Monthly Regulatory Update– This Month in Telehealth

This month in behavioral health and telemedicine you’ll see new legislative developments in several states and with CMS. The Federal State Medical Board’s Interstate Licensure Compact gets a boost as well.

Legislative Updates

Ernst Introduces Telehealth Bill for Veterans (KIOW)

U.S. Senators Joni Ernst (R-IA) and Mazie Hirono (D-HI), led eight co-sponsors, in introducing the bipartisan Veterans E-Health & Telemedicine Support Act of 2015 (VETS Act), legislation to improve health care access for disabled or rural veterans by expanding telehealth services provided by the Department of Veterans Affairs (VA).

Read more here

Read the bill here

 

Legislation, Reimbursement Expand Telemedicine Technology Use (mHealth Intelligence)

Telemedicine technology use is expanding throughout the United States due to new legislative changes, the breakdown of telehealth site restrictions, and the increase in payment parity and reimbursement for telehealth services.

Read more here

 

Rep. Stefanik Cosponsors Bill to Improve Mental Health Care (Watertown Daily News)

U.S. Rep. Elise M. Stefanik, R-Willsboro, has cosponsored legislation that seeks to reform the federal mental health care system. The bill, called the “Helping Families in Mental Health Crisis Act,” will refocus existing programs, reform grants and remove federal barriers to mental health care.

Read more here

Read H.R. 2646 here

Medicare

 

Stakeholders’ Proposal Lifts Restrictions on Telemedicine Coverage for Medicare Beneficiaries (FierceHealthIT)

Stakeholders across the healthcare industry joined together to ask Senate lawmakers for support of a proposal that would lift “outdated restrictions” on use and reimbursement of telemedicine services for Medicare patients.

Read more here

Read the letter here

 

What’s Happening at the State Level?

 

Arkansas

Arkansas Medical Board Proposes to Relax State Telemedicine Laws (National Law Review)

Last month, the Arkansas State Medical Board’s Telemedicine Advisory Committee indicated that it was in the process of drafting a rule that would allow the establishment of a physician-patient relationship through the use of real-time audiovisual communication rather than an in-person visit.  This is a significant development given that the Arkansas telemedicine rules are among the most restrictive in the nation and signals that physicians in Arkansas are prepared to embrace telemedicine as a safe and cost-effective way to provide medical services to patients.

Read more here

 

Draft Telemedicine Proposal

The Arkansas Medical Board’s Telemedicine Advisory Committee released a draft telemedicine proposal that outlines numerous ways that a physician-patient relationship can be established via telemedicine.  The committee will review this proposal on Wednesday, November 4th at 2pm.

 

Florida

Lawmakers Prepare For Familiar Health Battles (Health News FL)

Health care has been a hot-button policy issue for years in the Florida Legislature, and it’s starting to look like the session scheduled to start on Jan. 12 will be no different.

Read more here

 

Massachusetts

Massachusetts Legislative Committee Requests Input on Telemedicine

The Massachusetts General Assembly’s Joint Committee on Health Care Financing held a hearing on October 13th on H.B 267.  If enacted, the bill would permit clinicians to be credentialed to provide telemedicine services within their scopes of practice and allow for coverage of telemedicine services by all private payers, state employee health plans and Medicaid.

Read H.B. 267 here

 

Recent Developments in Massachusetts Health Policy (National Law Review)

Building on the momentum of early October hearings on the state’s growing health care expenditures, the Health Policy Commission (HPC), the Joint Committee on Health Care Financing, Governor Charlie Bakes, and others spent the past two weeks crafting new policies for the industry and its consumers.

Read more here

 

New Hampshire

Six Ways to Take Advantage of New Hampshire’s New Telemedicine Law (Lexology)

A physician in New Hampshire can now establish a valid doctor-patient relationship without needing a prior in-person exam. This is among several recent changes in New Hampshire’s telemedicine laws that offer new opportunities for telemedicine companies and healthcare providers, so long as they can quickly adapt their business models and finalize their contractual arrangements soon. The business potential also holds true for New Hampshire hospitals and health systems looking to solidify the engagement of their existing patient base or expand.

Read more here

 

New Jersey

New Jersey Individual Health Coverage and Small Employer Health Benefits Programs have approved new language covering “telemedicine”, “e-visits”, and “virtual visits” under individual health and small employer plans.

The terms are defined as such:

  • TELEMEDICINE:  A telephone consultation between a Provider that has contracted with Carrier to offer telemedicine services and a Member
  • E-VISIT:  A visit with a Provider using electronic means such as website portals, e-mail or other technology that allows communication between a Provider that has contracted with Carrier to offer E-visit services and [Members] who are established patients of the Provider.
  • VIRTUAL VISIT:  A visit with a Provider that has contracted with Carrier to diagnose and treat low acuity medical conditions through the use of interactive audio and video telecommunication and transmissions and audio-visual technology. A virtual visit provides real-time communication between the Member and the Provider.

These changes will go into effect only for individual and small employer health plans issued or renewed in 2016.  This has no effect on other state regulated health plans.

 

New York

Changes to New York Telehealth Coverage Coming Soon (Lexology)

After New York became the 22nd state to enact a telemedicine commercial coverage statute, Governor Andrew Cuomo signed an amendment changing the statute. The amendment makes sweeping changes to telehealth coverage under New York Medicaid and commercial health insurance. With an effective date of January 1, 2016, providers and insurers need to be ready and positioned for the patients who will want to enjoy this new coverage. Those providers who develop their business models, finalize their contractual arrangements, and timely deploy their telehealth offerings will have a significant strategic advantage come January.

Read more here

Read amendment here

 

Regulatory Update Matrix

State Status Concerning Issue
Arkansas Draft– Nov 4th Medical Board Practice Standards
Iowa Final Medicaid Telehealth Parity
Louisiana Final Medical Board Licensure; Physician- patient relationship; prescribing
Maryland Final Medicaid Medical Assistance Program  will reimburse approved providers for services rendered via telemedicine
Mississippi No Rule Change Medical Board Board sent letter clarifying interpretation of telemedicine
Missouri Discussions Pharmacy and Medical Boards No drafts or proposals yet
New Jersey Final Individual Health and Small Employer Plans Telemedicine and virtual visit coverage
North Dakota Revised DraftOct 12th Medical Board Practice Standards
Ohio Board Approved- Language Attached*** Medical Board Internet Prescribing
South Carolina Board Approved Guidance Medical Board Practice Standards and Internet Prescribing
Wisconsin Draft Proposal Medical Board Practice Standards

***Information Gathered from ATA Monthly Update Webinar

 

In Other News…..

 

Telemedicine Evolving, Impacting Health Care of State’s Over 65s (Jacksonville)

Read more here

 

Behavioral Telehealth Key for ACO Success (HealthCare IT News)

Read more here

 

DEA Agenda item RIN 1117-AB40

 

How the Telehealth Field Strengthens Patient Engagement (mHealth Intelligence)

Read more here

FYI…..

 

Providers Must Understand Legal Limits of Telemedicine (Doctors Lounge)

Read more here

 

Legislative Barriers the Telemedicine Field Needs to Overcome (mHealth Intelligence)

Read more here

 

Survey: 8 Percent of Employees Used a Telemedicine Service Last Year (mobihealthnews)

Read more here

 

Providers Must Understand Legal Limits of Telemedicine (Renal&Urology News)

Read more here

 

The Importance of Reimbursement in Telemedicine Adoption (mHealth Intellignece)

Read more here

 

Secure Patient Data Carefully for Telemedicine Use (Business Insurance)

Read more here

 

Enhanced Nurse Licensure Compact (NLC) and APRN Compact Receive Support of the American Telemedicine Association and National Patient Safety Foundation (NCSBN)

Read more here

 

Back in the News…..

 

Senators Throw Support Behind Telemedicine-friendly Licensing Compact (mHealth News)

Read more here

Read the letter here

 

Interstate Compact Could Fundamentally Transform Medicine (Highland County Press)

Read more here

 

Stay Tuned…..

 

AAFP Still Searching for Right Stance on Telemedicine (MedPage Today)

Read more here

 

AAFP Considers Telemedicine, EHRs and Interoperability Issues (iHealth Beat)

Read more here

 

AMA coding group gets to work on telemedicine (Modern Healthcare)

Read more here

 

AMA workgroup targets telemedicine and CPT codes (mHealth News)

Read more here

 

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