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April Regulatory Update – This Month in Telehealth

State Regulatory and Legislative Recap

Arkansas

Arkansas is at it Again! Telemedicine Regulation in Arkansas Undergoes Additional Change (National Law Review)

  • Full article here
  • Signed law SB 146 here
  • Key Takeaways:
    • Senate Bill 146, signed into law on February 20th, further amended AK telemedicine laws to, among other things) enable patients to access telemedicine services from their home or other remote locations.
    • The Act modified the “originating site” location requirement, redefining “originating site” to permit services to be provided wherever the patient is located at the time of the consult.
    • The Act also added language that reaffirms that a patient relationship can only be formed in Arkansas with an Arkansas-licensed provider utilizing both real time audio and visual technology.
    • While this change has the potential to expand the use of telemedicine in

Ohio

Ohio Board Relaxes Telemedicine Policies to Allow Prescribing (mHealth Intelligence)

  • Full article here
  • Key Takeaways:
    • Effective March 23, 2017- changes were made to 4731-11-09 and rule 7331-11-01.
    • The law outlines 9 requirements that must be met for an Ohio physician to prescribe non-controlled substances via telemedicine, without an in-person exam.
    • The law then adds an additional 6 requirements that must be met for an Ohio physician to prescribe controlled substances via telemedicine, without an in-person exam.
    • These six requirements are extremely limiting and in alignment with the Ryan Haight Act.

Texas

Texas to Take a Leap Forward in Telehealth – A Proposed Bill Drops the Controversial In-Person Evaluation Requirement (National Law Review)

  • Full article here
  • Proposed law SB 1107 here
  • Key Takeaways:
    • Proposed Bill removes the controversial “face-to-face” or in-person consultation requirement to establish a physician-patient relationship and lawfully provide telehealth and telemedicine services within the state.
    • Synchronous audiovisual technology or a combination of store and forward technology, synchronous audio technology, and certain clinical information may be used to create a physician-patient relationship as long as the provider complies with the conventional standard of care.
    • The conventional, in-person standard of care is the same standard for telemedicine and telehealth services in many states, a practice also supported by the FTC, the DOJ and many industry groups.

West Virginia

Adam Greathouse: West Virginians shouldn’t have to climb a mountain to see a doctor (Gazette)

  • Full article here
  • Proposed law HB 2509 here
  • Key Takeaways:
    • Provides guidelines for physicians’ use of telemedicine services.
    • Allows the patient-provider relationship to be established using telemedicine rather than requiring an initial in-person meeting. It also requires the provider to follow the same standard of care in telemedicine as he or she would in a traditional in-person encounter.
    • Under this proposed law, that relationship can only be established using interactive audio-visual communication or through “store and forward” technology.
  • Proposed law HB 2460 here
  • Key Takeaways:
    • Lays out requirements relating to how doctors must be paid for performing telemedicine services, including requiring coverage of certain telemedicine services, but also requiring those services to be reimbursed at the same rate as in-person services.

Washington

Washington Senate Telemedicine Bill Heard in House Committee (State of Reform)

  • Full article here
  • Proposed law SB 5436 here
  • Key Takeaways:
    • Proposed legislation includes language designed to help more people access health care from their home or any other location the patient determines they are comfortable receiving care.

Interstate Licensure Compact

National Reciprocity
No Bills Pending
Expedited
Federation of State Medical Boards (FSMB): 18 states have joined Pending: Arkansas, Michigan, Nebraska, North Dakota, Rhode Island, Tennessee and Washington
Mutual Recognition
National Council for State Boards of Nursing (Enhanced NLC and APRN) Enhanced NCL Pending: Arkansas, Colorado, Georgia, Kentucky, Iowa, Maryland, Mississippi, Nebraska, Nevada, New Jersey, North Dakota, South Dakota, Utah and West Virgina

 

APRN Pending: Iowa, North Dakota and West Virginia

Association for State and Provincial Psychology Boards (PSYPACT) Needs 7 states: Pending Illinois, Missouri and Utah

***Information Gathered from ATA Monthly Update Webinar

In Other News

States Continue Trend to Reduce Telemedicine Barriers (National Law Review)

Psychiatric Services ‘Crisis’ Spurs Call for Reform (Health Leaders Media)

Making the Case for Telemedicine

UC Davis Tracks 18 Years of Telemedicine and Finds Benefits Beyond the Bottom Line (Healthcare IT News)

  • Rather than only looking at how the technology reduces costs and improves outcomes, researches focused on related time, transportation and environmental factors.
  • Full article here
  • Read the study here

A ‘Perfect Storm’ For Telemental Health (OpenMinds)

Parity and Reimbursement…..

Telemedicine: Reimbursement in Fee-For-Service, Quality Models (Urology Times)

North Carolina Lawmakers Eye Telemedicine Payment Parity (mHealth Intelligence)

  • Full article here
  • Proposed law HB 283 here
  • Key Takeaways:
    • Bill would:
      • Would mandate that health plans cover telemedicine services as they would in-person treatment.
      • Would prohibit insurers from denying the service simply because it isn’t provided in-person.
      • Make it so insurers wouldn’t be able to limit where the service is provided.

CPT Manual Lists 79 Codes that can be Billed if Telemedicine Used (AAP)

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