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Trending in Telehealth: July 2 – 8, 2024

by Amanda Enyeart and Jae Hyun Lee | Jul 12, 2024 | Telehealth

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:

Insurance and Medicaid reimbursement
Behavioral and mental health

A CLOSER LOOK

Finalized Legislation & Rulemaking:

In Pennsylvania, the governor signed SB 739, which amends Title 40 (Insurance) of the Pennsylvania Consolidated Statutes to require health insurers and Medicaid and CHIP managed care programs to provide coverage for healthcare services delivered through telemedicine using a HIPAA compliant technology. This bill establishes definitions related to telemedicine, as well as requirements for health insurance and Medicaid coverage of telemedicine services.

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

Delaware issued a proposed rule to amend the Delaware Administrative code concerning professional counselors of mental health and chemical dependency professionals to clarify that face-to-face supervision or counseling includes live video conferencing.
Arizona issued a notice of rulemaking to notify of its intent to amend the Arizona Board of Behavioral Health Examiners rules to make them consistent with statutory changes including: (1) amending the definition of direct client contact to include therapeutic or clinical care via telehealth; (2) registration of out-of-state providers of telehealth services; (3) removing the requirements for evidence of indirect client hours obtained during training for social workers, counselors, marriage and family therapists, and addiction counselors; and (4) implementing the interstate compact for licensed professional counselors.

Why it matters:

States are increasing access to and coverage for telemedicine services. Pennsylvania expanded access to and coverage of telehealth services across insurance providers and across the state. Additionally, Delaware and Arizona are considering rules to include live video conferencing under the definition of direct patient care.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott 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.

Trending in Telehealth: June 25 – July 1, 2024

by Lisa Mazur and Jae Hyun Lee | Jul 2, 2024 | Telehealth

Trending in the past week:

Interstate compacts
Medicaid reimbursement
Teledentistry
Professional standards
Behavioral and mental health

A CLOSER LOOK

Finalized Legislation & Rulemaking:

Rhode Island entered into the following compacts:
- Social Work Licensure Compact (SB 2184)
- Counseling Compact (SB 2183)
- Speech-Language Pathology Interstate Compact (SB 2173)
- Occupational Therapy Licensure Compact (SB 2623)

Louisiana enacted HB 888 which enters the state into the Social Work Licensure Compact.
In New Hampshire, the governor signed SB 411 which requires coverage of behavioral health or mental health crisis assessments, including both in-person and telehealth services for children and youth 21 years of age and younger.
In Illinois, the governor signed SB 1 which creates the Department of Early Childhood and transfers to it certain rights, powers, duties and functions currently exercised by various state agencies. The bill makes for provision of certain programs that have the ability to utilize telehealth as an option.
Ohio adopted a final rule that provides guidance from the Chemical Dependency Professional Board regarding the ethics and professional conduct of practice for certificate holders and licensees when using telehealth.

Legislation & Rulemaking Activity in Proposal Phase: 17

Highlights:

The Ohio Senate passed SB 211 that would enroll the state in the Dietitian Licensure Compact.
The Pennsylvania Senate passed SB 739 which would amend Title 40 (Insurance) of the Pennsylvania Consolidated Statutes to provide for telemedicine. This bill updates definitions related to telemedicine and requirements for health insurance and Medicaid coverage of telemedicine services.
The lower chamber in Pennsylvania passed HB 2268 which defines telehealth for speech language pathology and requires coverage by payors.
The upper chamber in Pennsylvania passed SB 913 which would require parental consent for virtual mental health services provided by a school entity.
The Delaware House 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.
In Puerto Rico, the Senate passed PS 1136 which would establish the Dental Examining Board of Dentists, Hygienists, Dental Assistants, Dental Technicians or Technologists and, among other things, develop a framework for teledentistry. The bill includes items on consent, patient information protection, definitions and other items related to teledentistry.
Mississippi published a proposed rule that amends the Department of Mental Health’s rules concerning assessments for persons receiving mental health services and/or substance use services to allow initial and subsequent visits to be provided [...]

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Trending in Telehealth: June 13 – 21, 2023

by Patrick Zanayed and Adetoro Olugbemi | Jun 27, 2023 | Telehealth

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

by Marshall E. Jackson, Jr. and Adetoro Olugbemi | Jun 9, 2023 | Telehealth

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:
- HB181 would [...]
  
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Illinois Medicaid Program Expands Telehealth Reimbursement Increasing Access to Behavioral Health and Other Critical Services

by Lisa Mazur | Sep 5, 2018 | Telehealth

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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