Trending in Telehealth highlights monthly 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 April:
- Telehealth reimbursement
- Cross-state telehealth practice and continuity of care
- Telehealth practice standards and supervision requirements
- Expansion of telehealth across provider types and care settings
A CLOSER LOOK
Proposed legislation and rulemaking:
- In New York, S 354 passed one chamber and would amend the state public health law to expand reimbursement for telehealth services. The bill would require that healthcare services delivered via telehealth be reimbursed on the same basis, at the same rate, and to the same extent as equivalent services provided in person. The bill clarifies that reimbursement would not extend to facility-based costs not incurred in the delivery of telehealth services.
Finalized legislation and rulemaking:
- Tennessee passed HB 2029, which enacts the Dietetics and Nutrition Practice Act. The legislation defines “telehealth” and authorizes licensed dietitians and nutritionists to provide medical nutrition therapy and other nutrition care services via real-time audio, video, or other media. It also permits certain out-of-state practitioners to provide telehealth services under specified conditions, including for continuity of care.
- Oregon enacted HB 4070, which expands Medicaid telemedicine reimbursement by broadening the categories of eligible providers, including licensed and certain unlicensed providers, community mental health programs, hospitals, and federally qualified health centers.
- Oregon enacted HB 4107, which establishes requirements for urgent care centers, including disclosure of whether telemedicine services are offered. When a provider is unavailable due to illness, emergency, or similar circumstance, an urgent care center may operate temporarily without a licensed healthcare provider onsite if a licensed provider is available via telemedicine and the patient is notified at the first point of contact that services will be delivered through telemedicine.
- Kansas enacted HB 2761, which expressly authorizes the use of telepractice in the delivery and supervision of speech-language pathology services. The law defines “telepractice” as the use of telecommunication and internet-based technology to provide remote intervention services and permits speech-language pathology assistants to deliver teletherapy under the direction of a licensed speech-language pathologist. It also allows supervising speech-language pathologists to satisfy direct supervision requirements via real-time audiovisual technology, provided they can observe and communicate with the assistant during service delivery.
- Kentucky enacted HB 424, which updates the regulation of social work practice and authorizes the provision of services via telehealth. It also establishes requirements for telehealth practice, including informed consent, confidentiality, accessibility, standards of care, documentation, and cross-jurisdiction practice.
- Maryland enacted HB 1483, which repeals the state board’s authority to issue temporary telehealth licenses for clinical professional counselors and social workers, and establishes a limited telehealth exception for continuity of care. Under the exception, certain out-of-state licensed clinical professional counselors may continue providing telehealth services to existing clients for up to six months following the client’s relocation.
- Vermont enacted H 84, which amends the state’s telemedicine and audio-only telephone consultation statutes to prohibit the recording of telehealth or telephone appointments without the consent of both the patient and the provider.
- The Wyoming Board of Medicine adopted an emergency rule amending physician licensure regulations to clarify when out‑of‑state physicians may provide services via telemedicine without obtaining a Wyoming license. The rule specifies that establishing a physician‑patient relationship through telemedicine constitutes “practicing medicine” in the state unless the physician qualifies for an applicable exemption, including limited‑duration consultations with a Wyoming‑licensed attending physician or continuity‑of‑care telehealth services provided to established Wyoming patients for up to six months.
Compact activity:
- In Alaska, HB 110 would enter the state into the Social Work Licensure Compact, facilitating multistate practice, including the provision of services via telehealth.
- In Alaska, HB 173 would enter the state into the Occupational Therapy Compact, allowing licensed occupational therapists to practice across participating states.
- In Iowa, SF 2139 would enter the state into the Athletic Trainer Compact, enabling licensed athletic trainers to provide services across state lines in participating jurisdictions.
- In Ohio, SB 320 would enter the state into the Athletic Trainer Compact.
- In Oklahoma, SB 1653 would enter the state into the Occupational Therapy Compact.
Why it matters:
- States continue to expand reimbursement for telehealth services. Legislative activity reflects a focus on payment parity and broader Medicaid coverage, including reimbursement for services delivered by a wider range of providers.
- Cross-state practice frameworks are evolving. States are refining licensure requirements and adopting continuity-of-care exceptions that allow out-of-state providers to deliver telehealth services under defined circumstances.
- Telehealth is being integrated into more care settings and professions. New laws extend telehealth authority to additional provider types and settings, including dietitians, speech-language pathology assistants, and urgent care centers, while establishing clearer supervision and practice standards.
Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott Will & Schulte digital health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care, and mitigate enforcement risk through proactive compliance.
