Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate the delivery of virtual care.

Trending in the past week:

• Interstate compacts
• Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking:

• Arizona enacted SB 1036, entering into the Social Work Compact. Arizona is the 19th state to enact this compact.
• Arizona also signed SB 1267 into law, which revises the definition of “general supervision” to include supervision through telehealth for physical therapy services provided by physical therapist assistants.
• In Louisiana, the governor signed HB 896, the Louisiana Remote Patient Monitoring Program Law, which establishes a patient monitoring program including definitions, eligibility, and reimbursement requirements under Medicaid. It also addresses equipment and network requirements and availability, and is aimed at patients with costly, chronic illnesses. The act goes into effect August 1,
• Nevada adopted a final rule that revises social work regulations, and now clearly states that licensed social workers are not allowed to provide telehealth services to a client outside of Nevada, unless authorized under that state’s laws.
• Ohio partially adopted a rule regulating the provision of personal care activities, which includes documentation requirements when the care is provided by telehealth.

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

• New Hampshire passed to enter into the Social Work Compact. The bill heads to the governor’s desk.
• Nevada proposed a rule that would revise optometry regulations and what is required of an optometrist before providing optometry services via telehealth, such as reviewing the patient’s chart and, if prescribing ophthalmic lenses, performing a manifest refraction.
• Although not a formal rule, the Washington Insurance Commissioner is seeking feedback on amending telehealth-related rules. Specifically, the Office of the Insurance Commissioner (OIC) is considering consolidating healthcare regulations be consistent with state and federal changes. This would include amending definitions related to “established relationship” as it applies to audio-only telemedicine services. Interested parties can reach out to the OIC.

Why it matters:

• Interstate compacts continue to grow. As we’ve seen consistently, states continue to join interstate compacts. This week, Arizona became the 19th state to enact the Social Work Compact, which New Hampshire introduced legislation to enroll into. Three other states have also introduced or fully enacted legislation to enroll in the Social Work Compact this year so far.
• States are expanding the use of technology related to telehealth. Multiple states have legislation and regulations that account for difference in documentation when using telehealth or other technology, versus traditional in-person care. This week, Nevada a proposed rule that establishes standards of care specifically for providing optometry services via telehealth, and Ohio partially adopted a rule which factors in the automatic record creation of certain technologies. This push to incorporate technology is also evident in Louisiana’s passing of the Remote Patient Monitoring [...]
  
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Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate the delivery of virtual care.

Trending in the past week:

• Interstate compacts
• Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking:

• In Florida, the governor signed H 7021, which revises substance abuse and mental health laws. This change allows for an individual to receive treatment via telehealth when a law enforcement officer determines involuntary examination is warranted.
• Colorado enacted SB 24-141, which allows healthcare regulating bodies to create a telehealth registration process for out-of-state providers. A regulator must create the registration process, but an applicant is eligible for registration if the applicant (i) possesses an unencumbered out-of-state credential issued by another state that has educational and supervisory standards equivalent or exceeding Colorado’s standards or maintains the interstate compact license, (ii) has an agent of service in Colorado, (iii) has not been subject to disciplinary action in the last 5 years, and (iv) passes a jurisprudence examination.

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

• Rhode Island had a very active week passing compact-related bills. If signed by the Governor, Rhode Island will be enrolled in the:
  • Social Work Licensure Compact (SB 2184)
  • Counseling Compact (SB 2183)
  • Speech-Language Pathology Interstate Compact (SB 2173)
  • Occupational Therapy Licensure Compact (SB 2623)
• The Ohio Senate also passed SB 28 that would enroll the state in the PA Licensure Compact.
• Arizona bill SB 1036 would enact the Social Work Compact; it heads to the Governor’s desk.
• Arizona also passed SB 1267 in both houses that would revise supervision requirements for physical therapy assistants, allowing for supervision via telehealth.
• The Delaware Senate passed SB 301, which would require public universities to provide access to medication to terminate pregnancy and emergency contraception, including requirements for accommodating a student’s request for a telehealth appointment if the student health center is not equipped or staffed to provide the medication.

Why it matters:

• Interstate compacts continue to grow. Although this week was relatively slow for telehealth-related legislation and rulemaking, interstate compact enrollments were the exception. States continue to pass compact-related legislation, with Rhode Island leading the charge this week with four bills passing both houses. Additionally, as we saw last week, states are also amending statutes and rules to accommodate compact providers. We see this in Colorado’s new telehealth registration under SB 24-141, the final version of which was amended from the original bill text to include compact providers.
• Telehealth is playing a key role in program guidance. States continue to amend the rules and statutes related to various healthcare programs to account for the usage of telehealth. Ohio’s recently passed rule for homemaker services explicitly speaks to the difference in documentation [...]
  
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