Telehealth Archives - OF DIGITAL INTEREST

Trending in Telehealth: December 18, 2024 – January 6, 2025

by Marshall E. Jackson, Jr. and Samantha Pearsall | Jan 10, 2025 | 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 weeks:

Reimbursement parity
Provider telehealth education

A CLOSER LOOK

Proposed Legislation & Rulemaking:

In Ohio, Senate Bill 95 passed both the House and Senate chambers. This bill will allow for remote pharmacy dispensing, as current state law prohibits the dispensing of a dangerous drug by a pharmacist through telehealth or virtual means.
In Oregon, the Oregon Health Authority, Health Systems Division: Medical Assistance Programs proposed rule amendments to clarify the telehealth rule definitions, including adding cross-references to established definitions in OAR 410-120-0000.
In New York, the Department of Public Health (DPH) proposed two new amendments to the Medicaid State Plan for non-institutional services:
- To comply with the 2024-2025 enacted budget, DPH proposed a clarification to the March 27, 2024, notice provision regarding provider rates for early intervention services. This clarification includes a decrease to provider rates for early intervention services delivered via telehealth, with rate decreases as high as 20% in some regions.
- DPH also proposed to reimburse Federally Qualified Health Centers and Rural Health Clinics a separate payment in lieu of the prospective payment system rate for non-visit services, such as eConsults and remote patient monitoring.

Finalized Legislation & Rulemaking Activity:

In Illinois, an amendment to the Illinois Public Aid Code went into effect on January 1, 2025. Passed in June of 2024, Senate Bill 3268 provides that the Department of Human Services will pay negotiated, agreed-upon administrative fees associated with implementing telehealth services for persons with intellectual and developmental disabilities receiving Community Integrated Living Arrangement residential services.
Also in Illinois, an amendment to the Illinois Physical Therapy Act went into effect January 1, 2025. Passed in August of 2024, House Bill 5087 significantly limits the ability of physical therapists to provide telehealth services to patients in the state. For more information on the effects of this bill, please read our article discussing its implications.
In Kentucky, Senate Bill 111 went into effect January 1, 2025. This bill requires health benefit plans, limited health service benefit plans, Medicaid and state health plans to provide coverage for speech therapy provided via telehealth.
Missouri’s emergency rule amendments for virtual visit coverage under the Missouri Consolidated Health Care Plan took effect as of January 1, 2025. For more information on this bill, please see our related article from last month.
In New Jersey, Assembly Bill 3853 was signed into law by the governor. The legislation extends certain pay parity regarding telemedicine and telehealth until July 1, 2026, meaning that New Jersey health plans shall reimburse telehealth and telemedicine services at the same [...]

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Trending in Telehealth: November 26 – December 10, 2024

by Amanda Enyeart and Angela Irene Theodoropoulos | Dec 13, 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 two weeks:

Behavioral and mental telehealth
Coverage and payment parity

A CLOSER LOOK

Proposed Legislation & Rulemaking:

In Illinois, HB 4475 gained another co-sponsor. If adopted, the bill would provide that a group or individual policy of accident and health insurance or managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2025, or any third-party administrator administering the behavioral health benefits for the insurer, must cover all out-of-network medically necessary mental health and substance use benefits and services (inpatient and outpatient) as if they were in-network for purposes of cost sharing for the insured. The bill specifically provides that the insured has the right to select the provider or facility of their choice and the modality, whether the care is provided via in-person visit or telehealth, for medically necessary care. To date, the proposed legislation has passed the house chamber and committee.
In Washington, the Department of Health announced a proposed rule concerning certification standards for the new, voluntary certified peer specialist and trainee credentials created by passed SB 5555 (chapter 469, Laws of 2023) for behavioral health. The proposed rule would require a certified peer specialist who provides telehealth services to take the telehealth training as specified in WAC 246-929-340.

Finalized Legislation & Rulemaking Activity:

Missouri enacted several emergency rule amendments related to coverage under the Missouri Consolidated Health Care Plan, which provides coverage to employees and retirees of most state agencies, as well as public entities that have joined the plan. The amendments include revisions to coverage of virtual visits, non-network payments, the timing of other deposits to health savings accounts, and the right of the state plan to recoup certain deposits. Under the amendments, virtual visits offered through the vendor’s telehealth tool are covered at 100% after deductible is met unless Internal Revenue Service guidance permits them to be paid at 100% prior to deductible being met.

Why it matters:

Use of telehealth services for behavioral healthcare continues to grow. There has been a notable trend of telehealth modalities being adopted for mental health and substance abuse care. Legislative and regulatory activity is responding to this trend with increased access, as in the Illinois proposed legislation regarding telehealth coverage parity, and increased safeguards, such as the telehealth training requirements in the Washington proposed rule. This expansion of tele-behavioral health may increase access to mental health services for those in remote or underserved communities, and may increase convenience and flexibility, in turn promoting more consistent attendance and better treatment outcomes.
States are assessing the extent of insurance coverage and payment rates for telehealth services. Telehealth services continue to inspire debate regarding coverage parity (i.e., covering telehealth services to the [...]

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Trending in Telehealth: December 11 – December 17, 2024

by Dale C. Van Demark and Angela Irene Theodoropoulos | Dec 10, 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:

Licensure compacts
Telepharmacies
Telehealth practice standards

A CLOSER LOOK

Proposed Legislation & Rulemaking:

In Michigan, House Bill 4169 was referred to the second committee after passing the first chamber. The bill would enact the Interstate Occupational Therapy Licensure Compact in Michigan. The compact is designed to facilitate use of telehealth technology to increase access to occupational therapy services.
New York’s Assembly Bill 6799, which has passed both chambers, was delivered to the governor for review. The proposed legislation seeks to establish an education program for screening drug-induced movement disorders and specifically includes services provided via telehealth.
In Ohio, Senate Bill 95 passed the second chamber. If enacted, the legislation would provide an exception to current state law that prohibits pharmacists from dispensing dangerous drugs through telehealth or virtual means. Under state law, dangerous drugs include prescription medications, schedule V controlled substances, injectables, biological products, and drugs with certain mandatory federal caution labels. The proposed legislation would create an allowance for remote dispensing pharmacies, which dispense drugs, counsel patients, and provide other pharmacist care through a telepharmacy system. Telepharmacy is a system that monitors the dispensing of drugs and provides for related drug utilization review and patient counseling services via electronic means. The dispensing of drugs at a remote dispensing pharmacy may include the dispensing of drug-therapy-related devices.

Finalized Legislation & Rulemaking Activity:

In Delaware, the Board of Mental Health and Chemical Dependency Professionals final rule took effect, updating existing regulations that include telehealth practice standards. The board clarified that “face-to-face” services include both in-person and live video mental health counseling services. The board also removed the previous supervision requirement for counselor applicants that restricted the amount of supervision that could be credited for live video conferencing rather than in-person means.

Why it matters:

Interstate licensure compacts are progressively expanding. Michigan’s proposed legislation to join the Interstate Occupational Therapy Licensure Compact demonstrates states’ ongoing interest in compacts that enable healthcare professionals to practice across state lines. These compacts can expand access to qualified practitioners in underserved and rural areas, enhance career flexibility, and reduce the administrative burdens associated with applying for multiple state licenses.
States are adapting to the sustained significance of telehealth. Legislative and regulatory trends reflect a continued recognition that telehealth can be utilized for a wide variety of purposes, including provision of health services education (as in New York’s proposed bill) and supervisory training (as in Delaware’s final rule).

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 [...]

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Trending in Telehealth: November 19 – 25, 2024

by Lisa Mazur and Nathan Gray | Nov 26, 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:

Medical marijuana

A CLOSER LOOK

Finalized Legislation & Rulemaking:

In New York, the governor signed an act (A 8168) requiring Medicaid to provide remote ultrasound and remote fetal nonstress tests in certain circumstances.

In Massachusetts, the Massachusetts Cannabis Control Commission finalized amendments that permit patients to request a telehealth appointment for a patient’s initial visit to a provider. An initial visit conducted via telehealth must be synchronous and face-to-face. The adopted changes also permit certified providers to be out-of-state so long as the conditions for certification are met.

Why it matters:

Regulators continue to recognize telehealth as an effective care delivery method in new settings. Massachusetts’ decision to permit the use of telehealth to conduct a patient’s initial visit to a provider for a certificate of registration for medical marijuana and New York Medicaid coverage of remote ultrasounds and fetal nonstress tests reflects growing recognition by regulators that telehealth can be an effective care delivery method for a wide range of procedures and patients.

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: November 12 – 19, 2024

by Patrick Zanayed and Nathan Gray | Nov 20, 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:

Veterinary services

A CLOSER LOOK

Proposed Legislation & Rulemaking:

In Florida, the Board of Veterinary Medicine proposed a rule that would require veterinarians to include a notation in the medical record if an examination was conducted by telehealth. The Board also proposed a set of guidelines that the Board must follow when imposing disciplinary penalties for violations of telehealth practice rules. The penalties include reprimand, suspension with administrative fines, and revocation of the individual’s license.

In New York, a bill requiring Medicaid to provide remote ultrasound procedures and remote fetal nonstress tests in certain circumstances passed the first house.

Why it matters:

Regulation of the use of telehealth in veterinary medicine continues to grow. Florida joins an increasing number of states beginning to develop regulations specifically related to the practice of veterinary medicine via telehealth. This emerging trend in the health industry regulation reflects the steady adoption of telehealth as a valuable care delivery modality across the full gambit of health services industries.

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: October 29 – November 11, 2024

by Stacey Callaghan, Marshall E. Jackson, Jr. and Nathan Gray | Nov 19, 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:

Interstate compacts
Behavioral health
Veterinary services
Disciplinary guidelines

A CLOSER LOOK

Proposed Legislation & Rulemaking:

In Washington, the Veterinary Board of Governors proposed amendments to board regulations to address the provision of veterinary services via telehealth. The proposed rule would permit licensed veterinarians to use telehealth to provide general health advice and emergency animal care advice, prescribe non-controlled substance sedation medication to facilitate transportation to an in-person visit, and, in certain circumstances, to dispense non-controlled substance medications prescribed by another veterinarian. Once a veterinarian-client-patient relationship had been established, the proposed rule would permit ongoing care to be provided via telemedicine.
In California, the Board of Behavioral Sciences proposed amendments to its telehealth rule to require licensed providers rendering services via telehealth to employ technologies, methods, and equipment that comply with all applicable federal and state privacy, confidentiality, and security laws, including HIPAA and the California Confidentiality of Medical Information Act.
South Carolina’s Department of Public Health released a proposal to permit licensed opioid treatment programs to perform the required initial screening examination via telehealth for patients admitted for treatment with buprenorphine or methadone. The proposed rule would require the use of audio-visual communications when evaluating patients for treatment using Schedule II medications but would permit use of audio-only platforms when treating patients with Schedule III medications.

Finalized Legislation & Rulemaking Activity:

The Florida Board of Clinical Social Work, Marriage and Family Therapy, and Mental Health Counseling finalized a set of guidelines that the board must follow when imposing disciplinary penalties upon telehealth registrants. The penalties include fines, reprimands, suspension with a corrective action plan, and revocation of the individual’s license.
In the District of Columbia, the mayor signed a bill (B 25-287) in which DC joins the Interstate Counseling Compact.

Why it matters:

Adoption of interstate licensure compacts continues to grow. Over the past year, there has been a notable trend of adoption of interstate licensure compacts for a wide range of providers. Even during slow periods for legislative and regulatory activity, DC’s adoption of the Interstate Counseling Compact reflects continued interest in these compacts.
States continue to adapt to the ongoing relevance of telehealth as a method of care delivery. The rule amendments proposed in Washington to permit the delivery of veterinary services via telehealth reflects ongoing recognition that telehealth can be used to provide a wide range of health services. The recently adopted disciplinary guidelines in Florida demonstrate how states have begun to adopt regulations specifically with telehealth in mind.

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 [...]

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Trending in Telehealth: October 21 – 28, 2024

by Renae Flowers, Lauren Ellison and Jayda Greco | Oct 31, 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:

Professional standards
Marriage and family therapy services
Advance practice registered nurses (APRNs)

A CLOSER LOOK

Finalized Rulemaking:

The Arkansas Department of Health adopted a final rule setting forth requirements for the provision of marriage and family therapy services. The rule defines telemedicine and requires that a therapist-client relationship be established prior to the delivery of telemedicine services. Counselors and therapists also must document the treatment record, establish protocols for emergency services referrals, and provide the client with an electronic or hard copy of the treatment record documenting the encounter, if requested. While group therapy may be delivered via telemedicine, the rule precludes the use of group therapy for individuals 18 years of age or younger.
The Arkansas Board of Nursing adopted a final rule imposing requirements for APRNs providing care via telemedicine. Like the rule promulgated by the Department of Health, this rule requires APRNs to establish an APRN-patient relationship prior to the delivery of telemedicine services. An APRN rendering telemedicine services in Arkansas must be licensed to practice nursing in the state and cannot prescribe controlled substances unless the APRN has seen the patient for an in-person exam or a relationship exists through consultation or referral.

Why it matters:

States continue to implement rules to ensure that virtual care is delivered effectively, safely, and ethically. The Arkansas Department of Health and Board of Nursing enacted similar regulations, mandating that practitioners adhere to specific professional standards, including those related to scope of practice and licensure.
With the election less than one week away, legislative and regulatory activity remains slow. We anticipate an uptick in telehealth-related activity once the election concludes.

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: October 14 – 21, 2024

by Amanda Enyeart, Lauren Ellison and Jayda Greco | Oct 25, 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:

Medical practice standards
Maternal care
Opioid treatment

A CLOSER LOOK

Proposed Legislation & Rulemaking:

The Massachusetts Executive Office of Health and Human Services Division of Medical Assistance proposed a rule to establish requirements for the participation of programs of assertive community treatment (PACTs) in MassHealth. Each PACT provider may render services via telehealth, with justification for each instance of telehealth use documented and supported in the member’s record. The PACT provider also must be available to respond to member needs 24 hours per day, seven days a week, 365 days a year by phone, in person, or via telehealth whenever appropriate or safe. This includes ongoing or crisis services determined by member need.

Finalized Legislation & Rulemaking:

North Carolina adopted an emergency rule mandating that opioid treatment program (OTP) counseling staff be available, either in person or by telehealth, a minimum of five days per week. OTPs must establish and implement policies to determine the appropriateness of telehealth services that take into consideration the patient’s choice along with the patient’s behavior and physical and cognitive abilities. The patient’s verbal or written consent must also be documented when telehealth services are provided.

Why it matters:

States are proposing rules to ensure that healthcare providers are available around the clock to respond to patient needs through telehealth. Massachusetts’s PACT rule would require 24/7 provider availability, whether in person or via telehealth.
States continue to implement informed consent requirements for telehealth providers. North Carolina OTP providers must obtain written consent prior to rendering telehealth services.
As the election approaches, both legislative and regulatory activity remain slow.

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: October 7 – 14, 2024

by Amanda Enyeart, Lauren Ellison and Jayda Greco | Oct 18, 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:

Speech language pathology
Mental health and substance use disorder treatment

A CLOSER LOOK

Proposed Legislation & Rulemaking:

Illinois introduced to amend its insurance code to require coverage for speech therapy services that a treating provider deems medically appropriate as treatment for stuttering, regardless of whether the services are provided in person or via telehealth, as of January 1, 2026. Coverage would include the use of any communication technology, applications, or platforms that comply with the applicable privacy provisions of the federal Health Insurance Portability and Accountability Act of 1996.

The District of Columbia Department of Health Care Finance proposed a rule regarding the provision of medication therapy management services by pharmacists under the district’s Medicaid program, in accordance with the requirements of 29 DCMR § 910, which establishes the department’s standards for the provision of telemedicine services. The services, which are aimed at optimizing therapeutic outcomes for Medicaid beneficiaries, are limited to one initial visit and three follow-up visits per calendar year and may be provided in person or via telehealth.

Finalized Legislation & Rulemaking:

Alaska enacted HB 126, which authorizes associate counselors to provide certain services via telehealth. The legislation also extends certain immunity protections to providers who volunteer to provide services without pay through a medical clinic, medical facility, nonprofit facility, temporary emergency site, or other governmental facility, if acting within the scope of their responsibilities in such organization.
Pennsylvania’s upper house passed HB 2268, which, if signed by the governor, will mandate insurance coverage of rehabilitative speech therapy treatments for individuals with childhood stuttering and neurological stuttering.

Why it matters:

States are increasingly relying on telehealth to expand access to speech-language pathology services. Pennsylvania and Illinois took steps this week to expand access to such services, particularly for treatments involving stuttering therapy.
States continue to use telehealth as a means to address mental health and substance use disorders. Last week, Mississippi enacted a final rule to allow community service providers to perform substance use assessments either in person or via telehealth. Continuing this trend, this week Illinois expanded insurance coverage for behavioral health benefits with the goal of enhancing equity in mental health and substance use treatment. We expect to see a continued uptick in this activity going forward.

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. Are you working to make healthcare more accessible through telehealth? Let us help you transform telehealth.

Trending in Telehealth: September 30 – October 7, 2024

by Lisa Mazur, Lauren Ellison and Jayda Greco | Oct 17, 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:

Professional standards
Teledentistry
Occupational therapy

A CLOSER LOOK

Proposed Rulemaking:

The Florida Nursing Board proposed a set of guidelines that the board must follow when imposing disciplinary penalties upon telehealth registrants. The penalties include reprimand, suspension with a corrective action plan, and revocation of the individual’s license.
New York proposed a rule to update its regulations for personal recovery-oriented services to align with telehealth guidance. The rule would mandate that individuals receiving intensive rehabilitation services be seen at least once in-person or through audio-visual telehealth during the calendar month.

Finalized Rulemaking:

Mississippi enacted a final rule that defines the Department of Mental Health’s certification requirements for community service providers. For all individuals reviewing mental health services and/or substance use services, the initial assessment and subsequent assessments may be provided either in-person or via telehealth.

Ohio adopted a final rule permitting occupational therapists to provide telehealth services. A provider may use synchronous or asynchronous technology during the initial patient visit. A provider also may deny a patient telehealth services and require the patient to undergo an in-person visit if care is continued with that provider.
Maine enacted a final rule permitting dentists to deliver diagnostic services via telehealth in accordance with the MaineCare Benefits Manual and current rules and guidance. The rule states that when delivering services via telehealth, dentists should bill for the underlying service and include the appropriate teledentistry CDT code that indicates a synchronous real-time encounter or an asynchronous encounter in which information is stored and forwarded to the dentist for subsequent review.

Why it matters:

States continue to expand access to telehealth services. Maine expanded access to teledentistry services, while Ohio expanded access to occupational therapy services and clarified the corresponding reimbursement methodology.
Legislation continues to slow as we approach the election, and many states have concluded the year’s legislative sessions. As mentioned in last week’s update, legislative activity has slowed, including legislation related to telehealth. Many legislators prefer to maintain the status quo until after elections, and legislative sessions in several states, such as California, have already concluded.

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. Are you working to make healthcare more accessible through telehealth? Let us help you transform telehealth.

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