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Trending in Telehealth: May 14 – May 20, 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:

  • Reimbursement requirements
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Iowa’s Board of Physical and Occupational Therapy amended two rules, Chapter 201, relevant to physical therapists and Chapter 208, relevant to occupational therapists. These rules establish standards for telehealth visits for physical therapy and occupational therapy, permitting the use of audio or video equipment, or both, at the discretion of the licensee. In connection with the adoption of the revised rules, the board noted that the expansion was a response to public comment from ATA Action, the American Telemedicine Associate’s affiliated trade association, which urged the board to expand the modalities that can be used for telehealth appointments in the interest of expanding Iowa patients’ access to affordable, high-quality healthcare.
  • Maryland enacted HB 1127, which authorizes certain healthcare providers to provide sexual assault forensic exams conducted through “peer-to-peer telehealth” without charge to victims and makes those services eligible for reimbursement by the Criminal Injuries Compensation Board (CICB). The peer-to-peer telehealth modality permits the performance of a forensic examination using interactive audio, video, or other telecommunications or electronic technology by a forensic nurse examiner to assist in the performance of a forensic examination when the forensic nurse examiner is in one location and the patient is with a qualified healthcare provider in another location.
  • Maryland also enacted HB 1078, which requires Medicaid to provide remote ultrasound procedures and remote fetal nonstress tests in certain circumstances.
  • South Carolina enacted S 858. This bill adds acute hospital care at home programs as exempt from Certificate of Need review by the SC Department of Health and Environmental Control. “Acute hospital care at home” includes the utilization of technology to provide continuous remote patient monitoring and connectivity to the patient.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Colorado, SB 24-054 passed the first chamber. The bill requires all private insurance companies to provide coverage for the treatment of the chronic disease of obesity and the treatment of pre-diabetes, including coverage for intensive behavioral or lifestyle therapy, bariatric surgery, and FDA-approved anti-obesity medication. The definition of intensive behavioral or lifestyle therapy includes interventions virtually through telehealth.
  • In Michigan, HB 4580 and HB 4213 passed the second chamber. If enacted, HB 4580 would require telemedicine services to be covered under Medicaid if the originating site is an in-home or in-school setting, in addition to any other originating site allowed in the Medicaid provider manual. HB 4213 would also require Medicaid to cover telemedicine services, however, further clarifies the requirements for Medicaid coverage. First, HB 4213 requires Medicaid coverage parity for telehealth services. Additionally, HB 4213 requires coverage of [...]

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Trending in Telehealth: May 7 – May 13, 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:

  • Interstate compacts
  • Reimbursement requirements
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Mississippi enacted legislation, HB 764, which permits the State Board of Health to promulgate rules and regulations, and to collect data and information on the delivery of telemedicine services and the use of electronic records for the delivery of telemedicine services.
  • Alabama enacted legislation, SB 208, which adopts the Social Worker Licensure Compact.
  • The Texas Department of Licensing and Regulation adopted a rule for speech-language pathologists and audiologists confirming that direct and indirect supervision may be performed through tele-supervision and that in-person supervision is not required. This rule also allows a licensee providing telehealth services to provide proof of licensure to a requestor through the department’s online license search.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Colorado, SB 24-141 passed two chambers. If enacted, all healthcare providers who possess a license, certificate, registration or other approval as a healthcare provider in another state may provide healthcare services through telehealth to patients located in Colorado if the provider registers with the appropriate Colorado regulatory agency.
  • In Colorado, SB 24-168 passed two chambers. This bill requires the Department of Health Care Policy and Financing to provide reimbursement for the use of telehealth remote monitoring for outpatient services for certain Medicaid members.
  • In Minnesota, HF 4247 passed two chambers, which would allow transfer care specialists and veterinarians to provide “direct supervision” via telephone.
  • In South Carolina, H 5183 passed two chambers. This bill would allow for the delegation of nursing tasks, including the performance of nonclinical tasks via telemedicine.
  • In Tennessee, SB 2368 passed two chambers. If enacted, this bill would require that any policy, certificate or agreement for health insurance coverage under TennCare must include coverage for telehealth visits for complex rehabilitation technology.
  • Connecticut HB 5198 passed the second chamber. If enacted, this bill would make permanent certain temporary expanded requirements for telehealth services.
  • Several states saw activity related to interstate compacts.
    • Social Worker Licensure Compact
      • In Connecticut, HB 5197 passed two chambers.
      • In New Hampshire, SB 318 passed one chamber.
      • In Tennessee, SB 2134 passed two chambers.
    • In Connecticut, HB 5058 passed two chambers, which would enact the Nurse Licensure Compact.
    • In Alabama, SB 207 passed two chambers, which would enact the Dietician Licensure Compact.
    • In South Carolina, S 610 passed two chambers, which would enact the Counseling Compact.

Why it matters:

  • States continue to increase activity surrounding licensure compacts for [...]

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Trending in Telehealth: April 30 – May 6, 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:

  • Interstate compacts
  • Professional standards
  • Reimbursement requirements

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • Iowa enacted HF 2402, which requires the Iowa Department of Health and Human Services to review and update its administrative rules regarding psychiatric medical institutions for children (PMICs), including the review of rules related to the use of telehealth services to conduct post-restraint and seclusion assessments.
  • Iowa enacted HF 2512, which adopts the Social Worker Licensure Compact.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Louisiana, HB 896 passed one chamber. This bill establishes the Louisiana Remote Patient Monitoring Program Law, which allows remote patient monitoring services provided through telehealth for patients who meet certain criteria as outlined in the bill.
  • In Connecticut, HB 5198 passed one chamber. If enacted, this bill would make permanent certain temporary expanded requirements for telehealth services. These expanded provisions include the following: allows authorized telehealth providers to use audio-only telephone to provide services, allows authorized providers to provide telehealth services from any location to patients at any location, prohibits providers from charging uninsured patients more than the Medicare reimbursement rate for telehealth services, and prohibits health carriers from reducing the amount of reimbursement they pay to telehealth providers for covered services provided through telehealth.
  • In Colorado, HB 24-1045 passed the second chamber. This bill adds 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.
  • In Colorado, SB 24-141 passed one chamber. If enacted, this bill would allow a licensed out-of-state healthcare provider to provide telehealth services to patients located in Colorado if the provider registered with the appropriate regulator in Colorado.
  • In Hawaii, HCR 125 passed one chamber, which requests the establishment of a telehealth working group to examine the impact of widespread telehealth adoption during the COVID-19 pandemic and to identify public policy initiatives at the federal and state level to optimize telehealth utilization as the state transitions out.
  • Several states saw activity related to interstate compacts.
    • Michigan HB 4169 passed one chamber, which would enact the occupational therapy licensure compact.
    • In South Carolina, S 610 passed two chambers, which would enact the professional counseling compact.
    • In Alabama, SB 208 passed two chambers, which would enact the Social Worker Compact.
  • In Nevada, the Board of Dental Examiners published a proposed rule that expands requirements related to teledentistry. This rule specifies the circumstances under which a licensed provider may provide teledentistry services, including issuing prescriptions.
  • In Kansas, the Board of Pharmacy proposed a rule that sets forth requirements to establish a telepharmacy outlet, as well as requirements for the personnel who would staff the telepharmacy outlet. This rule [...]

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Trending in Telehealth: March 26 – April 1, 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:

  • Interstate compacts
  • Reimbursement requirements
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • West Virginia enacted SB 522, which specifies that an emergency medical services agency may triage and transport a patient to a destination other than a hospital, dialysis center, skilled nursing facility or residence within the state or treat the patient in place if the ambulance service is coordinating the care of the patient through medical command or telehealth services. The bill also requires insurance plans to provide coverage for those services. SB 522 further requires the West Virginia Office of Emergency Medical Services to establish related protocols by October 1, 2024.
  • West Virginia also enacted rulemaking pertaining to the practice of medical imaging and radiation therapy technologists. The rulemaking includes a provision stating that telehealth practice is inapplicable to the practice of a medical imaging and radiation therapy technologist.
  • Maine enacted LD 1965, which provides telehealth standards for optometrists, including requirements for establishing an optometrist-patient relationship via telemedicine. While the bill establishes new flexibilities to allow for telehealth and provides relevant practice standards and definitions for telehealth practice, it also includes limiting language requiring either an in-person visit or an established relationship with the patient.
    • For example, an optometrist-patient relationship is established when an individual agrees to receive ocular or healthcare services from the licensee and there has been an in-person encounter between the licensee and the individual, unless the standard of care requires that an individual be seen without an in-person visit, such as in an emergent situation as reasonably determined by the licensee.
    • The bill also provides a pathway for an optometrist-patient relationship in which a licensee who uses telehealth in providing care and a patient who receives telehealth services through consultation with another licensee or other healthcare provider and who has an established relationship agrees to participate in, or supervise, the patient’s care through telehealth.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • Three states – Kansas, Tennessee and Colorado – either introduced or progressed legislation relating to the Social Work Licensure Compact.
    • In Kansas, SB 2484 passed both chambers.
    • In Tennessee, HB 2405 also passed both chambers.
    • In Colorado, SB 24-1002 passed the first chamber.
  • In Arizona, SB 1173 passed both chambers. If enacted, the bill would adopt the Counseling Compact.
  • In Mississippi, SB 2157 passed the second chamber. If enacted, the bill would adopt the Psychology Interjurisdictional Compact.
  • In Tennessee, JB 2587 passed the second chamber. If enacted, the bill would revise the state’s insurance code to remove from the definition of “provider-based telemedicine” the requirement that [...]

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Trending in Telehealth: February 12 – February 26, 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:

  • Interstate compacts
  • Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

  • South Dakota enacted the Counseling Compact, making it the 33rd state to ratify the compact.
  • South Dakota also adopted HB 1029, which specifies that licensed hearing aid dispensers and audiologists can deliver services via telehealth provided they are of the same quality as services delivered face-to-face.
  • In Texas, the Commission of Licensing and Regulation adopted rules that reorganize and revise telehealth standards for behavioral analysts. The changes include better aligning the telehealth practice standards with those for other professions regulated by the Department of Licensing and Regulation. Similarly, the Commission of Licensing and Regulation adopted a rule addressing supervision for behavioral analysts, which includes provisions addressing supervision via telehealth.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

  • In Arizona, SB 1036 passed the first chamber. If enacted, the bill would enact the Social Work Licensure Compact.
  • In Florida, SB 7016 passed both chambers. If enacted, the bill would enter Florida into the Interstate Medical Licensure Compact.
  • In Louisiana, the Behavior Analyst Board proposed rules governing behavioral analyst practice, including establishing telehealth practice standards.
  • In Oklahoma, the Board of Examiners in Optometry proposed rule 505:10-5-19 that would address telemedicine practice by optometrists and, among other things, prohibit an optometrist from prescribing contact lenses or spectacles via a telemedicine encounter. The rule would also establish requirements for informed consent and practice requirements associated with a telemedicine visit.
  • In Tennessee, SB 2134 and HB 2405 each passed one chamber. If enacted, the bills would enact the Social Work Licensure Compact.
  • In Utah, SB 24 passed both chambers. If enacted, the bill would require Medicaid reimbursement for telepsychiatric consultations between a physician assistant and a psychiatrist. The law currently requires reimbursement only for telepsychiatric consultations between a physician and a psychiatrist.
  • In Virginia, HB 326 passed the first chamber. If enacted, the bill would enter Virginia into the Counseling Compact.
  • In West Virginia, HB 4110 passed the first chamber. If enacted, the bill would authorize the state’s Board of Licensed Dietitians to promulgate a legislative rule relating to telehealth practice, requirements and definitions.
  • In Wisconsin, SB 158 passed both chambers and awaits the governor’s signature. If enacted, the bill would enact the Social Work Licensure Compact.

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 [...]

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