By Christine Kern, contributing writer
As telemedicine makes its way mainstream, legislation must keep pace.
Telehealth is a powerful tool that can help achieve the trifecta of better healthcare, improved health outcomes, and lower healthcare costs. By creating efficiencies and extending the reach of existing providers, it has the ability to ameliorate healthcare workforce issues and can reduce health disparities for aging and underserved populations by overcome access barriers and reducing both costs and burdens for patients. As telehealth makes its ways mainstream, legislation must keep pace. A total of 200 telemedicine bills were introduced in all but eight states across the United States in 2015, according to a National Conference of State Legislatures (NCSL) report.
The report, Telehealth Policy Trends and Considerations, explores the benefits and risks of telehealth for state legislatures and provides an overview of the status of reimbursement for telemedicine in various states. For the report, NCSL defines telemedicine as video visits, store and forward, remote patient monitoring, and mobile health, though individual state definitions may vary.
Included in the numerous telehealth bills introduced in 2015 were those involving the Federation of State Medical Board’s proposed interstate licensing compact. Eleven states — Alabama, Idaho, Illinois, Iowa, Minnesota, Montana, Nevada, South Dakota, Utah, West Virginia, and Wyoming — easily passed the compact language in 2015. Only seven more states are needed to implement the compact.
Two federal bills also appeared that could supersede local laws for VA and Medicare patient population. The TELEmedicine for MEDicare Act of 2015 (TELEMED Act) and the Veterans E-Health and Telemedicine Support Act of 2015 would create an interstate license for practicing medicine on VA and Medicare populations, easing some issues of access to care.
The study found Rhode Island is the only state that does not offer any type of Medicaid reimbursement for telemedicine, and nearly all of the states reimburse for live video visits. Nine states — including Alaska, Arizona, California, Illinois, Minnesota, Mississippi, New Mexico, Oklahoma, and Virginia — include reimbursement for store and forward services, while 17 states reimburse for remote patient monitoring services.
Thirty-two states, plus the District of Columbia, have telehealth parity laws mandating telehealth services be reimbursed at the same rate as in-person visits, while 23 states, and the District of Columbia, have full parity that provides coverage and reimbursement for telehealth services.
Telehealth reimbursement varies by state, with some distinguishing between types of providers or excluding behavioral health providers. Some restrict telemedicine reimbursement to rural areas and others require a specific originating site.
The report concludes, “Telehealth is a rapidly growing field that has the potential to help states leverage a shrinking and maldistributed provider workforce, increase access to services, improve population health and lower costs." It added states are "grappling with how to capitalize on this potential while safeguarding state investments in telehealth and ensuring patient outcomes and safety.”