OF DIGITAL INTEREST

Human Trafficking Monitoring for Telehealth Providers

by Jayda Greco, Alan LeBlang and Lisa Mazur | Feb 3, 2025 | Telehealth

Overview: Telehealth providers are uniquely positioned to monitor for human trafficking when interacting with patients. Survivor records indicate that health services are among the most common points of access to help trafficked persons, and nearly 70% of human trafficking survivors report having had access to health services at some point during their exploitation. While there’s limited data regarding trafficked persons’ use of telehealth services, empirical evidence demonstrates that a greater proportion of trafficked persons completed telehealth appointments during the early period of the COVID-19 pandemic than pre-pandemic. To enable telehealth providers to assist trafficked patients, this article discusses the legal landscape surrounding human trafficking and lays out best practices for telehealth providers.

Background: Telehealth providers are subject to a patchwork of legal requirements aimed at reducing human trafficking. If the patient is under the age of 18 or is disabled, many states require telehealth providers to report instances in which they know or reasonably believe the patient has experienced or is experiencing abuse, mistreatment, or neglect. Some states, such as Florida and New Jersey, also require telehealth providers partake in anti-trafficking education.

Online platforms that offer telehealth services are also subject to federal legislation regarding sex trafficking monitoring. In 2018, US Congress passed the Allow States and Victims to Fight Online Trafficking Act of 2017 (FOSTA). The law was enacted primarily in response to unsuccessful litigation against Backpage.com, a website accused of permitting and even assisting users in posting advertisements for sex trafficking. Before FOSTA’s enactment, Section 230 of the Communications Decency Act essentially shielded online platforms from liability for such conduct. FOSTA, however, effectively created an exception to Section 230 by establishing criminal penalties for those who promote or facilitate sex trafficking through their control of online platforms. These penalties, generally limited to a fine, imprisonment of up to 10 years, or both, may be heightened for aggravated violations, which are violations involving reckless disregard of sex trafficking or the promotion or facilitation of prostitution of five or more people. State attorneys general and, in cases of aggravated violations, injured persons also may bring civil actions against those who control online platforms in violation of the law.

Since FOSTA’s inception, the US Department of Justice (DOJ) has brought at least one criminal charge under the law. In 2021, after being charged by DOJ, the owner of the online platform CityXGuide.com pleaded guilty to one count of promotion of prostitution and reckless disregard of sex trafficking, a violation of FOSTA’s aggravated violations provision. According to DOJ officials, more charges have not been brought under FOSTA because the law is relatively new and federal prosecutors have had success prosecuting those who control online platforms by bringing racketeering and money laundering charges. Nonetheless, it is possible that prosecutors will pursue FOSTA violations more regularly during the Trump administration, particularly because US President Donald Trump signed it into law during his first term in office, calling it “crucial legislation.”

Best Practices for Telehealth Providers

Telehealth providers and [...]

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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: December 11 – 17, 2024

by Dale C. Van Demark and Angela Irene Theodoropoulos | Dec 18, 2024 | Telehealth

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 26 – December 10, 2024

by Amanda Enyeart and Angela Irene Theodoropoulos | Dec 13, 2024 | Telehealth

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: November 19 – 25, 2024

by Lisa Mazur and Nathan Gray | Nov 26, 2024 | Telehealth

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.