Good news on telemedicine from the US…and one small potentially dark cloud

According to FierceHealthIT, last week three more states – Indiana, Minnesota and Nevada – enacted telemedicine parity laws, bringing the total to 27 plus the District of Columbia, to make it that much easier to provide – and to request provision – of a telemedicine service.

  • Indiana’s requires coverage of the services under private insurance through video, audio or other media. The law prohibits a provider from having to obtain written consent for use of telemedicine.
  • Minnesota’s law says health plans must cover and reimburse for telemedicine the same way and at the same cost as in-person service. Medicaid coverage, according to the law, is limited to three telehealth services per week per beneficiary.
  • Nevada’s requires coverage and reimbursement for telehealth under private insurance and Medicaid, as well as workers compensation (the first state to include this) to the same extent and at the same price as provided in person.

Meanwhile MorningStar reports that a Federal Court ruled in favor of Teladoc, blocking as illegally limiting competition revisions to Rule 190.8 adopted in April by the Texas Medical Board that required a face-to-face visit before physicians are allowed to prescribe medication to patients.

However one other interesting aspect of telemedicine emerged in a RAND Corporation study of patients with acute respiratory infection reported in a letter to JAMA Internal Medicine that whilst total drug prescribing by Teladoc doctors and by physicians face:face was similar in that study, perhaps because of the lack face:face examination, some Teladoc physicians were hedging their bets with broader spectrum drug prescriptions. Clearly it is still early days for telemedicine; doubtless as it becomes widely accepted, this issue will be addressed, as overprescribing broad spectrum drugs encourages antibiotic resistance.

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