Telehealth Archives - Page 7 of 34

Telehealth

Trending in Telehealth: August 15 – 21, 2023

by Purnima Boominathan and Abby Higgins | Aug 25, 2023 | 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:

Expansion of Telehealth Services
Broadband Access
Clarity on Supervision Requirements

A CLOSER LOOK

Finalized Legislation and Rulemaking

Colorado moved, but did not amend or modify, the supervising requirements for physician supervisors to 3 CCR 713-1 Rule 1.15 .
The District of Columbia finalized and adopted rules for the practice of professional art therapy, addressing practice standards and licensure relating to the use of telehealth in this area of practice.
Maryland finalized a rule related to participation in the Medicaid program for podiatrists, which includes required compliance with telehealth regulations. Maryland also finalized regulations related to home care for disabled children, allowing care to be provided, under certain circumstances, through “audio-visual telehealth” in accordance with other Maryland telehealth requirements.
New Hampshire’s governor signed a bill that provides an exception to New Hampshire licensing requirements for out-of-state healthcare professionals treating patients in the custody of the state’s department of corrections, provided the out-of-state healthcare professionals are licensed, certified or registered by and are in good standing with the appropriate licensing body within the professional’s state of practice. The bill goes into effect on October 7, 2023.
New Hampshire also amended an existing parentage-related law to permit a mental health consultation to be conducted via telehealth. This amendment went into effect on August 19, 2023.
Oklahoma adopted emergency regulations related to reimbursement by the state Medicaid program, including a new section for definitions and standards for audio-only health services.
Oregon permanently repealed a rule addressing COVID-19 workplace risks, which in part included telehealth information. This rule had previously been temporarily suspended, so no significant impact is expected.
South Dakota adopted changes to the licensure regulations for speech-language pathologists, which removes the definition of “telepractice.” The rule now refers to the definitions section of South Dakota codified laws §36-37-1 and §36-37-2.
Tennessee finalized rules related to healthcare facility licensing, specifically requiring rural emergency hospitals to include a description of additional services provided within the licensing application, citing telehealth services as an example of additional services to be included.
Texas amended the telemedicine, telehealth and teledentistry rule (§133.30) within the Texas Administrative Code. The amended section implements §413.011 of the state’s Labor Code, which requires the Texas Department of Insurance to adopt healthcare reimbursement policies and guidelines related to workers’ compensation that reflect the standardized reimbursement structures found in other healthcare delivery systems. Interestingly, §413.011 requires the commissioner of workers’ compensation to adopt the current reimbursement methodologies, models and values or weights used by the federal Centers for Medicare & Medicaid Services.
Washington finalized two rules [...]

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Trending in Telehealth: August 8 – 14, 2023

by Lisa Mazur and Abby Higgins | Aug 17, 2023 | 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:

Expansion of Telehealth Services
Jurisdictional Clarifications for Providers

A CLOSER LOOK
Finalized Legislation and Rulemaking

Maryland amended the requirements for participation in the state’s medical assistance program for advanced practice registered nurses to explicitly require compliance with the state’s telehealth rule in COMAR 10.09.49.
Oregon has finalized a rule related to the licensing of optometrists in either a public health emergency or state emergency, incorporating telehealth licenses into the relevant provisions.
Wisconsin adopted regulations that would expand reimbursement under the state’s medical assistance program for certain services provided via telehealth. This rule, which focuses on mobile crisis units, is a result of a directive by the Wisconsin legislature to determine which services provided via telehealth should be reimbursed under the medical assistance program. This was only a partial adoption of rules proposed earlier this year.

Legislation and Rulemaking Activity in Proposal Phase
Highlights:

Illinois has proposed a rule (page 234) that expands and clarifies the definition of telemedicine in the context of hospital licensing to include provider-to-provider consultations with physicians licensed in the United States.
Illinois has also signed into law its enrollment into the Counseling Compact through an amendment to the Professional Counselor and Clinical Professional Counselor Licensing and Practice Act. Illinois joins more than 30 other states that are part of this intrastate compact.
Massachusetts has proposed regulations related to the provision of doula services, which includes defining the standard of care in terms of telehealth.
West Virginia has proposed regulations (page 20) for best practices related to the provision of sexual assault care. This includes providing the initial evaluation via a telehealth service called teleSANE, which would require additional training for relevant providers.

Why it matters:

States are expanding services that can be provided via telehealth. States continue to identify new service areas in which telehealth can be utilized. Examples include the newly proposed bills related to sexual assault examinations in West Virginia and doula services in Massachusetts. As telehealth has become more common, states have expanded opportunities for telehealth services into more specialized fields.
Jurisdictional questions are being more clearly defined in state regulations. Some states have recently provided clarification for providers who are not physically present in the state, clearing up questions regarding what it means to be practicing within a state. For example, although only applicable in an emergency, the Oregon optometry licensing change specifically addresses physical location. Additionally, Illinois’s enrollment in the Counseling Compact expands and standardizes out-of-state practice for certain provider types.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team works alongside the [...]

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Trending in Telehealth: August 1 – 7, 2023

by Patrick Zanayed and Abby Higgins | Aug 14, 2023 | Telehealth

Trending in the past week:

Professional Practice Standards

A CLOSER LOOK
Finalized Legislation & Rulemaking

A law creating the Continuum of Care Program in Arkansas went into effect on July 31, 2023, permitting care coordination of certain reproductive health services to be conducted via telemedicine.
Illinois updated the Hearing Instrument Act, allowing patients 18 years or older to be evaluated for a hearing aid prescription via telehealth. Patients who are 17 years or younger still must have an in-person visit to obtain a prescription. These updates are not effective until January 1, 2024.
The Medical Care Program in Maryland adopted updated standards for physical therapy services provided via telehealth. This update generally aligns those requirements with broader telehealth standards in the state.
Massachusetts passed an emergency rule permitting mobile crisis intervention care to be provided via telehealth and still be eligible for reimbursement under government health care programs. These emergency measures went into effect on August 1, 2023, and will be made permanent pending federal approval.
Oklahoma revised the standards surrounding community mental health centers (CMHCs) and certified community behavioral health clinics to add telehealth encounters to the definition of “face to face” visits. This term is used to determine psychotherapy or therapy services provided by CMHCs, which provide certain assessments and emergency services throughout the community.
The Kentucky Board of Optometric Examiners updated telehealth standards for optometrists, including regulations permitting the provision of services by optometrists physically located outside of Kentucky, via telehealth in certain situations.
Kentucky also passed an emergency rule to address the shortage of social workers. Unlike optometrists, social workers must be physically located within the Commonwealth to use telehealth to care for Kentucky patients.
Texas passed an amendment to the physical therapy practice standards for early childhood intervention care, which permits certain previously onsite-only care to be conducted via telehealth.
New standards related to the use of telemedicine within the practice of occupational therapy in Wisconsin have gone into effect as of August 1, 2023. To note, the initial regulations proposed were not fully accepted, the Wisconsin Occupational Therapists Affiliated Credentialing Board adjusted the regulations after the public comments.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

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Trending in Telehealth: July 25 – 31, 2023

by Amanda Enyeart and Grayson Dimick | Aug 4, 2023 | Telehealth

Trending in the past week:

Professional Practice Standards

A CLOSER LOOK

Finalized Legislation and Rulemaking

Nevada finalized a rule that updates its physical therapy standards. Physical therapists may now provide services via telehealth in accordance with Nevada’s general telehealth statute, Nev. Rev. Stat. § 629.515.
Legislation and Rulemaking Activity in Proposal Phase

Highlights:

Texas proposed a rule that would amend Division of Workers’ Compensation regulations that set telehealth and telemedicine billing requirements for services provided to injured employees in the Texas workers’ compensation system. The proposed rule would add a definition for “teledentistry services” and would add Medicaid payment policies to the list of applicable payment policies that healthcare providers must use to bill for telemedicine, telehealth and teledentistry services.
West Virginia’s Medical Imaging and Radiation Therapy Technology Board of Examiners proposed a rule that would clarify that telehealth practice is inapplicable to the performance of medical imaging and radiation therapy. This proposed rule comes in response to W.V. Code § 30-1-26, which requires all health boards to adopt rules governing telehealth.

Why it matters:

States continue to refine and adopt professional practice standards for telehealth. Some states have recently adopted new or revised professional practice standards that vigorously regulate telehealth. As the latest Nevada and West Virginia rules demonstrate, regulation for certain health professions may be less robust and may simply clarify whether the profession is permitted to practice via telehealth.

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: July 18 – 24, 2023

by Marshall E. Jackson, Jr. and Grayson Dimick | Jul 26, 2023 | Telehealth

Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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

A CLOSER LOOK

Finalized Legislation and Rulemaking

Connecticut enacted Substitute for SB 9, which enters the state into the Physical Therapy Licensure Compact.
Hawaii enacted SB 674, which enters the state into the Interstate Medical Licensure Compact.
Maine enacted LD 1749, which enters the state into the Physical Therapy Licensure Compact. Maine also enacted LD 717, which enters the state into the Audiology and Speech-Language Pathology Interstate Compact.
Rhode Island enacted HB 5737, which enters the state into the Nurse Licensure Compact.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

Alaska proposed a rule that would establish teletherapy standards of practice for psychologists and psychological associates, with the aim of providing clear guidelines for engaging in technology-assisted distance professional services.

Why it matters:

There continues to be elevated activity surrounding licensure compacts. This year has seen an uptick in legislative activity by states seeking to ease out-of-state licensure barriers through the use of interstate compacts. Certain compacts have a majority of states as members. As examples, Hawaii and Missouri became the Interstate Medical Licensure Compact’s 40th and 41st members, respectively, while Rhode Island became the Nurse Licensure Compact’s 41st member. As established compacts continue to grow their membership, a new compact has emerged: Missouri joined the Social Worker Licensure Compact earlier in July, becoming the first state to adopt the compact.

Trending in Telehealth: July 11 – 17, 2023

by Dale C. Van Demark and Grayson Dimick | Jul 21, 2023 | Telehealth

Trending in the past two weeks:

Medicaid coverage
Maternal health

A CLOSER LOOK

Finalized Legislation and Rulemaking

Alaska finalized regulations that implement 2022 legislation (HB 265) requiring the state Medicaid program to provide coverage for telehealth services. The regulations set out requirements related to coverage and payment through Medicaid for services provided via telehealth, including requirements for modalities and providers.
Maryland finalized regulations for the state Medicaid program that update the final date for which telehealth includes audio-only telephone conversations. The final date has been moved from June 30, 2023, to June 30, 2025, in line with legislation enacted in May 2023. The regulations also broaden eligibility for remote patient monitoring services by removing the requirement that the participant be at high risk for avoidable hospital utilization.
Maryland also finalized regulations for the state Medicaid program that update the requirements for urgent care centers, including requirements for supervision and services provided via telehealth.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

California passed AB 1478 in the first chamber. The bill would require the Department of Public Health to maintain a public database of referral networks for community-based mental health providers and support services addressing postpartum depression and prenatal care, including information on mental health providers and support groups that allow for patient-driven care access through telehealth and virtual care.
Colorado proposed a rule that would authorize the use of electronic consultation (eConsults) in the state Medicaid program. eConsults would take place through the authorized eConsult platform, which is currently in the process of being implemented by the Colorado Department of Health Care Policy and Financing. eConsults would involve an asynchronous interaction between a primary care provider and a specialty provider in order to obtain the specialty provider’s expert opinion. Specialty providers would be reimbursed only for eConsults that occur on the approved eConsult platform. More information regarding the eConsult Platform, currently scheduled to go live in winter 2024, is available here.
Texas proposed a rule that would extend the eHealth Advisory Committee (eHAC) for an additional two years. eHAC advises the Health and Human Services Commission Executive Commissioner and Health and Human Services agencies on strategic planning, policy, rules and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth and home telemonitoring services, and is scheduled to sunset December 31, 2023.

Why it matters:

States continue to adopt rules addressing the use of telehealth in state Medicaid programs. Much of this regulatory activity is focusing on clarifying and expanding coverage for telehealth services in state Medicaid programs, [...]

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Trending in Telehealth: June 27 – July 10, 2023

by Stacey Callaghan and Grayson Dimick | Jul 12, 2023 | Telehealth

Trending in the past two weeks:

Telehealth pilot programs, with a focus on home health
Licensure compacts

A CLOSER LOOK

Finalized Legislation and Rulemaking

Connecticut enacted SB 1705, which requires the Department of Public Health to establish a Hospice Hospital at Home pilot program to provide hospice care through a combination of in-person visits and telehealth.
Delaware adopted rules for home health agencies and personal assistance services agencies that define “telehealth mechanism” and address services provided via telehealth mechanisms.
Illinois enacted SB 1913, which requires the Department of Healthcare and Family Services and contracted managed care plans to provide for coverage of mental health and substance-use disorder treatment or services delivered as behavioral telehealth services, and reimburse such services on the same basis, in the same manner, and at the same reimbursement rate as in-person services are reimbursed.
Maine enacted LD 231, which establishes a statewide child psychiatry telehealth consultation service, to the extent funding allows. The service will support primary care physicians who are treating children and adolescent patients and need assistance with diagnosis, care coordination, medication management and any other behavioral health questions.
New Mexico finalized rules that define “telemedicine” for respiratory therapists.
Missouri enacted SB 70, which enters the state into the Counseling Interstate Compact, Interstate Medical Licensure Compact and Social Work Licensure Compact.
Oklahoma enacted HB 2686, which specifies telehealth encounters cannot be used to establish a valid physician-patient relationship for the purpose of prescribing opiates, synthetic opiates, semisynthetic opiates, benzodiazepine or carisoprodol, unless the encounter is used to prescribe opioid antagonists or partial antagonists under certain circumstances, or Schedule III-V controlled substances for medication-assisted treatment or detoxification treatment for substance-use disorder.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

Kentucky proposed a rule that would significantly update telehealth requirements for optometrists, including revising applicable definitions, informed consent requirements, practice standards and jurisdictional considerations (i.e., where a patient or physician may be located).
New Jersey passed S 3604 in the first chamber. The bill would incorporate the use of healthcare platforms (defined as “as an Internet-based service through which a consumer, who may or may not have separate health insurance coverage, may set-up an account or become a member to obtain discounts on prescription or non-prescription drugs or devices and through which other services, including telemedicine, may be provided”) into the laws governing pharmacy benefits managers, pharmacists and telehealth.
Ohio passed SB90 in the first chamber to enter the state into the Social Worker Licensure Compact.

Why it matters:

States continue [...]

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Trending in Telehealth: June 20 – 25, 2023

by Lisa Mazur and Adetoro Olugbemi | Jun 30, 2023 | Telehealth
Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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:

Medicaid reimbursement

Medical marijuana

Mental health

Reproductive health

A CLOSER LOOK

Finalized Legislation & Rulemaking

Florida enacted H 387, permitting qualified physicians to perform telehealth physical patient examinations before issuing subsequent physician certifications for the medical use of marijuana, as long as the patient examination for the initial certification was conducted in person.

Hawaii enacted HB 907, which conforms the state’s law regarding telehealth to the Medicare standards by clarifying that telehealth services provided by way of an interactive telecommunications system will be reimbursed by Medicaid.

Louisiana passed a final rule to adopt provisions in the Professional Services Program to continue to provide Medicaid reimbursement for physician-directed treatment-in-place ambulance services after the COVID-19 public health emergency ended on May 11, 2023. Reimbursement to the ambulance providers for initiation and facilitation of the physician-directed treatment-in-place telehealth service requires a corresponding treatment-in-place telehealth service. The corresponding treatment-in-place telehealth service is demonstrated via a Louisiana Medicaid paid treatment-in-place telehealth service claim.

New Hampshire enacted SB 264, which defines a mental health consultation during a surrogacy process to include a telehealth meeting.

New York enacted S 6749, creating a community-based paramedicine demonstration program that would permit emergency medical service personnel to provide community paramedicine and use alternative destinations, telemedicine to facilitate treatment.

New York enacted SB 1066, expanding protections for persons who perform legally protected reproductive health activity under state law to include protections for reproductive health services provided in person or by means of telehealth.

Ohio passed a final rule to amend the Ohio Vision Professionals Board rules to define telehealth-related terms and clarify the standard of care for telehealth services, patient consent requirements, doctor-patient relationship requirements and prescribing requirements.

Rhode Island enacted SB 565, which establishes telepractice standards for speech language pathologists and audiologists and adopts and incorporates the American Speech-Language-Hearing Association’s Code of Ethics.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

Maine progressed LD 231 in the second chamber to establish a statewide child psychiatry telehealth consultation service to support primary care physicians who are treating children and adolescent patients and need assistance with diagnosis, care coordination, medication management and any other necessary behavioral health questions.

Maine progressed LD 717 in the second chamber, establishing the Audiology and Speech-Language Pathology Interstate Compact.

West Virginia issued a proposed rule to establish procedures for the practice of telehealth by a licensed dietitian, including requirements for the patient-provider relationship.

Why it matters:

States continue to progress and pass legislation establishing telehealth processes for medical [...]

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Trending in Telehealth: June 13 – 21, 2023

by Patrick Zanayed and Adetoro Olugbemi | Jun 27, 2023 | Telehealth
Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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:

Telehealth pilot programs

Mental health

A CLOSER LOOK

Finalized Legislation & Rulemaking

Connecticut enacted HB 6768, which permits physicians, advanced practice registered nurses and physician assistants to certify a qualifying patient’s use of medical marijuana and provide follow-up care using telehealth if they comply with other statutory certification and recordkeeping requirements.

Florida enacted HB 5101, which requires each school district to implement a school-based mental health assistance program that provides behavioral health services in-person and supplemented by telehealth.

Florida enacted SB 2500, which provides additional funding for telehealth services under the Minority Maternity Care program.

Illinois enacted SB 1298, amending the Home and Community-Based Services Waiver Program for Adults with Developmental Disabilities to permit medical and emergency telehealth services for persons with intellectual and developmental disabilities.

Louisiana enacted SB 186, adopting the Occupational Therapy Licensure Compact.

Louisiana enacted SB 66, which amends the state insurance code by replacing the term “telemedicine” with “telehealth,” for consistency throughout the code. The amendment does not require a provider to have an in-person examination with the patient prior to using telehealth but does require that a referral be made to an in-state healthcare provider or in-state follow-up care be arranged if necessary. The amendment also permits the use of interactive audio without video if, after access and review of the patient’s medical records, the healthcare provider determines that the provider is able to meet the same standard of care as if the services were provided in-person.

Louisiana enacted HB 41, which requires health plans to provide equivalent coverage and payments for telehealth occupational therapy services as for in-person services, unless the plan and the provider agree otherwise.

Louisiana enacted HB 181, which allows coroners to use telehealth when conducting an examination for an emergency mental health commitment.

Texas enacted HB 2727, which amends the requirements for the home telemonitoring program under Medicaid, including reimbursement requirements.

Texas enacted HB 617, which establishes a pilot project to provide emergency medical services instruction and emergency prehospital care instruction through a telemedicine medical service or telehealth service provided by regional trauma resource centers to healthcare providers in rural trauma facilities and emergency medical services providers in rural areas.

Texas enacted SB 1146, increasing access to telehealth services for inmates. The law requires the Department of Criminal Justice, in conjunction with The University of Texas Medical Branch at Galveston and the Texas Tech University Health Sciences Center, to establish procedures to expand access to telemedicine medical services, telehealth services and onsite medical care [...]

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Trending in Telehealth: June 6 – 12, 2023

by Amanda Enyeart and Adetoro Olugbemi | Jun 15, 2023 | Telehealth
Trending in Telehealth is a new series from the McDermott digital health team in which we highlight 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:

Telehealth pilot programs

A CLOSER LOOK

Finalized Legislation & Rulemaking

Nebraska enacted LB 227, which amends the definition of the “practice of dietetics and nutrition” to include telehealth services.

Nebraska enacted LB 50, which requires the state court administrator to create a pilot program to use physical space and information technology resources within Nebraska courts to serve as points of access for virtual behavioral health services for individuals at court. The pilot program is intended to provide access to confidential, reliable and safe behavioral health treatment via telehealth for individuals involved with the criminal justice system as defendants, probationers or victims in criminal proceedings.

Nevada enacted AB 432, which amends state optometry laws to establish requirements for synchronous and asynchronous optometry telemedicine and remote patient monitoring in optometric practice. The law imposes an established patient requirement for certain optometric telemedicine services, meaning that an optometrist must have conducted an in-person “comprehensive evaluation” of the patient within two years before the date of the service. Exceptions to the comprehensive evaluation requirement include synchronous services where the performing optometrist has access to records of a comprehensive examination conducted by another optometrist and certain limited asynchronous evaluations solely to determine whether a comprehensive evaluation is necessary. The law permits optometrists with out-of-state licenses to conduct the limited asynchronous services without a Nevada license. Finally, the law specifically imposes the comprehensive exam requirement with respect to patients who are located outside of the state and are treated by optometrists licensed in Nevada.

Oregon enacted SB 232, which allows out-of-state physicians or physician assistants who are not licensed in Oregon to provide care to patients located in Oregon, specifically when the out-of-state physician or physician assistant has established a provider-patient relationship with the patient in Oregon temporarily for the purpose of business, education, vacation or work and such patient requires direct medical treatment by the out-of-state physician or physician assistant. Out-of-state physicians or physician assistants may also provide care for patients with whom they have an established provider-patient relationship to provide temporary or intermittent follow-up. The law further clarifies that the practice of medicine using telemedicine occurs where patient is physically located.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

Connecticut progressed SB 1075 in the second chamber. The legislation would require the state’s Department of Public Health to establish, in collaboration with a hospital in the state, a Hospice Hospital at Home pilot program to provide hospice care to patients in the home through a combination of in-person visits and telehealth. If passed, the law would require the Department of Public Health to create [...]

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