July Regulatory Update – This Month in Telehealth

Federal and Medicare

Medicaid and CHIP Managed Care Final Rule Revises Access to Care and Network Adequacy Standards, Promotes Innovative Technology (National Law Review)

The Centers for Medicare & Medicaid Services (CMS) recently issued the Final Rule regarding managed care in Medicaid and Children’s Health Insurance Programs (CHIP) that revises and expands the federal rules governing the operation, contracting, oversight and payment of Medicaid managed care plans.

Read more here

Read final rule here

Government Telemedicine Decision Makers Urged to Look Outside Medicare for Telehealth Benefits (Insights)

As an industry, healthcare understands the benefits of telemedicine and telehealth tools, but the government has been slow to catch up, leaving government treatment of this emerging care delivery method lagging.

This is why 22 health systems, along with other healthcare organizations and individuals, recently sent a letter to the Director of the Congressional Budget Office (CBO), Keith Hall, in an effort to convey the importance of using commercial data to evaluate the effectiveness of telehealth.

Read more here

Read the letter here

What’s Happening at the State Level?


Why Arizona’s New Telemedicine Law Sends an Important Message (National Law Review)

Arizona Governor Doug Ducey signed a bill (S.B. 1363) into law, on May 17, 2016, requiring private health plans to pay for telemedicine services across the whole state rather than only services received in rural areas of the state.

Read more here

Read SB 1363 here


Louisiana Joins its Peers in Removing In-State Barriers to Telemedicine (National Law Review)

Last week, Louisiana legislators approved the removal of certain restrictions on the delivery of telemedicine services to residents of Louisiana to encourage the provision of telemedicine services in the state.  H.B. No. 570 was signed by the President of the Senate on June 5, 2016 and sent to Governor John Bel Edwards on June 6, 2016.

Read more here

Read HB 570 here


Legislature Considers How to Regulate and Cover Telemedicine (MassLive)

A bill under consideration by the state Legislature would set guidelines for the use of telemedicine and establish a framework for insurers to cover telemedicine. The goal is to expand the use of the virtual doctor appointments, which could increase access to health care specialists for people living in rural parts of the state while at the same time cutting costs.

Read more here

Massachusetts Drops Parity from Telemedicine Reimbursement Bill (mHealthIntelligence)

Facing stiff resistance from insurers, lawmakers rework a telemedicine bill to give payers the power to negotiate coverage. And even that may not be enough.

Read more here


State Lawmakers Push Telemedicine Bill (witf)

A group of lawmakers and physicians are advocating for legislation that would expand access to telemedicine in the commonwealth. Companion legislation in the House and Senate would allow Pennsylvania to join the Interstate Medical Licensure Compact, which would give Pennsylvanians access to doctors in other states through telemedicine, while making sure those outside physicians meet Pennsylvania standards.

Read more here


Texas Medical Board Proposes New Call Coverage Rules for Telemedicine and Traditional Patient Care (Lexology)

On June 9, 2016, the Texas Medical Board proposed for comment new rules regarding physician call coverage. The proposed new rule originated from the Board’s Telemedicine Committee and changes the current telemedicine call coverage rule. The rule would apply to all physician call coverage relationships, not just telemedicine.

Read more here

Texas Groups Try to End Telemedicine Battle (MedCityNews)

A year after Texas imposed controversial restrictions on the practice of telemedicine — prompting a lawsuit from Teladoc, which has its operational base in Dallas — many of the warring parties apparently want peace.

Read more here

West Virginia

West Virginia Health Care Authority Issues First Telemedicine Decision (National Law Review)

The West Virginia Health Care Authority (“HCA”) recently issued its first decision on a telemedicine Certificate of Need (“CON”) application.

Read more here

Regulatory Update Matrix

State Status Concerning Issue
Arkansas Final Medical Board Practice Standards
Delaware Hearing- June 20th– Comments due July 5th Board of Clinical Social Work Examiners Standards for the Practice of Clinical Social Work through telehealth
Delaware Proposed Medicaid Coverage for mental health services via telemedicine for children
District of Columbia Proposed Department of Health Telemedicine practice standards for physicians
District of Columbia Meeting– June 8th Medicaid Telemedicine coverage
Florida Final Medicaid Telemedicine coverage
Maine Proposed rule– July 15th Joint Medical Boards Clinical Practice
Nebraska Proposed Medicaid State plan amendment removing mileage requirements and permitting RPM and asynchronous coverage
New York Draft Proposal Medicaid
New York Proposed- Rule Status Unknown Office of Mental Health Telepsychiatry
North Dakota Amended Medical Board Practice Standards
Texas Notice Medical Board Withdraw regulations for on call services (22 TAC 174.11)
Washington Proposed rule Medicaid Telemedicine coverage for school based services
Wisconsin Meeting- July 20th Medical Board Telemedicine Committee

***Information Gathered from ATA Monthly Update Webinar

All Things Parity

State Bill Number Status Issue
Hawaii SB 2395 Waiting on Transmittal to Governor -Removes telepresenter requirements- Required insurers to provide written disclosures about telehealth coverage- Expands coverage to include store-and- forward, RPM, and mHealth
Massachusetts HB 267 Redraft Would allow access to telemedicine services by allowing certain clinicians to be credentialed and allowing for coverage of such services by all payers and the Medicaid program.
New Jersey S 1936 Referred to Senate Budget and Appropriations Committee Coverage Parity for Telestroke
New York SB 7953 and AB 10500 Reimbursement parity
Rhode Island H 7160 and S 2577 Referred to House Corporations Private insurance parity and partial coverage parity for private insurance based on geography

***Information Gathered from ATA Monthly Update Webinar

Interstate Licensure Compact Updates…..

Federation of State Medical Boards (FSMB) 17 states Alabama, Arizona, Idaho, Illinois, Iowa, Kansas, Minnesota, Mississippi, Montana, Nevada, New Hampshire, South Dakota, Utah, West Virginia, Wisconsin, Wyoming and Colorado
Mutual Recognition
National Council for State Boards of Nursing (Enhanced NLC and APRN) Arizona, Florida, Idaho, Missouri, New Hampshire, Oklahoma, South Dakota, Tennessee, Virginia, and Wyoming
Association for State and Provincial Psychology Boards (PSYPACT) Needs 7 states: Arizona

***Information Gathered from ATA Monthly Update Webinar

In Other News…..

ACOs Add Telehealth, Despite Regulatory, Reimbursement Barriers to Implementation (AISHealth)

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Before: AMA Delegates to Vote on Guidelines for Ethical Telemedicine (HealthCareDive)

Read more here

After: AMA Posts New Telehealth Ethical Guidance (HealthIT News)

Read more here


Navigating Reimbursement for Telemedicine (McKnight’s)
Read more here

Telemedicine Consultations May Help Reduce Use of Antipsychotic Meds in Dementia Patients (FireceHealthcare)

Read more here

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