Trending in Telehealth: May 14 – May 20, 2024

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:

  • Reimbursement requirements
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Iowa’s Board of Physical and Occupational Therapy amended two rules, Chapter 201, relevant to physical therapists and Chapter 208, relevant to occupational therapists. These rules establish standards for telehealth visits for physical therapy and occupational therapy, permitting the use of audio or video equipment, or both, at the discretion of the licensee. In connection with the adoption of the revised rules, the board noted that the expansion was a response to public comment from ATA Action, the American Telemedicine Associate’s affiliated trade association, which urged the board to expand the modalities that can be used for telehealth appointments in the interest of expanding Iowa patients’ access to affordable, high-quality healthcare.
  • Maryland enacted HB 1127, which authorizes certain healthcare providers to provide sexual assault forensic exams conducted through “peer-to-peer telehealth” without charge to victims and makes those services eligible for reimbursement by the Criminal Injuries Compensation Board (CICB). The peer-to-peer telehealth modality permits the performance of a forensic examination using interactive audio, video, or other telecommunications or electronic technology by a forensic nurse examiner to assist in the performance of a forensic examination when the forensic nurse examiner is in one location and the patient is with a qualified healthcare provider in another location.
  • Maryland also enacted HB 1078, which requires Medicaid to provide remote ultrasound procedures and remote fetal nonstress tests in certain circumstances.
  • South Carolina enacted S 858. This bill adds acute hospital care at home programs as exempt from Certificate of Need review by the SC Department of Health and Environmental Control. “Acute hospital care at home” includes the utilization of technology to provide continuous remote patient monitoring and connectivity to the patient.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Colorado, SB 24-054 passed the first chamber. The bill requires all private insurance companies to provide coverage for the treatment of the chronic disease of obesity and the treatment of pre-diabetes, including coverage for intensive behavioral or lifestyle therapy, bariatric surgery, and FDA-approved anti-obesity medication. The definition of intensive behavioral or lifestyle therapy includes interventions virtually through telehealth.
  • In Michigan, HB 4580 and HB 4213 passed the second chamber. If enacted, HB 4580 would require telemedicine services to be covered under Medicaid if the originating site is an in-home or in-school setting, in addition to any other originating site allowed in the Medicaid provider manual. HB 4213 would also require Medicaid to cover telemedicine services, however, further clarifies the requirements for Medicaid coverage. First, HB 4213 requires Medicaid coverage parity for telehealth services. Additionally, HB 4213 requires coverage of [...]

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Trending in Telehealth: May 7 – May 13, 2024

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
  • Reimbursement requirements
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Mississippi enacted legislation, HB 764, which permits the State Board of Health to promulgate rules and regulations, and to collect data and information on the delivery of telemedicine services and the use of electronic records for the delivery of telemedicine services.
  • Alabama enacted legislation, SB 208, which adopts the Social Worker Licensure Compact.
  • The Texas Department of Licensing and Regulation adopted a rule for speech-language pathologists and audiologists confirming that direct and indirect supervision may be performed through tele-supervision and that in-person supervision is not required. This rule also allows a licensee providing telehealth services to provide proof of licensure to a requestor through the department’s online license search.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Colorado, SB 24-141 passed two chambers. If enacted, all healthcare providers who possess a license, certificate, registration or other approval as a healthcare provider in another state may provide healthcare services through telehealth to patients located in Colorado if the provider registers with the appropriate Colorado regulatory agency.
  • In Colorado, SB 24-168 passed two chambers. This bill requires the Department of Health Care Policy and Financing to provide reimbursement for the use of telehealth remote monitoring for outpatient services for certain Medicaid members.
  • In Minnesota, HF 4247 passed two chambers, which would allow transfer care specialists and veterinarians to provide “direct supervision” via telephone.
  • In South Carolina, H 5183 passed two chambers. This bill would allow for the delegation of nursing tasks, including the performance of nonclinical tasks via telemedicine.
  • In Tennessee, SB 2368 passed two chambers. If enacted, this bill would require that any policy, certificate or agreement for health insurance coverage under TennCare must include coverage for telehealth visits for complex rehabilitation technology.
  • Connecticut HB 5198 passed the second chamber. If enacted, this bill would make permanent certain temporary expanded requirements for telehealth services.
  • Several states saw activity related to interstate compacts.
    • Social Worker Licensure Compact
      • In Connecticut, HB 5197 passed two chambers.
      • In New Hampshire, SB 318 passed one chamber.
      • In Tennessee, SB 2134 passed two chambers.
    • In Connecticut, HB 5058 passed two chambers, which would enact the Nurse Licensure Compact.
    • In Alabama, SB 207 passed two chambers, which would enact the Dietician Licensure Compact.
    • In South Carolina, S 610 passed two chambers, which would enact the Counseling Compact.

Why it matters:

  • States continue to increase activity surrounding licensure compacts for [...]

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Trending in Telehealth: April 30 – May 6, 2024

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
  • Reimbursement requirements

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Iowa enacted HF 2402, which requires the Iowa Department of Health and Human Services to review and update its administrative rules regarding psychiatric medical institutions for children (PMICs), including the review of rules related to the use of telehealth services to conduct post-restraint and seclusion assessments.
  • Iowa enacted HF 2512, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Louisiana, HB 896 passed one chamber. This bill establishes the Louisiana Remote Patient Monitoring Program Law, which allows remote patient monitoring services provided through telehealth for patients who meet certain criteria as outlined in the bill.
  • In Connecticut, HB 5198 passed one chamber. If enacted, this bill would make permanent certain temporary expanded requirements for telehealth services. These expanded provisions include the following: allows authorized telehealth providers to use audio-only telephone to provide services, allows authorized providers to provide telehealth services from any location to patients at any location, prohibits providers from charging uninsured patients more than the Medicare reimbursement rate for telehealth services, and prohibits health carriers from reducing the amount of reimbursement they pay to telehealth providers for covered services provided through telehealth.
  • In Colorado, HB 24-1045 passed the second chamber. This bill adds substance use disorder treatment to the list of healthcare services required to be reimbursed at the same rate for telemedicine as comparable in-person services.
  • In Colorado, SB 24-141 passed one chamber. If enacted, this bill would allow a licensed out-of-state healthcare provider to provide telehealth services to patients located in Colorado if the provider registered with the appropriate regulator in Colorado.
  • In Hawaii, HCR 125 passed one chamber, which requests the establishment of a telehealth working group to examine the impact of widespread telehealth adoption during the COVID-19 pandemic and to identify public policy initiatives at the federal and state level to optimize telehealth utilization as the state transitions out.
  • Several states saw activity related to interstate compacts.
    • Michigan HB 4169 passed one chamber, which would enact the occupational therapy licensure compact.
    • In South Carolina, S 610 passed two chambers, which would enact the professional counseling compact.
    • In Alabama, SB 208 passed two chambers, which would enact the Social Worker Compact.
  • In Nevada, the Board of Dental Examiners published a proposed rule that expands requirements related to teledentistry. This rule specifies the circumstances under which a licensed provider may provide teledentistry services, including issuing prescriptions.
  • In Kansas, the Board of Pharmacy proposed a rule that sets forth requirements to establish a telepharmacy outlet, as well as requirements for the personnel who would staff the telepharmacy outlet. This rule [...]

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Trending in Telehealth: April 23 – April 29, 2024

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 and licensure
  • Reimbursement requirements and payment parity

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Oklahoma enacted HB 3330, which would require every mental health professional who is renewing a behavioral health certification or license issued by a designated board to report certain information, including their use of telehealth.
  • Vermont enacted H 543, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Ohio, S 1074 passed the first chamber. If enacted, the bill would amend the supervision and delegation laws for physicians and physician assistants including adding the ability for both licensee types to . Some examples included in the bill are collecting specimens (e.g., urine or stool samples), point of care testing and screening and recording information. The bill does not specify any particular non-clinical tasks that would be particularly suited for telemedicine.
  • In Vermont, H 861 passed the first chamber. If enacted, the bill would provide for reimbursement parity for all medically necessary, clinically appropriate, delivered in-person, by telemedicine, and by audio-only telephone. Services covered under the bill would include services that are covered when provided in the home-by-home health agencies. The bill specifically provides that health insurance plans provide the same reimbursement rates for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract.
  • In Colorado, HB 24-1045 passed the first chamber. If enacted, the bill would add substance use disorder treatment to the list of healthcare services required to be reimbursed at the same rate for telemedicine as comparable in-person services.
  • Numerous states progressed legislation relating to the Social Worker Compact
    • In Alabama, HB 318 passed the first chamber.
    • In Iowa, HB 2512 passed both chambers
    • In Ohio, SB 90 passed both chambers.
    • In Louisiana, HB 888 passed the first chamber.

Why it matters:

  • States continue to increase activity surrounding licensure compacts for a variety of health professionals. These state efforts ease the burdens of the licensing process and demonstrate a desire to facilitate multijurisdictional practice without giving up authority over professional licensure. This week, the Social Work Compact saw increased activity.
  • States continue to amend and clarify professional practice standards for telehealth. With the increase in the delivery of care through virtual modalities, professional boards are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices, to ensure there is consistency across the professions. This week, we saw a particular emphasis on mental health professionals as it relates to Board reporting obligations, [...]

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Trending in Telehealth: April 16 – April 22, 2024

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 and licensure
  • Reimbursement requirements and payment parity

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Nevada’s Physical Therapy Board adopted a final rule which permits physical therapists to use telehealth in accordance with the provisions of Nevada’s general telehealth law (Rev. Stat. 629.515).
  • Nebraska enacted legislation, LB 932, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Illinois, HB 5087 passed the first chamber. The bill provides that physical therapy through telehealth services may be used to address access issues to care, enhance care delivery or increase the physical therapist’s ability to assess and direct the patient’s performance in the patient’s own environment. It also provides that a physical therapist or a physical therapist assistant working under the general supervision of a physical therapist may provide physical therapy through telehealth services pursuant to the terms and use defined in the Telehealth Act and the Illinois Insurance Code under specified conditions.
  • In Tennessee, SB 1862 and mirroring HB 1863 passed the second chamber. The bill would adopt the Dietician Licensure Compact.
  • In Minnesota, SF 4399 passed the second chamber. The bill specifies that subject to federal approval, substance use disorder services that are otherwise covered by the state’s Medicaid program as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, subdivision 3b. The use of telehealth to deliver services must be medically appropriate to the condition and needs of the person being served. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to direct face-to-face services.
  • In Ohio, proposed rules by the Chemical Dependency Professionals Board would provide guidance regarding the ethics and professional conduct of practice for certificate holders and licensees overseen by the Chemical Dependency Board, which includes chemical dependency counselor assistants, licensed chemical dependency counselors and licensed independent chemical dependency counselors, when using telehealth.

Why it matters:

  • States continue to amend and clarify professional practice standards for telehealth. With the increase in the delivery of care through virtual modalities, professional boards are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices to ensure there is consistency across the professions. This week, we saw a particular emphasis in practice standards impacting physical therapists and substance use disorder professionals who provide services via telehealth.
  • States continue to evaluate reimbursement standards as they relate to delivery of care provided via telehealth. State efforts, such as the bill in Minnesota (highlighted above), help to promote access to telehealth by giving patients a choice to seek telehealth [...]

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