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Trending in Telehealth: June 13 – 21, 2023

Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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:

  • Telehealth pilot programs
  • Mental health

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Connecticut enacted HB 6768, which permits physicians, advanced practice registered nurses and physician assistants to certify a qualifying patient’s use of medical marijuana and provide follow-up care using telehealth if they comply with other statutory certification and recordkeeping requirements.
  • Florida enacted HB 5101, which requires each school district to implement a school-based mental health assistance program that provides behavioral health services in-person and supplemented by telehealth.
  • Florida enacted SB 2500, which provides additional funding for telehealth services under the Minority Maternity Care program.
  • Illinois enacted SB 1298, amending the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities to permit medical and emergency telehealth services for persons with intellectual and developmental disabilities.
  • Louisiana enacted SB 186, adopting the Occupational Therapy Licensure Compact.
  • Louisiana enacted SB 66, which amends the state insurance code by replacing the term “telemedicine” with “telehealth,” for consistency throughout the code. The amendment does not require a provider to have an in-person examination with the patient prior to using telehealth but does require that a referral be made to an in-state healthcare provider or in-state follow-up care be arranged if necessary. The amendment also permits the use of interactive audio without video if, after access and review of the patient’s medical records, the healthcare provider determines that the provider is able to meet the same standard of care as if the services were provided in-person.
  • Louisiana enacted HB 41, which requires health plans to provide equivalent coverage and payments for telehealth occupational therapy services as for in-person services, unless the plan and the provider agree otherwise.
  • Louisiana enacted HB 181, which allows coroners to use telehealth when conducting an examination for an emergency mental health commitment.
  • Texas enacted HB 2727, which amends the requirements for the home telemonitoring program under Medicaid, including reimbursement requirements.
  • Texas enacted HB 617, which establishes a pilot project to provide emergency medical services instruction and emergency prehospital care instruction through a telemedicine medical service or telehealth service provided by regional trauma resource centers to healthcare providers in rural trauma facilities and emergency medical services providers in rural areas.
  • Texas enacted SB 1146, increasing access to telehealth services for inmates. The law requires the Department of Criminal Justice, in conjunction with The University of Texas Medical Branch at Galveston and the Texas Tech University Health Sciences Center, to establish procedures to expand access to telemedicine medical services, telehealth services and onsite medical care [...]

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Trending in Telehealth: May 31 – June 5, 2023

Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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
  • Medical Cannabis
  • Mental Health

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Iowa enacted HF 671, adopting the Professional Counselors Licensure Compact.
  • Minnesota enacted HF 100, permitting the medical sale and use of cannabis through the state’s registry program. HF 100 permits remote pharmacist consultations by secure videoconference, telephone or other remote means, as long as the pharmacist engaging in the consultation is able to confirm the identity of the patient and the consultation adheres to patient privacy requirements that apply to healthcare services delivered through telemedicine. A Minnesota licensed physician, physician assistant or advanced practice registered nurse (APRN) must determine on a yearly basis if the patient continues to have a qualifying medical condition for enrollment on the Division of Medical Cannabis registry.
  • Missouri passed a final rule establishing the Telehealth Dental Pilot Project for Medically Underserved Populations to examine new methods of extending dental care to residents in assisted living facilities, intermediate care facilities, residential care facilities and skilled nursing facilities, and homebound special needs patients. This rule permits the supervision of dental assistants and dental hygienists using telehealth technology.
  • Oklahoma enacted SB 12, creating a mental health transport revolving fund for the Department of Mental Health and Substance Abuse Services. This law permits telemedicine assessments of patients when assessments are requested by sheriffs or peace officers. The state’s criminal code defines the term peace officer as “any sheriff, police officer, federal law enforcement officer, tribal law enforcement officer, or any other law enforcement officer whose duty it is to enforce and preserve the public peace.” Okla. Stat. tit. 21 § 99.
  • Vermont enacted three telehealth-related laws:
    • H 62 adopts the Interstate Counseling Compact to facilitate interstate practice of licensed professional counselors with the goal of improving public access to professional counseling services.
    • H 86 adopts the Audiology and Speech-Language Pathology Interstate Compact, which streamlines the licensure process for audiologists and speech-language pathologists and allows the use of telehealth technology to facilitate increased access to audiology and speech-language pathology services.
    • H 282 adopts the Psychology Interjurisdictional Compact, which regulates the day-to-day practice of telepsychology and streamlines the licensure process for psychologists.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • Connecticut progressed HB 6768, which would permit physicians, APRNs and physician assistants to certify a qualifying patient’s use of medical marijuana and provide follow-up care using telehealth if they comply with other statutory certification and recordkeeping requirements.
  • Louisiana progressed two bills:



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Illinois Medicaid Program Expands Telehealth Reimbursement Increasing Access to Behavioral Health and Other Critical Services

In an effort to address the need for increased access to behavioral health services, Illinois has passed a series of bills that meaningfully expand the reimbursement of telehealth services delivered to its Medicaid patients. Illinois’ legislators, telemedicine advocates, healthcare providers and patient advocacy groups collaborated in an impressive effort to develop focused and targeted legislative solutions that effectively balance the need to get critical behavioral health services to patients in need with long-standing concerns that increasing access via telehealth will result in greater health care costs to a state already experiencing severe financial challenges.

Governor Bruce Rauner advised that these “initiatives work together to improve the quality of care and hopefully the quality of life for so many Illinoisans suffering from mental health and substance use disorders.” Supporters of the legislation are optimistic that these changes will further expand telehealth programs in Illinois, continuing the growth experienced in the past several years.

As a result of changes to the Illinois Public Aid Code (305 ILCS 5/5-5.25), the following will receive reimbursement from the Department of Healthcare and Family Services (“Department”) for delivering telehealth services that meet applicable requirements:

  • Clinical psychologists
  • Clinical social workers
  • Advanced practice registered nurses certified in psychiatric and mental health nursing
  • Mental health professionals and clinicians who are authorized by Illinois law to provide mental health services to recipients via telehealth (in addition to psychiatrists and federally qualified health centers)

The Department is also required to reimburse any Medicaid certified eligible facility or provider organization that acts as the originating site (i.e., the location of the patient at the time a telehealth service is rendered), including substance abuse centers licensed by the Department of Human Services’ Division of Alcoholism and Substance Abuse.

In addition to these changes, the Illinois Telehealth Act’s definition of a “Health care professional” (225 ILCS 150/5) has been revised to include dentists, occupational therapists, pharmacists, physical therapists, clinical social workers, speech-language pathologists, audiologists, and hearing instrument dispensers. As a result of this change, these professionals are now explicitly subject to the Illinois Telehealth Act’s requirements.

Finally, the Illinois Insurance Code (215 ILCS 5/356z.22) has been amended to require that any individual or group policy of accident or health insurance that provides coverage for telehealth services also provide coverage for telehealth services provided by licensed dietitian nutritionists and certified diabetes educators to senior diabetes patients. The amended section clearly states that this change is intended to “remove the hurdle of transportation for senior diabetes patients to receive treatment.” While this change is a step in the right direction, Illinois remains in the minority as one of the states without a telehealth coverage and/or payment parity law. The vast majority of states have parity laws that, at a minimum, include a coverage requirement, mandating certain types of payors to approve and reimburse certain telehealth encounters the same as they would in-person medical encounters.

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The Illinois legislators who sponsored the passed legislation will be recognized for their efforts [...]

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