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Trending in Telehealth: February 20 – 26, 2023

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
  • Audiology and Speech Pathologists
  • Prescribing
  • Health Practitioner Licensing
  • Behavioral Health

A CLOSER LOOK

Finalized Legislation & Rulemaking: 7

  • Wyoming has signed into law a bill to join the Interstate Compact for Licensed Professional Counselors.
  • Virginia has had significant activity over the past week:
    • The state has enrolled the Audiology and Speech-Language Pathology Interstate Compact (HB 2033). The bill will become law if signed by the governor or if the governor does not act within 30 days of the date of adjournment under the terms of the state constitution.
    • Virginia has also enrolled a bill (HB 2374) prohibiting pharmacies and pharmacists from refusing to fulfill prescriptions based solely on the fact that the prescriber used a telemedicine platform to provide services.
    • In addition, the state’s legislators have enrolled another bill (HB 1754) that modifies telemedicine exceptions for out-of-state doctors of medicine or osteopathy, physician assistants, respiratory therapists, occupational therapists or nurse practitioners. Specifically, under HB 1754, if such a practitioner with whom the patient has previously established a practitioner-patient relationship is unavailable when the patient seeks continuity of care, another practitioner of the same subspecialty at the same group practice with access to the patient’s treatment history may provide continuity of care using telemedicine services until the practitioner with whom the patient has a previously established relationship becomes available.
  • Texas has adopted rules to implement Code § 531.02161(b)(4), which requires Texas Health and Human Services to ensure that, if cost effective, clinically effective and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy, physical therapy and speech-language pathology, as a telehealth service. The adopted rules require initial eligibility and personal assistant services assessments to be completed in person unless certain conditions exist, in which case the assessment may be completed by telehealth, telephone or video conferencing.
  • In Washington, the two final rules concerning telehealth addressed in detail in last week’s post have gone into effect.

Legislation & Rulemaking Activity in Proposal Phase: 40

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Trending in Telehealth: February 13 – 19, 2023

Trending in Telehealth is a series from the McDermott Digital Health team where 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
  • Audiology and Speech Pathologists
  • Behavioral Health
  • E-Prescribing

A closer look:

Finalized Legislation & Rulemaking: 5

  • Wyoming has officially adopted the Psychology Interjurisdictional Compact (PSYPACT).
  • South Dakota has passed legislation that amends 36-37-7, which states that any person who is licensed pursuant to this chapter may provide speech-language pathology services via telehealth. Services delivered via telehealth must be equivalent to the quality of services delivered face-to-face. For the purposes of this section, the term, telehealth, has the meaning provided in § 34-52-1. The legislation also amends § 36-37-1 and removes the definition for “telepractice.”
  • Washington passed two final rules concerning telehealth:
    • WSR 23-04-048: This final rule promulgates regulations to align with recently passed legislation that, among other items, touches on consent when audio-only is used and store-and-forward services. The agency revised this part of the regulations to clarify that the patient consent to billing requirement applies to audio-only telemedicine services.
    • WSR 23-04-052: This final rule consolidates the telehealth sections into one and makes a technical correction on the use of telehealth for speech language pathology. Specifically, “speech language pathology services by telemedicine when not available in person” will be removed. This was added in a rule making during the public health emergency in error. The consolidated telemedicine rules apply to all programs and will reside in new WAC 182-501-0300.
  • Ohio passed a final rule concerning Medicaid reimbursement. The rule permits the use of Intensive home-based treatment (IHBT) via telehealth in accordance with rule 5122-29-31 of the Administrative Code.

Legislation & Rulemaking in Proposal Phase: 36

Highlights:

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Trending in Telehealth: February 6 – 12, 2023

Trending in Telehealth is a series from the McDermott Digital Health team where we track telehealth regulatory and legislative activity. Each week we will highlight 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
  • Interstate Compacts
  • Medical Cannabis
  • E-Prescribing

A closer look:

Finalized: 3

  • Ohio’s State Medical Board has adopted new telehealth rules via the issuance of three final rules: (1) implementing the requirements of the telehealth statute for physicians (MD, DO, and DPM), physician assistants, dietitians, respiratory care professionals and genetic counselors, (2) regulating controlled substances and telehealth prescribing and (3) rescinding past e-prescribing language. The rules will go into effect on February 28, 2023.

Proposed: 20

Highlights:

Why it matters:

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FTC Weighs-in on Telehealth: Providing Comments Regarding Alaska’s Proposed Licensure and Standard of Care Requirements

In March 2016, the US Federal Trade Commission (“FTC”) staff submitted public comments regarding the telehealth provisions of a proposed state bill in Alaska demonstrating the FTC’s continued focus on health care competition and general discouragement of anti competitive conduct in health care markets, with a renewed interest and focus on telehealth.

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New Year, New Telehealth Opportunities

As we reflect upon how the health care industry has changed in 2015 and what we expect to see in 2016, there is one area that stands out as having great promise for continued growth—telehealth.

  • There were more than 200 telehealth-related bills introduced in 42 states in 2015, many of which helped to encourage the growth and expansion of telehealth. More than half of the states now have laws that mandate some degree of coverage of telemedicine programs by private payers. In addition, nearly a quarter of the states have joined the Interstate Medical Licensure Compact, which provides a more streamlined licensure process for physicians who are located in a “Compact state” and who provide telemedicine services to residents of another “Compact state.” In 2016, we expect even more states will adopt laws to require health insurance coverage for telemedicine services and ease the licensure requirements for health care professionals who are engaged in multi-state telemedicine programs. See our article, “States Begin 2016 with the Expansion of Telehealth Services,” for additional details.
  • There has been a marked increase in consumer investment in personal health and wellness, partly as a cost reduction strategy in light of high-deductible health plans, over the past few years. Consumers are particularly excited about the possibilities of telehealth, which has spurred the expansion of direct-to-consumer telehealth programs. In 2016, we anticipate an increase in the number of consumers who use telehealth services, as well as an increase in the types of telehealth technologies used.
  • An increasing number of employers—ranging from big to small—offered telemedicine as a benefit to employees in 2015 in an effort to reduce health care costs and as a means of improving employee health. Given the broad breadth of coverage included in the cost of employer-sponsored coverages, and the desire for employers to improve employee health to increase productivity and satisfaction levels, we anticipate that even more employers will turn to telemedicine as a solution in 2016.
  • The telehealth programs of accountable care organizations (ACOs) and clinically integrated networks (CINs) proved to improve patient access to care (particularly in the area of behavioral health) and deliver quality care at a lower cost—a critical imperative in the post-Accountable Care Act era of value-based purchasing. The realization of these benefits in 2015 will likely contribute to an increase in the number of ACOs and CINs using telemedicine as a tool in 2016.
  • There was a marked rise in 2015 in the number of partnerships between U.S. health care providers and international institutions for U.S. physicians (particularly in certain orthopedic and oncology sub-specialty areas) to provide consultations to international physicians about their patient cases, as well as “second opinion” programs where U.S. physicians review the medical records and diagnostic tests of patients located abroad, and then render a second opinion to that patient. We anticipate that these international telemedicine arrangements will continue throughout 2016 as U.S. providers search for ways to expand their patient base and grow their brands internationally.

If these telehealth trends [...]

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