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2024: The Year of the Telehealth Cliff

by , , and | Jan 12, 2024 |

What does December 31, 2024, mean to you? New Year’s Eve? Post-2024 election? Too far away to know?

Our answer: December 31, 2024, is when we will go over a “telehealth cliff” if Congress fails to act before that date, directly impacting care and access for Medicare beneficiaries. What is this telehealth cliff? Let’s back up a bit.

TELEHEALTH COVERAGE POLICIES

Current statute (1834(m) of the Social Security Act) lays out payment and coverage policies for Medicare telehealth services. As written, the provisions significantly limit Medicare providers’—and therefore patients’—ability to utilize telehealth services. Some examples:

  • If the patient is in their home when the telehealth service is being provided, telehealth is generally not eligible for reimbursement.
  • Providers cannot bill for telehealth services provided via audio-only communication.
  • There is a narrow list of providers who are eligible to seek reimbursement for telehealth services.

COVID-19-RELATED TELEHEALTH FLEXIBILITIES

When the COVID-19 pandemic hit in 2020, a public health emergency (PHE) was declared. Congress passed several laws, and the administration acted through its own authorities to provide flexibilities around these Medicare telehealth restrictions. In general, nearly all statutory limitations on telehealth were lifted during the PHE. As we all know, utilization of telehealth skyrocketed.

The PHE ended last year, and through subsequent congressional efforts and regulatory actions by the Centers for Medicare and Medicaid Services (CMS), many flexibilities were extended beyond the end of the PHE, through December 31, 2024. Congress and CMS continue to grapple with how to support the provision of Medicare telehealth services for the future.

CMS has taken steps through the annual payment rule, the Medicare Physician Fee Schedule (MPFS), to align many of the payment and coverage policies for which it has regulatory authority with congressional deadlines. CMS has also restructured its telehealth list, giving more clarity to stakeholders and Congress as to which pandemic-era telehealth services could continue if an extension is passed. But CMS can’t address the statutory limitations on its own. Congress must legislate. CMS highlighted this in the final calendar year (CY) 2024 MPFS rule released on November 2, 2023, noting that “while the CAA, 2023, does extend certain COVID-19 PHE flexibilities, including allowing the beneficiary’s home to serve as an originating site, such flexibilities are only extended through the end of CY 2024.”

THE TELEHEALTH CLIFF

This brings us to the telehealth cliff. CMS generally releases the annual MPFS proposed rule in July, with the final rule coming on or around November 1. If history is any indication, Congress is not likely to act on the extensions much before the current December 31 deadline. This sets up the potential for a high level of uncertainty headed into 2025.

If we go over, this telehealth cliff would directly impact care and access for Medicare beneficiaries. The effects could be felt acutely in rural and underserved areas, where patients have been able to access, via telehealth, medical services that may have been out of reach for them in the past. The telehealth cliff would [...]

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Trending in Telehealth: December 21, 2023 – January 3, 2024

by , and | Jan 5, 2024 |

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:

  • Behavioral health
  • Interstate compacts

A CLOSER LOOK
Finalized Legislation & Rulemaking

  • Arkansas issued a final rule whereby certain assessments under the Arkansas Independent Assessment (ARIA) system may be performed via telemedicine. The ARIA system is used to perform a functional-needs assessment for eligible Medicaid beneficiaries served through one of the state’s waiver programs or state plan personal care services.
  • Mississippi issued a final rule, which adds Licensed Marriage and Family Therapists and Mississippi State Department of Health clinics to the list of Medicaid-covered providers for telehealth services. The final rule also clarifies that Medicaid would not cover physician or other practitioner visits through telehealth for Evaluation and Management Level IV or V visits.
  • New Jersey signed AB 5757  into law on December 31, 2023. This substitute bill amends Section 11 of P.L.2021, c.310 to extend the end date from December 31, 2023, to December 31, 2024, during which time a health benefits plan in New Jersey must extend coverage and payment parity for telehealth services. Healthcare services delivered to a covered person through telemedicine or telehealth must be covered at a rate equal to the in-person provider reimbursement rate, provided the services are otherwise covered by the health benefits plan when delivered in-person.
  • Washington, DC, issued a final rule updating Medicaid’s Assertive Community Treatment reimbursement methodology from a fee-for-service model to a monthly rate model. The new model requires eight (8) contacts with a consumer per calendar month. Three (3) of the required eight (8) contacts can be performed via . The Assertive Community Treatment program provides intensive, integrated, rehabilitative treatment and community-based to adults with serious and persistent mental illness.
  • Virginia joins the Counseling Licensure Compact, effective January 1, 2024. The authorizing bill was signed into law on March 27, 2023, with a delayed effective date.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

  • In New Jersey, AB 5311 passed the General Assembly with a vote of 73-0-0. If enacted, the bill would enter New Jersey into the Counseling Compact.
  • New Jersey’s General Assembly also passed SB 3604 with a vote of 74-0-0. The bill authorizes the use of healthcare platforms that provide discounted prices for payment of prescription and nonprescription drugs or devices and for telehealth and telemedicine services.

Why it matters:

  • There continues to be an increase in activity surrounding licensure compacts. States closed the year by adopting interstate compacts for a variety of professionals. In general, 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.
  • States continue to pass rules to increase access to behavioral [...]

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Trending in Telehealth: December 14, 2023 – December 20, 2023

by and | Dec 22, 2023 | ,

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:

  • Telehealth pilot programs
  • Standards of practice

A CLOSER LOOK
Finalized Legislation & Rulemaking

  • Effective February 1, 2024, the Wisconsin Hearing and Speech Examining Board clarified, by final rule, the standard of care for hearing instrument specialists and audiologists. The final rule defines telehealth; expands the scope of unprofessional conduct; and requires licensure for a person engaged in the practice of selling or fitting hearing aids to a patient located in the state, whether in-person or via telehealth.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

  • New Jersey continues to progress Assembly Bill 5311. If enacted, the bill will enter New Jersey into the Counseling Compact.
  • Wisconsin progressed AB 573 and AB 541. AB 573 directs the Department of Health Services to establish a pilot program to implement virtual behavioral health crisis care services for use by county or municipal law enforcement agencies in the field. The service will connect law enforcement officers who encounter persons in crisis to behavioral healthcare services. AB 541 provides that no mental health care provider may be required to be licensed, registered, certified or otherwise approved to practice in Wisconsin to provide mental health services by telehealth to patients located in Wisconsin if the mental health care provider satisfies certain conditions, including:
    • the mental health care provider is licensed, registered, certified or otherwise approved to practice in the state in which the provider is physically present when providing telehealth services;
    • the mental health care provider may provide telehealth services in Wisconsin within the scope of his or her license, registration, certification or approval from the state from which the mental health care provider is providing telehealth services; and
    • the mental health care provider informs the patient whether the provider is licensed in Wisconsin, what state he or she is providing telehealth services from, what states in which he or she is licensed, registered, certified or otherwise approved to practice, and which regulatory boards the patient may contact to file a complaint.
  • The Texas State Board of Dental Examiners issued a proposed rule that would amend 22 Tex. Admin. Code § 111.5 related to electronic prescribing waivers. The proposed amendment removes the requirement that a dentist must submit a written statement and supporting documentation describing the circumstances necessitating a waiver, and instead requires a dentist to attest to the circumstances necessitating a waiver. The board indicates that the amendment will make it less burdensome on the dentist when submitting a waiver request to the board and it will make the Board’s waiver process more efficient. The comment deadline is January 14, 2024.

Why it matters:



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Trending in Telehealth: December 6 – December 13, 2023

by and | Dec 14, 2023 |

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:

  • Standards of practice
  • Interstate compacts

A CLOSER LOOK
Finalized Legislation & Rulemaking

  • Alaska’s Department of Commerce, Community, and Economic Development issued a final rule to clarify that the Alaska Board of Nursing may discipline a licensee by assessing a civil fine, in accordance with central licensing statutes, for each finding the board makes of a cause for discipline. The final rule also updates the standard of practice for advanced practice registered nurses (APRNs) for services provided via telehealth and adopts by reference the American Association of Nurse Practitioners’ position statement on telehealth. While the position statement reflects broad support for telehealth and payment parity, the final rule is much more specific. Effective January 5, 2024, 12 AAC 44.925 will be readopted to clarify that an APRN must provide the same standard of care to a patient who is at a different location as would be provided to that patient in person. The final rule also clarifies that an APRN may practice telehealth if (1) the APRN is licensed and (2) the APRN or another licensed healthcare provider is available to provide follow-up care. Finally, the rule provides that for a telehealth encounter, an APRN must complete and document:
    1. The patient’s informed consent to use telehealth technologies;
    2. A clinical history and review of systems establishing diagnoses and identifying conditions and contraindications to recommended treatment;
    3. A plan of care that lists all recommendations and prescriptions issued by electronic means;
    4. The patient and provider locations at the time of the telehealth visit; and
    5. The provider-patient relationship prior to prescribing.
  • As previewed last week, Wisconsin enacted SB 196 and SB 197. The bills enact the Counseling Compact and Audiology and Speech-Language Pathology Interstate Compact.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

  • New Jersey AB 5311 passed the General Assembly with a vote of 73-0. If enacted, the bill would enter New Jersey into the Counseling Compact.

Why it matters:

  • There continues to be an increase in activity surrounding licensure compacts. Consistent with past months, states intend to close the year by adopting interstate compacts for a variety of professionals. In general, 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.
  • States continue to amend and clarify telehealth-related standards of care. Following the advent of novel telehealth-related modalities, states continue to adopt and revise the definition of various standards of care to address telehealth-related concerns and provide certainty for providers predominately practicing in the remote space.

Telehealth is an important development in care [...]

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Trending in Telehealth: November 29 – December 05, 2023

by and | Dec 8, 2023 |

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

A CLOSER LOOK
Finalized Legislation & Rulemaking

  • Ohio issued a final rule clarifying when annual assessments performed by registered nurses (RNs) under the Ohio home care waiver program may be conducted via telehealth. Ohio issued another final rule in connection with the Ohio home and community-based services program clarifying the same. In short, at least twice per year, the RN will conduct RN assessment visits in person. All other RN assessment service visits may be conducted via telehealth, unless the individual’s needs necessitate an in-person visit.
  • In Oregon, the Oregon Health Authority issued a final rule updating and amending certain defined terms under the Medical Assistance Program, including “telehealth,” “telemedicine,” “telecommunication technologies,” “asynchronous” and “meaningful access.”

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

  • Wisconsin presented Senate Bill 196 and Senate Bill 197 to the governor. The bills propose to enact the Counseling Compact and Audiology and Speech-Language Pathology Interstate Compact.

Why it matters:

  • There continues to be an increase in 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. Healthcare licensure compacts offer benefits to providers, licensing boards and states by enabling professionals to meet increased patient needs while maintaining state sovereignty and patient safety. Wisconsin’s advancing proposal to enter multiple interstate licensure compacts represents a continued effort by state lawmakers to improve access to care for its state’s residents.
  • States continue to amend and clarify telehealth-related definitions. Following the advent of novel telehealth-related standards of care, states continue to amend and clarify definitions, including incorporating those definitions across state healthcare programs.

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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Trending in Telehealth: November 15 – 28, 2023

by and | Dec 1, 2023 |

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:

  • Professional Licensure
  • Telehealth Practice Standards
  • Medicaid Reimbursement
  • Cross-State Licensing Compact

A CLOSER LOOK
Finalized Legislation and Rulemaking

  • In Alaska, the Board of Optometry’s final rule from October concerning licensing, continuing education and telehealth standards went into effect on November 15, 2023. The final rule created new standards for optometrists providing services via telehealth. Notably, an optometrist must create a pre-existing optometrist relationship verbally, in writing or through an in-person exam before conducting a patient visit through telehealth, as well as verify the patient’s identity. Additionally, the optometrist also may not determine an ophthalmic prescription used to correct a refractive error based solely on an examination conducted through telehealth.
  • The District of Columbia passed legislation requiring professional members of licensing boards to be District residents and to maintain an active, primarily non-telehealth healthcare practice. This legislation was signed by the Mayor of the District of Columbia on November 21, 2023, and will take effect following a 30-day period of congressional review and publication in the District of Columbia Register.
  • Florida’s Department of Health issued a final rule, effective December 7, 2023, to update its procedure for healthcare providers licensed in other states and territories to register with the department to provide telehealth services to patients in Florida.

Legislation and Rulemaking Activity in Proposal Phase
Highlights:

  • Texas, through the Texas Behavioral Health Executive Council, proposed amendments to §781.323, which would provide clarification regarding telehealth practice requirements for social workers.
  • In Utah, the Department of Health & Human Services issued a notice of a proposed rule to update its current telehealth policies, in part to implement the reimbursement provision for audio-only telehealth legislated in H.B. 437, passed in the 2023 general session.
  • Washington’s Department of Health published a proposed rule focused on implementing the multistate nurse licensure compact. The department also published a proposed rule that would allow a certified dietitian or nutritionist to provide services in person or through telehealth, as appropriate, based on the needs of the client.

Why it matters:

  • Increased Barriers to Telehealth Flexibilities. The end of the COVID-19 public health emergency brought with it the expiration of interstate licensure waivers and the rollback of telehealth regulatory flexibilities across the states. As states continue to assess how the shift in telehealth policies will impact residents, some of the recent legislative and rulemaking activity illustrate the impact of restrictive attitudes toward telehealth on patient care. Some common policy barriers to telehealth include a requirement to establish the provider-patient relationship via an in-person visit prior to a telehealth appointment or the outright prohibition of using telehealth as the sole method [...]

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Trending in Telehealth: November 8 – 14, 2023

by and | Nov 17, 2023 |

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:

  • Coverage and Payment Parity
  • Regulatory Licensing
  • Interstate Compacts
  • Medicaid Reimbursement

A CLOSER LOOK
Finalized Legislation and Rulemaking

  • In Florida, the Florida Board of Psychology issued Rule 64B19-17.002 to revise the disciplinary guidelines for licensed psychologists who commit professional conduct violations. The guidelines provide for first and subsequent offenses committed by licensees, including separate disciplinary consequences for out-of-state telehealth registrants.
  • In Texas, the state’s Health and Human Services Commission (HHSC) renewed its e-Health Advisory Committee (eHAC) by final rule. eHAC currently advises the HHSC executive commissioner and health and human services agencies in the state 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. eHAC was set to expire on December 31, 2023, but has now been extended for a two-year period until December 31, 2025.
    Legislation and Rulemaking Activity in Proposal Phase

Highlights:

  • Michigan proposed several bills concerning coverage and payment parity for telehealth services.
    • HB 4580 focuses on coverage parity for telemedicine services in the Medicaid context for the state’s medical assistance program or Healthy Michigan program through amending the state’s Social Welfare Act.
    • HB 4131 aims to amend the state’s insurance code to prohibit health insurance policies from denying or restricting coverage for telemedicine services and to require that telemedicine services be treated the same as in-person medical care.
    • HB 4579 focuses on amending the state’s insurance code to provide coverage parity for services provided via telemedicine.

Why it matters:

  • A push for parity. Michigan’s proposed bills are pushing for coverage parity across insurers and payment parity (i.e., telehealth and in-person services must be reimbursed at equal rates). While coverage parity for private payors is already widespread across most states, there is an ongoing debate as to the benefits and drawbacks of payment parity for telehealth. Some argue that equal reimbursement rates for telehealth results in overuse, or that telehealth services are lower value and/or cause less to administer, thereby warranting the lower reimbursement rate. However, without payment parity, a lower reimbursement rate makes telehealth financially impractical for many providers, particularly those with small practices or who are working in underserved communities. The reduction in telehealth services, in turn, has a negative outcome; without as many options, patients face diminished access to care overall and to provider choice, expertise and quality.
  • Advisory committees can provide state-level oversight to health initiatives. While some states quickly sunset their telehealth advisory councils, others continue to have telehealth and e-health advisory committees and initiatives to guide state programs. Texas’ choice to renew eHAC for another two years signals a [...]

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Trending in Telehealth: November 1 – 7, 2023

by and | Nov 10, 2023 |

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:

  • Telehealth Practice Standards
  • Medicaid Reimbursement
  • Interstate Licensure Compacts
  • Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

  • In Michigan, the Department of Licensing and Regulatory Affairs promogulated, through final rule, practice standards and requirements for dentistry (including tele-dentistry under Part 6B of the final rule) found at Mich. Admin. Code R. 338.11611 to 338.11615.
    • Under the final rule, “telehealth” covers the use of electronic information and telecommunication technologies to support or promote long-distance clinical healthcare, patient and professional health-related education, public health or health administration. Telehealth also may include, but is not limited to, “telemedicine,” which is the use of electronic media to link patients with healthcare professionals in different locations. The final rule also allows for e-prescribing, subject to enumerated requirements.
    • The Department waived the existing requirement for in-person contact with the dentist or dental therapist once every 24 months for telehealth services, unless the dentist or dental therapist delegates or assigns duties other than radiographic imaging to allied dental personnel.
    • The Department set forth specific requirements for the informed consent process to treat remotely via telehealth. Among other requirements, the licensee must explain the alternatives, capabilities and limitations of telemedicine, and the patient may decline to receive telehealth services.
    • The Department articulated privacy standards for telehealth, including that the telehealth encounter must be secure and compliant with federal and state security and privacy regulations.
  • In Washington, the state’s Health Care Authority issued a permanent rule amending the standards for Medicaid reimbursement of childbirth education classes. The permanent rule added criteria to allow reimbursement for online classes through telemedicine, subject to a one-on-one check-in with the client and qualified childbirth education provider during or after the online classes.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

  • In West Virginia, the Governor’s Committee on Crime, Delinquency, and Correction modified its proposed rule on Sexual Assault Forensic Examinations to specifically include sexual assault telehealth services. The modification adds a definition for “TeleSANE” to allow certified sexual assault nurse examiners (SANE) with documented expertise to provide forensic exam guidance through telehealth technology.
  • In Wisconsin, SB 1, discussed in-depth last week, continued to advance after passing through the first chamber and being recommended for concurrence during an executive session. The proposed legislation would ratify and enter Wisconsin into several interstate compacts, including the Audiology and Speech-Language Pathology Interstate Compact, the PA Licensure Compact, the Social Work Licensure Compact and the Counseling Compact.

Why it matters:

  • Telehealth increasingly represents a mechanism to satisfy niche and specialty care needs. This week saw significant rulemaking activity aimed at leveraging telehealth in unique contexts, from dentistry services to childbirth education, and even sexual assault forensic [...]

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Trending in Telehealth: October 24 – 31, 2023

by and | Nov 3, 2023 |

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 Licensure Compacts
  • Telehealth Practice Standards
  • Fiscal Policies and Incentives
  • Behavioral Health
  • Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

  • In Wisconsin, the governor signed AB 364 into law. The bill amends the Wisconsin tax code by adopting certain Internal Revenue Code provisions relating to telehealth services and other remote care services and high-deductible health plans (HDHPs) under the Consolidated Appropriations Acts of 2022 and 2023. Specifically, AB 364 authorizes individuals covered by an HDHP to claim a state income tax deduction for contributions to a health savings account, even if the plan has a $0 deductible for telehealth or remote services. The tax deduction will be available for taxable years beginning after 2021.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

  • In Wisconsin, SB 1 passed through the first chamber. The proposed bill aims to ratify and enter Wisconsin into the following interstate compacts: the Audiology and Speech-Language Pathology Interstate Compact, the PA Licensure Compact, the Social Work Licensure Compact and the Counseling Compact.
  • In Illinois, SB 767 passed through the first chamber. The proposed bill would amend the HMO Act and permit audiologists and physicians to prescribe hearing aids via in-person or telehealth evaluations.
  • Nevada proposed a rule that defines the remote practice standards for social workers. Among other things, the rule would 1) permit the remote supervision of trainees, removing the in-person supervision requirements; 2) clarify that telehealth must be provided through Nevada-licensed providers; 3) authorize social workers to elect “inactive status” for periods during which the licensee is not actively providing services in the state; and 4) create a new licensure-by-endorsement process for social workers licensed in different countries.
  • Vermont proposed a rule to implement two new professional credentials created by statute: the telehealth license and telehealth registration. Under the proposed rule, out-of-state healthcare professionals may obtain 1) a telehealth license to provide telehealth services to a total of no more than 20 patients in Vermont during a two-year license term or 2) a telehealth registration to provide telehealth services for a period of no more than 120 consecutive days from the date the registration was issued and to a total of no more than 10 patients over the 120-day period. The license and registration offer a discount for out-of-state providers, as the fee for a telehealth license is 75% of a full license fee, and the telehealth registration is one-half of the full license fee.

Why it matters:

  • Professional mobility and flexibility. Vermont’s initiative to introduce telehealth licenses and registrations for out-of-state healthcare professionals represents a significant step in facilitating telehealth practice within the state. This proposal aims to streamline the licensure process by offering [...]

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Trending in Telehealth: October 17 – 23, 2023

by and | Oct 27, 2023 | ,

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 Licensure Compacts
  • Telehealth Practice Standards
  • Disciplinary Guidelines
  • Behavioral Health
  • Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

  • Alaska adopted a final rule creating new standards for optometrists providing telehealth services. To provide telehealth services, optometrists must: establish an optometrist-patient relationship verbally, in writing or in-person; verify the patient’s identity; maintain patient confidentiality; provide telehealth services at the same quality as in-person services; diagnose patients at the time of the patient visit; maintain complete and timely records; and perform additional examinations, in addition to telehealth, when dispensing prescription eyewear.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

  • In Wisconsin,
    • Three Interstate Compact bills advanced through the first chamber:
      • SB 196 would enact the Counseling Compact;
      • SB 391 would enact the Social Work Licensure Compact; and
      • SB 197 would enact the Audiology and Speech Pathology Compact.
    • The legislature is also considering AB 364, which advanced through the second chamber.
      • AB 364 would amend the Wisconsin tax code by adopting certain Internal Revenue Code provisions relating to high-deductible health plans (HDHPs) under the Consolidated Appropriations Acts of 2022 and 2023. Specifically, AB 364 authorizes individuals, covered by an HDHP, to claim a state income tax deduction for contributions to a health savings account, even if the plan has a $0 deductible for telehealth or remote services. The tax deduction would be available for taxable years beginning after 2021.
  • In Ohio, SB 90, a bill to enact the Social Work Licensure Compact (the Compact), passed through the first chamber. While Missouri is currently the only state to officially enact the Compact, Ohio is one of six states with pending legislation to join the Compact.
  • Oregon proposed a rule to implement and clarify SB 232. The Oregon Legislature passed SB 232 to enact certain exemptions for telemedicine licensure, clarify that the “temporarily” definition includes patients in Oregon for business, vacation or education, and authorize out-of-state physicians or physician assistants to provide telemedicine intermittently to Oregon patients when the healthcare professional has an established patient relationship. The proposed rule amendments align with these updates.

Why it matters:

  • Hybridization of Healthcare. Alaska’s final rule is an example of the further acceptance of hybrid healthcare models. While the new initiative authorizes optometrists to provide telehealth services to established patients, optometrists in the state must combine telehealth with other forms of examination, likely in-person, to dispense eyewear prescriptions to patients.
  • Modernizing Licensure Infrastructures. The legislative activity in Wisconsin, Ohio and Oregon facilitates the provision of services across state lines by standardizing licensing requirements for healthcare professionals. The streamlined licensure process also enables a [...]

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