May Regulatory Update — This Month in Telehealth

This month in telehealth, a new Medicaid rule carves out a place for telemedicine in care networks. Meanwhile, states’ bills and laws are working toward expanding access to and reimbursement for telemedicine. Also included in this update is a look at the APRN compact, which allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states.

Federal and Medicare

New Medicaid Rule Carves Out a Place for Telemedicine in Care Networks (MobiHealth News)

The Center for Medicare and Medicaid Services released its 1,425-page Managed Care Final Rule, a long-awaited update to CMS bylaws which, according to CMS, “aligns key rules with those of other health insurance coverage programs, modernizes how states purchase managed care for beneficiaries and strengthens the consumer experience and key consumer protections.”

Read more here.

Read the Managed Care Final Rule here.


What’s Happening at the State Level?

A State-by-State Look at the State of Telemedicine (MedCityNews)

Since the American Telemedicine Association began its annual reports in 2014 grading states on their telemedicine access, some states have maintained steady grades. But others have seen their grades fluctuate – and not always in the right direction – over the past three years.

Read more here.

In-State Telehealth Restrictions May Soon Be Eliminated (mHealth Intelligence)

The last two states to severely hinder out-of-state telemedicine companies from operating within their borders may soon be changing their ways.  While legislation eliminating certain telemedicine barriers breezed through Alaska’s House and Senate and is headed to Gov. Bill Walker’s desk, two bills in Louisiana are moving through legislative chambers and could soon become laws as well.

Read more here.

See more specific below in each state profile.


Telemedicine to Reduce Medicaid Travel Costs (Alaska Journal of Commerce)

Sen. Pete Kelly’s Medicaid reform bill would remove some of the hurdles created by the state’s existing medical laws just in time to take advantage of the state’s growing telemedicine infrastructure.  Kelly said in a March 21 House Finance Committee hearing that one Medicaid reform in his Senate Bill 74 that passed unanimously on March 18 — telemedicine, or telehealth, expansion — is a way of keeping up with the times to reach the best fiscal output for the state.

Read more here.

Read SB 74 here.


Florida Passes New Telehealth Bill: Focus is Reimbursement (Healthcare Law Today)

After several hard-fought years of unsuccessful attempts, the Florida Legislature on Friday passed a new bill designed to set the stage for telehealth commercial insurance coverage in the Sunshine State.

Read more here.

Read CS/CSHB 7087 here.


New Indiana Law Expands Use of Telemedicine (National Law Review)

Indiana Gov. Mike Pence recently signed into law House Enrolled Act (HEA) 1263, which expands physicians’ use of telemedicine. HEA 1263 will permit providers, which include physicians, optometrists, and advance practice nurses and physician assistants with prescriptive authority, to prescribe certain prescriptions, drugs and devices during remote patient visits. Currently, Indiana allows the prescribing of drugs through telemedicine only if a provider first examines a patient in person. Effective July 1, 2016.

Read more here.

Read HEA 1263 here.


Louisiana Telehealth Bills Move Closer to Passage (Statescoop)

Two bills that would grease the wheels for adopting telehealth practices in Louisiana are getting closer to becoming law. The bills, if enacted, would expand the number of doctors that can offer services in the state, using commonly available technology.

Read more here.

Read H.B. 570 here.

Read S.B. 378 here.


Telemedicine Bill Stalls Out in Senate Committee (Business Journal)

A telemedicine bill that sailed through the Mississippi House of Representatives did not make it out of Senate committee in time to be voted on in this session of the Legislature. House Bill 1178 was designed to modernize rules for the practice of telemedicine beyond the one-page law passed in 1997.

Read more here.

Read H.B. 1178 here.


Missouri House Proposes Putting Telehealth Allowances Into Law (Missourinet)

The state House has again proposed allowing more medical care to be conducted remotely.

Read more here.

New Jersey

RU-N Partnership Seeks to Study, Model Virtual Health Care Delivery in New Jersey (Newark)

Experts urge lawmakers to pass legislation needed to establish telemedicine.  With primary care physicians in chronic short supply in New Jersey, leveraging technology may be a key to keeping people healthy, according to experts who gathered at Monday’s second annual Legislative Open House at Rutgers University-Newark (RU-N). The meeting focused on telemedicine, a way for health providers to examine patients and monitor vital signs remotely — and direct significant amounts of their care — without a need for office visits.

Read more here.


On April 15, the State Medical Board of Ohio (Ohio Board) released proposed rules outlining the requirements for practitioners to prescribe or cause a prescription drug to be provided to a person who is at a location remote from the practitioner and for whom the practitioner has never conducted a physical examination.

Read more here.

South Dakota

No Decision Yet, but State Prepping for Medicaid Expansion (Rapid City Journal)

Although nothing is certain yet about South Dakota’s proposed expansion of Medicaid coverage, a member of Gov. Dennis Daugaard’s cabinet on Monday said preparations for adding 50,000 Medicaid recipients are moving “full speed ahead.”

Read more here.


Virginia Telehealth Law: What You Need to Know (Lexology)

Virginia has made strides to expand the telehealth offerings available to its residents and the Old Dominion took another step forward advancing telemedicine when it enacted a bill amending Virginia Code § 38.2-3418.16 to expand commercial insurance coverage of telemedicine-based services. Additionally, the Virginia Board of Medicine last year published Telemedicine Guidelines to instruct practitioners on this rapidly-growing industry.

Read more here.

West Virginia

West Virginia’s New Telemedicine Practice Standards & Remote Prescribing Laws (National Law Review)

West Virginia Gov. Earl Ray Tomblin (D) signed into law, on March 24, 2016, a new bill (House Bill No. 4463) implementing a variety of telemedicine practice standards and remote prescribing rules in the Mountain State. Effective June 11, 2016.

Read more here.

Read HB 4463 here.


M.D. Phone Home: New Legislation Expands Telemedicine in Washington (Lexology)

On March 29, as Gov. Jay Inslee signed Senate Bill 6519, Washington became a friendlier state for telemedicine. The new law or “Telemedicine Advancement Law” has a long-winded official title: “Expanding patient access to health services through telemedicine and establishing a collaborative for the advancement of telemedicine.”

Read more here.

Read S.B. 6519 here.

Regulatory Update Matrix

State Status Concerning Issue
Arkansas DraftApril Medical Board Practice standards
Connecticut Approved Medicaid Telehealth coverage for FQHCs
Delaware Final Mental Health and Chemical Dependency Board Scope of practice standards for mental health counseling, chemical dependency counselors and marriage and family therapists
Delaware Proposed Department of Health Telemedicine practice standards for physicians
D.C. Proposed Department of Health Telemedicine practice standards for physicians
D.C. Meeting- June 8 Medicaid Telemedicine coverage
Florida Revised Medicaid Telemedicine coverage
Maine Final Medicaid Telehealth coverage
Maryland Final Medicaid Telehealth coverage
Minnesota Proposed Medicaid State plan amendment

*Information gathered from ATA Monthly Update webinar


In Other News

Med Students Experience Telemedicine (SDPB)

Read more here.

Telemedicine Empowers Patients, but Challenges Physicians (Modern Medicine Network)

Read more here.

Could Insurers Use Telemedicine to Widen Provider Networks? (Medscape)

Read more here.

CAP: Telemedicine Licensure, Reimbursement Issues States Must Address (FierceHealthIT)

Read more here.

Read CAP Report here.



White House Rural Council Hosts ‘Telemedicine Summit’ to Improve Rural Health Care (GrayDC)

Read more here.

Recent Telemedicine Surveys Make For Interesting Reading (National Law Review)

Read more here.

SURVEY: Telemedicine High Priority, but Reimbursement Remains Challenging (Clinical Endocrinology News)

Read more here.

Read survey here.

New Report Paints a Frustrating Picture for Telehealth Advancement (mHealth Intelligence)

Read more here.


Back in the News

Telemedicine May Have a Role in Primary Care (The Olympian)

Read more here.


Stay Tuned…

Hospital and Health Care Systems’ Interest in Telemedicine is Intensifying (Healthcare Business Daily News)

Read more here.


“Gotcha” of the Month

APRNS Next up for Multistate Licensure

What is the APRN Compact?

The APRN Compact, approved May 4, 2015, allows an advanced practice registered nurse to hold one multistate license with a privilege to practice in other compact states.

What states have adopted the compact?

Six states have enacted legislation to adopt a licensure compact to allow nurses to practice telemedicine across states: Wyoming, Virginia, South Dakota, Idaho, Florida and Tennessee. Seven more have bills pending.

Where can I find:

  • Model APRN Compact Legislation here.
  • Model Rules here.
  • Key Provisions of the Act here.

Every month, we will feature a new “Gotcha of the Month.” Do you have a regulatory “Gotcha” or question that you want us to pay special attention to?  Email and your topic could be featured in next month’s newsletter!


Featured image by Architect of the Capitol on Flickr.

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