Here’s some brief updates on US telemedicine legislation scene to hit the news recently.
Florida is progressing the telehealth bill we reported on 12 Feb 2015. The Florida Senate Telehealth Policy Committee revised the draft bill on 18 Feb 2015 so the need for Medicaid reimbursements to be the same for telemedicine and face-to-face consultations is removed.
We have reported many telehealth initiatives from Mississippi and the state is now considered to be “a leader in telemedicine” according to a recent report in Politico. “Mississippi’s telemedicine program, ranked among the seven best in the country, has inspired neighboring Arkansas to take bigger steps in some areas of the field, and the impact of its success is making waves in Washington as well” continues Politico.
Mississippi is also helping to move telehealth at a federal level. Rep. Gregg Harper (R-Miss.) and Rep. Mike Thompson (D-CA) introduced a bipartisan bill in July last year to expand telehealth services under Medicare. The bill called Medicare Telehealth Parity Act 2014 starts to move face to face and telehealth consultations to be on an equal footing.
In addition, the work of the telemedicine working group (of the House Energy and Commerce Committee), which Harper leads, has been incorporated into the 21st Century Cures Bill, a draft of which was released in January 2015. As the accompanying discussion document states the output of the working group “will set the stage for new technologies to play a greater role in the delivery of quality health care services to Medicare beneficiaries. This team effort involved input from Health Subcommittee Chairman Joe Pitts (R – PA) and full committee Ranking Member Frank Pallone (D -NJ) in addition to Reps. Gregg Harper (R – MS), Bill Johnson (R – OH), Greg Walden (R – OR), Bob Latta (R – OH), Doris Matsui (D – CA), and Peter Welch (D – VT).”
The state of Utah is trying to legislate on the issue of insurance reimbursement for telehealth consultations. On Feb 26th 2015 Republican Governor Gary Herbert proposed to the House an agreement his office had come to with federal officials after months of negotiations. Under the two year agreement the state would enroll low income residents into private health plans and the federal government would return “hundreds of millions of dollars” of Utah tax back to the state. This agreement was accepted by the Senate and shunned by the House.
The Colorado legislature passed a bill on 4th March 2015 to give telemedicine consultations a similar weight as face to face consultations when it comes to health insurance cover. House Bill 15-1029, “Coverage under a health benefit plan for health care services delivered through telehealth in any area of the State“, including all amendments proposed by the Senate, has been passed by the Colorado House of Representatives and is waiting for signature by the Governor John Hickenlooper. If the bill is signed into law it will take effect on 1 January 2016.
Under current law, health benefit plans issued, amended, or renewed in the sate of Colorado cannot require in-person health care delivery for a person covered under the plan who resides in a rural county (with 150,000 or fewer residents) if the care can be appropriately delivered through telemedicine and the county has the technology necessary for care. The new bill gives this right to everyone in Colorado, not just those living in such rural counties.
Further, a provider need not demonstrate that a barrier to in-person care exists for coverage of telemedicine under a health benefit plan to apply.
In addition, carriers:
o Must reimburse providers who deliver care through telemedicine on the same basis that the carrier is responsible for coverage of services delivered in person;
o Cannot charge deductible, copayment, or coinsurance amounts that are not equally imposed on all terms and services covered under the health benefit plan; and
o Cannot impose an annual or lifetime dollar maximum that applies separately to telemedicine services.
National Conference of State Legislatures
The National Conference of State Legislatures (NCSL) champions state legislatures and supports various aspects of state legislation. The NCSL web site has a section devoted to telehealth and features a map showing states with insurance coverage for telehealth services as well as an associated table which lists the current status of telehealth with respect to Medicaid and private health insurance for each state. Unfortunately the site is somewhat out of date and the telehealth coverage page states that it was last updated in January 2014. Other pages on the site are similarly a bit out of date.