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
• Reimbursement requirements
• Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking:

• In Connecticut, the governor signed HB 5198, which permanently extends COVID-19 era telehealth provisions, originally set to expire at the end of this month. The bill also creates a registration requirement for mental and behavioral health providers who are providing care via telehealth from outside of the state. These providers do need to submit an application for licensure within 60 days of registration. The bill also addresses payment expectations for providers should a patient’s health insurance not cover telehealth services. Certain provisions went into effect immediately upon the governor’s signature, while others go into effect on July 1, 2024, after the existing provision expires.
• Colorado enacted HB 24-1045, which addresses updates to treatment for substance use disorders generally and requires payment parity for telemedicine care of substance use under the state’s Medicaid program. This takes effect 90 days following the final adjournment of the state congress. Colorado also enacted SB 24-034, which expands school-based healthcare, allowing services to be provided via telehealth.
• Illinois amended the Illinois Public Aid Code, through SB 3268, to include funding for the expansion of telehealth services in critical access hospitals with potential funding coming from the Department of Health Services (DHS) to support expansion. This also includes an amendment which states that beginning January 1, 2025, DHS 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.
• Michigan enacted several telehealth related bills, all taking effect 90 days following the end of the congressional session:
  • HB 4131 :This bill updates the state’s private payor laws and requires, among other things, that there be payment parity and that health plans not limit telehealth-delivered services to only be provided via a third-party entity.
  • HB 4580: This bill will ensure coverage parity through Medicaid for telehealth services.
  • HB 4213: This bill will, among other things, require coverage of telehealth in the Medicaid program, including specifically allowing for audio-only and telehealth to be an eligible encounter for federally qualified health centers (FQHCs) and rural health clinics (RHCs).
  • HB 4579: This bill requires that all health plans cover telehealth services at the same rate as in-person care.
• Nebraska’s enrollment in the Dietician Licensure and Physician Assistant Compacts took effect under LB 1215.
• West Virginia finalized a rule that would expand the definition of Occupational Therapist and Occupational Therapist Assistant, to include those enrolled in the Occupational Therapist Compact.
• Wyoming revised rules promulgated by the Medical [...]
  
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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
• Reimbursement requirements
• Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking:

• In Colorado, SB 24-168 was signed by the governor, requiring reimbursement for remote monitoring for outpatient services for certain Medicaid members. This bill also creates a grant program to provide grants to outpatient healthcare facilities that are in rural areas to assist with the cost of providing telehealth remote monitoring, recognizing the cost to set up these programs. These parameters go into effect July 1, 2025. This bill also requires that the State cover continuous glucose monitors for Medicaid members.
• Florida enacted HB 855, which addresses teledentistry treatment, specifically requiring a disclaimer to accompany dental care provided via telehealth that an in-person visit is recommended prior to telehealth treatment. The bill goes into effect July 1, 2024.
• Mississippi finalized a rule that removed restrictions for telehealth visits with an evaluation & management code of level IV or V to be reimbursable by the state’s Medicaid program.
• Tennessee enacted several telehealth related bills:
  • HB 2857: In the realm of general healthcare insurance statutes, the bill revises the definition of “provider-based telemedicine” in Tenn. Code Ann. § 56-7-1003 to remove the requirement that the patient has already established the provider-patient relationship via an in-person visit within 16 months prior to the telehealth visit. An in-person visit is still required, however it does not need to be within that 16-month lookback period. This bill took effect on May 28, 2024.
  • HB 2318: This bill allows a physician assistant who operates solely via telehealth to arrange for the required review of the physician assistant’s charts by a collaborating physician or any required visit by a collaborating physician to any remote site to be completed via HIPAA-compliant electronic means, rather than at the site of the clinic. The bill also removes telehealth as an option. This bill went into effect on May 28, 2024.
  • HB 2147: The Tennessee Medicaid Program, TennCare, is now required to cover complex rehabilitation visits that are conducted via telehealth. This goes into effect on July 1, 2024.
  • HB 2808: Tennessee now requires that healthcare services delivered to inmates for human immunodeficiency virus (HIV) treatment can be provided via telemedicine, if requested and associated payment through various state programs, including TennCare, to cover treatment. This bill goes into effect on July 1, 2024.
• Vermont enacted a law through H 861 that requires parity for healthcare services provided via telemedicine, broadly applicable to healthcare insurance plans. This bill goes into effect on January 1, 2025.
• Several states enacted compact-related legislation:
  • Colorado signed HB 24-1002, which enacts the Social [...]
    
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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
• Reimbursement requirements
• Interstate compacts

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Connecticut enacted HB 5197, which enacts the Social Work Licensure Compact.
• South Carolina enacted H 5183, which adds certain nursing tasks to the representative list of nursing tasks that may be delegated by a physician, physician assistant, or advanced practice registered nurse to unlicensed assistive personnel, including performing nonclinical tasks via telemedicine.
• South Carolina also enacted S 610, which enacts the Counseling Compact.
• The Wisconsin Psychology Examining Board amended its rules to bring them into alignment with the state’s establishment as a member of the Psychology Interjurisdictional Compact. Specifically, this adopted rule provides that the standards of practice and professional conduct apply to both telehealth and telepsychology services.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• In California, AB 2339 passed the first chamber. This bill would expand existing Medi-Cal definitions and exceptions that currently restrict the establishment of new patient relationships via telehealth. Specifically, this bill permits the use of asynchronous telehealth modalities to establish a new patient relationship when related to sensitive services or when requested by patient. For purposes of Medi-Cal, this bill expands the definition of “asynchronous store and forward” to include asynchronous electronic transmission initiated directly by patients, including through mobile telephone applications.
• In Illinois, HB 5087 passed the second chamber. This bill would amend the Illinois Physical Therapy Act to provide that physical therapy through telehealth services may be used to address access issues to care, enhance care delivery or increase the physical therapist’s ability to assess and direct the patient’s performance in the patient’s own environment. This bill also provides that a physical therapist or a physical therapist assistant working under the general supervision of a physical therapist may provide physical therapy through telehealth services, subject to certain restrictions.
• In Illinois, SB 2586 also passed the second chamber. This bill would amend the Illinois Dental Practice Act to include in the definition of teledentistry patient diagnosis and treatment planning services. This bill also provides practice standards by which a dentist may practice teledentistry, including that a dentist may only practice or utilize teledentistry on a patient of record and requires the dentist to obtain informed consent from the patient prior to rendering teledentistry services.
• In Ohio, SB 95 passed the first chamber. This bill would permit remote dispensing pharmacies to dispense drugs, provide patient counseling and other pharmacist care through a telepharmacy system. This bill also specifies the requirements for a pharmacy to be eligible to operate as a remote dispensing pharmacy.
• In Pennsylvania, SB 739 passed the first chamber. This [...]
  
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