire to reduce the burden of the licensing process and encourage practice in multiple jurisdictions without relinquishing authority over professional licensure. This week saw major developments in the Social Work Agreement and the Dietitian Agreement.
- States continue to amend and clarify their standards of professional practice regarding telehealth. With the increasing delivery of care through virtual modalities, professional boards have adopted standards to govern the practice of telehealth across multiple health care professions to (i) reflect current technology and practice, and (ii) We are revising existing standards to ensure consistency across positions. This week, there was a particular focus on areas such as out-of-state licensure benefits and supervision standards (for both social workers and skilled nursing).
- States continue to evaluate reimbursement standards related to the provision of care delivered via telehealth. Efforts in states like Minnesota (highlighted above) can help provide reimbursement for telehealth services without requiring reimbursement to be burdensome in-person visits. Efforts to equalize payment for services provided through telehealth are also being stepped up.
