teleprescribing Archives - OF DIGITAL INTEREST

teleprescribing

Trending in Telehealth: May 2– 8, 2023

by Lisa Mazur, Amanda Enyeart and Taylor Hood | May 12, 2023 | Telehealth

Trending in Telehealth is a series from the McDermott digital health team in which we highlight state legislative and regulatory developments that impact healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate virtual care.

Trending in the past week:

Maternal Health
Licensure/Prescription Flexibilities
Interstate Compacts

A CLOSER LOOK

Finalized Legislation & Rulemaking
Highlights:

Georgia enacted SB 106 also known as the Healthy Babies Act. The legislation, sponsored by Senate Majority Caucus Senator Larry Walker III, creates a three-year pilot program for remote maternal health services via the Georgia Department of Community Health. Beginning in FY 2024, the program will provide remote monitoring for pregnant women under the state’s Medicaid program. State legislators prioritized this bill in an effort to increase benefits for at-risk mothers in underserved rural communities. The program’s expanded benefits aim to encourage expecting mothers to utilize prenatal care.
Montana enacted legislation, SB 112, creating a new section related to a pharmacist’s prescribing authority exception. The exception states that a pharmacist may prescribe a drug or device for a legitimate medical purpose, as allowed under this section, for a person with whom the pharmacist has a patient-prescriber relationship. Supporters of the bill cited access-to-care hurdles for rural communities that could otherwise be overcome by allowing pharmacists to serve as a point of first contact. The bill, modeled after similar legislation passed in Idaho, will allow patients to be treated for certain minor conditions without having to visit a doctor’s office. Montana also enacted legislation (SB 214) to enact the Audiology and Speech-Language Pathology Compact and Occupational Therapy Compact (SB 155).
Oklahoma enacted legislation, SB 754, authorizing licensed dentists to allow teledentistry treatment by certain dental hygienists for patients in certain long-term care settings.

Legislation Rulemaking Activity in Proposal Phase
Highlights:

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Teleprescribing of Controlled Substances Temporarily Extended Beyond PHE – What’s Next?

by McDermott Will & Emery | May 10, 2023 | Telehealth

The US Drug Enforcement Administration (DEA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) are extending telehealth flexibilities that allow providers to prescribe controlled substances. While the extension is in place, the DEA indicated that, in light of the 38,000 comments it has received, it will be further evaluating its recently proposed rules for post-PHE telemedicine prescription of controlled substances. Learn what stakeholders need to monitor during this time and what may be next from the DEA.

Read the On the Subject here.

Trending in Telehealth: April 11 – 17, 2023

by Marshall E. Jackson, Jr. and Jayda Greco | Apr 21, 2023 | Telehealth

Trending in the past week:

Interstate Compacts
Telehealth Coverage and Reimbursement
Informed Consent Standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

In North Dakota, HB 1095 was enacted. The legislation requires health carriers to, in part, provide coverage for licensed pharmacists to provide comprehensive medication management, which may be provided via telehealth. North Dakota also enacted HB 1530, which requires that Medicaid cover asynchronous teledentistry.
Florida enacted SB 300. The legislation prohibits physicians from using telehealth to provide abortions or prescribe abortion-inducing medication. It also requires the physical in-person presence of a physician with a patient when an abortion is performed or when abortion-inducing medication is dispensed.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

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Trending in Telehealth: March 20 – 27, 2023

by Patrick Zanayed and Ashley Ogedegbe | Mar 31, 2023 | Telehealth

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 virtual care.

Trending in the past week:

Interstate Compacts
Medicaid and Private Payor Reimbursement
Prescribing
Health Practitioner Licensing
Behavioral Health

A CLOSER LOOK
Finalized Legislation & Rulemaking

In Virginia, the governor signed two bills into law: House bill 1602 (HB 1602) and Senate bill 1418 (SB 1418), which together amend the Medicaid state plan. The bills specify that a healthcare provider duly licensed in the Commonwealth of Virginia who provides healthcare services exclusively through telehealth services is not required to maintain a physical presence in Virginia to be considered an eligible provider for enrollment.
In Tennessee, two bills were enacted and signed by the governor: House bill 895 (HB 895) and Senate bill 680 (SB 680). Together the bills clarify that the Medical Assistance Act of 1968 does not require a vendor, healthcare provider or telehealth provider group that provides healthcare services exclusively via telehealth to have a physical address or location in Tennessee in order to be eligible to enroll as a vendor, provider or provider group under the state’s medical assistance program.
South Dakota enacted House bill 1183 (HB 1183), which authorizes the state to participate in the interstate compact on occupational therapy licensure. The bill aims to ease the burdens of the licensing process and facilitate multijurisdictional practice for practitioners providing occupational therapy services in person and via telehealth services.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

In Arizona, a Senate bill (SB 1218) passed both chambers and would permit physicians to establish a doctor-patient relationship through “telehealth,” which includes asynchronous store-and-forward technologies, remote patient monitoring services and audio-only telephone encounters. This bill would expand the current law, which only permits real-time audio-visual services to establish a doctor-patient relationship.
A Vermont bill (H 411) proposes to extend the state’s telehealth COVID-19 registration for out-of-state healthcare professionals until a permanent telehealth licensure and registration system is operational. The registration, currently set to expire on June 30, 2023, expedites the licensure process for out-of-state healthcare professionals to provide telehealth services in the state. The bill also would extend waivers of certain telehealth requirements. For example, the bill would clarify that the state will not penalize providers for using telehealth services that do not comply with the requirements of the Health Insurance Portability and Accountability Act of 1996. The bill states that the extension of waivers is subject to federal law or guidance regarding enforcement discretion.
A Washington Senate bill (SB 5036) passed both chambers and would extend the timeframe in which real-time telemedicine services can be used to establish a provider-patient relationship. Under the bill, a [...]

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Trending in Telehealth: March 13 – March 19, 2023

by Stacey Callaghan, Amanda Enyeart and Ashley Ogedegbe | Mar 24, 2023 | Telehealth

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
Medicaid Reimbursement
Prescribing
Health Practitioner Licensing
Behavioral Health

A CLOSER LOOK
Finalized Legislation & Rulemaking:
It was a relatively slow week for finalized legislation and rulemaking, with the exception of significant activity in Utah:

House Bill 159 (HB 159) provides that healthcare practitioners who are licensed outside of Utah may temporarily provide telemedicine services to individuals within the state of Utah if such practitioners receive a temporary telemedicine license. Utah will issue a temporary telemedicine license if a healthcare practitioner completes an application for license by endorsement from the applicable licensing agency and the agency determines that it will not be able to process the application within 15 days after submission.
Senate Bill 269 (SB 269) requires the Utah Department of Health and Human Services to apply for a Medicaid waiver and, if the waiver is approved, contract with a single entity to provide coordinated care through certain virtual and electronic services, including telemedicine, video-consults and in-home biometric monitoring, for qualified individuals with certain chronic conditions.
House Bill 166 (HB 166) allows for the provision of remote mental health therapy or substance use disorder counseling to Utah patients subject to certain conditions, including but not limited to:
- The practitioner may not prescribe drugs unless she obtains a license in Utah to do so.
- The practitioner must know how to access emergency services and resources in Utah, and must be aware of applicable laws and rules regarding required or permitted reporting or disclosure of confidential client communications.
- The practitioner must notify the Utah Department of Health and Human Services that she is providing such remote services within one day of providing the services.
- The practitioner must obtain a Utah license within nine months after the day on which she first provides the services remotely in Utah, or if she provides the services remotely to more than one client in Utah.
House Bill 152 (HB 152) repealed certain sections of law to clarify that healthcare professionals offering telemedicine services may not diagnose a patient, provide treatment or prescribe a drug based solely on an online questionnaire, an email message or a patient-generated medical history.

Legislation & Rulemaking Activity in Proposal Phase
Highlights:

In Montana, a proposed bill (SB 155) would enact the Occupational Therapy Licensure Compact. The compact would ease licensing requirements for occupational therapists providing telehealth services in Montana and facilitate interstate exchanges of licensure and disciplinary information regarding providers between the states that join the compact.
In Arizona, a proposed bill (SB 1457) would permit licensed psychologists to prescribe [...]

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Trending in Telehealth: March 6 – March 12, 2023

by Marshall E. Jackson, Jr. and Ashley Ogedegbe | Mar 16, 2023 | Telehealth

Trending in the past week:

Interstate Compacts
Medicaid and Private Payor Reimbursement
Prescribing
Health Practitioner Licensing
Behavioral Health

A CLOSER LOOK
Finalized Legislation & Rulemaking:

In Oregon, the Workers’ Compensation Division of the Department of Consumer and Business Services adopted a final rule that updates and incorporates by reference the new medical billing codes and fee schedule for telehealth and telemedicine services published by the American Medical Association. The rule, which becomes effective on April 1, 2023, among other things, specifies that providers should use certain place of service codes to indicate where the provider provides medical services to a patient through telehealth (i.e., place of service code “02” to be used for “Telehealth provided other than in a patient’s home,” and place of service code “10” to be used for “Telehealth provided in a patient’s home.”). The rule also clarifies that modifier 95 should be used when a provider renders synchronous medical services via a real-time interactive audio and video telecommunication system (i.e., technology that permits the provider and patient to hear each other and see each other in real-time).
In Colorado, the Department of Health Care Policy and Financing adopted an emergency rule that aims to expand access to healthcare in rural communities by launching two new projects, the Health Care Access Project and the Health Care Affordability Project. The Health Care Access Project will, among other things, increase access to telemedicine, including remote monitoring support, while the Health Care Affordability project aims to modernize the information technology infrastructure of qualified rural providers through shared analytics and care coordination platforms, enabling technologies, including telehealth and e-consult systems, and funding for qualified rural providers to share clinical information and consult electronically to manage patient care. The projects are currently set to commence no earlier than July 1, 2023 and to conclude no later than December 31, 2026.
Texas passed two rules: the first rule clarifies that during telehealth sessions, chiropractors must conspicuously display a mandatory notice from the Texas Board of Chiropractic Examiners (Board) that provides patients with the Board’s contact information in the event that the patient wants to issue a complaint against the chiropractor, and the second rule clarifies that licensed marriage and family therapists that provide telehealth services must complete two hours of continuing education in technology-assisted services.

Legislation & Rulemaking Activity in Proposal Phase:
Highlights:

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Trending in Telehealth: February 27 – March 5, 2023

by Ashley Ogedegbe and Dale C. Van Demark | Mar 13, 2023 | Telehealth

Trending in the past week:

Interstate Compacts
Medicaid Reimbursement
Prescribing
Health Practitioner Licensing
Behavioral Health

A CLOSER LOOK
Finalized Legislation & Rulemaking: 10

Virginia continues to have significant activity:
- The state’s legislature “enrolled” or agreed to the final version of the Counseling Compact (HB 1433). If signed by the governor, the bill will be effective on January 1, 2024.
- Virginia legislators also finalized a separate bill (SB 1119) which modifies licensing exceptions for out of state practitioners utilizing telemedicine for patients within the state who are in the same specialty and who belong to the same group practice. The bill was sent to the governor for approval on March 2, 2023.
- A third bill (HB 1602) approved by legislators among other things, amends the state Medicaid plan by specifying that a health care provider duly licensed in the Commonwealth who provides health care services exclusively through telehealth services will not be required to maintain a physical presence in the Commonwealth to be considered an eligible provider for enrollment.
Colorado legislators passed bill (HB 1071) requiring licensed psychologists to obtain a prescription certificate from the Colorado Medical Board to administer or prescribe psychotropic medication via telepsychology. The bill was sent to the governor for approval on March 1, 2023.
In Tennessee, the governor signed a bill (SB 1) prohibiting the use of telehealth services for the benefit of a minor with respect to a medical procedure related to discordance between a minor’s sex and identity.
Utah legislators agreed to pass a bill (SB 237) that eases the supervision requirements for dental hygienists by authorizing the practice of dental hygiene in a public health setting without general supervision by a dentist, usually via teledentistry and electronic methods, and without a collaborative practice agreement with a dentist under certain conditions. The bill will be sent to the governor for approval.
New York has finalized a rule (NY A 2200) providing for patient prescription pricing transparency through “real-time benefit tools” (RTBTs) which are electronic prescription decision support tools that can integrate with a health care provider’s electronic prescribing system. The rule parallels the Medicare Advantage and Part D Drug Pricing Final Rule published by the Centers for Medicare and Medicaid Services which require Part D plans to offer RTBTs to enrollees starting January 1, 2023 so that plan enrollees can access formulary, cost-sharing, and benefit information in real-time and potentially find lower-cost alternatives under their prescription drug plan.