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
• Professional standards and licensure
• Reimbursement requirements and payment parity

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Oklahoma enacted HB 3330, which would require every mental health professional who is renewing a behavioral health certification or license issued by a designated board to report certain information, including their use of telehealth.
• Vermont enacted H 543, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• In Ohio, S 1074 passed the first chamber. If enacted, the bill would amend the supervision and delegation laws for physicians and physician assistants including adding the ability for both licensee types to . Some examples included in the bill are collecting specimens (e.g., urine or stool samples), point of care testing and screening and recording information. The bill does not specify any particular non-clinical tasks that would be particularly suited for telemedicine.
• In Vermont, H 861 passed the first chamber. If enacted, the bill would provide for reimbursement parity for all medically necessary, clinically appropriate, delivered in-person, by telemedicine, and by audio-only telephone. Services covered under the bill would include services that are covered when provided in the home-by-home health agencies. The bill specifically provides that health insurance plans provide the same reimbursement rates for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract.
• In Colorado, HB 24-1045 passed the first chamber. If enacted, the bill would add substance use disorder treatment to the list of healthcare services required to be reimbursed at the same rate for telemedicine as comparable in-person services.
• Numerous states progressed legislation relating to the Social Worker Compact
  • In Alabama, HB 318 passed the first chamber.
  • In Iowa, HB 2512 passed both chambers
  • In Ohio, SB 90 passed both chambers.
  • In Louisiana, HB 888 passed the first chamber.

Why it matters:

• States continue to increase activity surrounding licensure compacts for a variety of health professionals. These state efforts ease the burdens of the licensing process and demonstrate a desire to facilitate multijurisdictional practice without giving up authority over professional licensure. This week, the Social Work Compact saw increased activity.
• States continue to amend and clarify professional practice standards for telehealth. With the increase in the delivery of care through virtual modalities, professional boards are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices, to ensure there is consistency across the professions. This week, we saw a particular emphasis on mental health professionals as it relates to Board reporting obligations, [...]
  
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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
• Professional standards and licensure
• Reimbursement requirements and payment parity

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Nevada’s Physical Therapy Board adopted a final rule which permits physical therapists to use telehealth in accordance with the provisions of Nevada’s general telehealth law (Rev. Stat. 629.515).
• Nebraska enacted legislation, LB 932, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• In Illinois, HB 5087 passed the first chamber. The bill provides 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. It 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 pursuant to the terms and use defined in the Telehealth Act and the Illinois Insurance Code under specified conditions.
• In Tennessee, SB 1862 and mirroring HB 1863 passed the second chamber. The bill would adopt the Dietician Licensure Compact.
• In Minnesota, SF 4399 passed the second chamber. The bill specifies that subject to federal approval, substance use disorder services that are otherwise covered by the state’s Medicaid program as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, subdivision 3b. The use of telehealth to deliver services must be medically appropriate to the condition and needs of the person being served. Reimbursement shall be at the same rates and under the same conditions that would otherwise apply to direct face-to-face services.
• In Ohio, proposed rules by the Chemical Dependency Professionals Board would provide guidance regarding the ethics and professional conduct of practice for certificate holders and licensees overseen by the Chemical Dependency Board, which includes chemical dependency counselor assistants, licensed chemical dependency counselors and licensed independent chemical dependency counselors, when using telehealth.

Why it matters:

• States continue to amend and clarify professional practice standards for telehealth. With the increase in the delivery of care through virtual modalities, professional boards are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices to ensure there is consistency across the professions. This week, we saw a particular emphasis in practice standards impacting physical therapists and substance use disorder professionals who provide services via telehealth.
• States continue to evaluate reimbursement standards as they relate to delivery of care provided via telehealth. State efforts, such as the bill in Minnesota (highlighted above), help to promote access to telehealth by giving patients a choice to seek telehealth [...]
  
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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
• Professional standards and licensure
• Reimbursement requirements and payment parity

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Michigan enacted a final rule that outlines telehealth practice standards including consent to telehealth, referrals to in-person providers (when needed), delegation of prescribing of controlled substances to advanced practice registered nurses, training standards related to human trafficking, licensure and continuing education.
• Delaware enacted a final rule related to social work practice. The amendments change the requirements for direct supervision in post-degree supervised clinical social work experience for licensure applicants to specify that supervision may be through 100% live video conferencing at the discretion of the supervisor. Telehealth requirements are revised to exempt individuals practicing through a Delaware interstate telehealth registration from the prerequisite that the individual hold a Delaware license.
• Tennessee enacted SB 1674, which directs the bureau of TennCare to – no later than December 31, 2024 – amend existing rules, or promulgate new rules, on fee-for-service and Medicaid managed care plans regarding reimbursement (specifically, to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests using established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient’s provider and meets the same standard of care).

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• In New Jersey, A 2803 passed the first chamber. If enacted, the bill would authorize certain out-of-state healthcare professionals and recent graduates of healthcare training programs to practice in the state upon application for licensure/certification in the state, but before such license is granted.
• In Texas, HB 1771 passed one chamber. If enacted, the bill would require that each agency with regulatory authority over a health professional providing a telemedicine medical service, teledentistry or telehealth adopt rules necessary to standardize formats for and retention of records related to a patient’s consent to: (i) treatment, (ii) data collection and (iii) data sharing.
• In Minnesota, SF 4399 passed both chambers. If enacted, the bill would provide that, subject to federal approval, substance use disorder services that are otherwise covered as direct face-to-face services may be provided via telehealth as defined in section 256B.0625, subdivision 3b. The use of telehealth to deliver services would need to be medically appropriate to the condition and needs of the person being served. Reimbursement would be at the same rates and under the same conditions that would otherwise apply to direct face-to-face services.
• In Alabama, SB 207 passed one chamber. If enacted, the bill would adopt the dietitian licensure compact. In Tennessee, HB 1863 (paired with SB 1862) also passed one chamber, and if enacted, would [...]
  
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