Telemedicine bills in state hoppers

While their colleagues in Washington are starting to take interest in the promises of digital health, lawmakers in several states are forging ahead with their own legislative ideas.

According to the American Telemedicine Association, seven states and the District of Columbia have seen bills introduced in the past four weeks that address coverage and reimbursement for telemedicine services. To date, 16 states have mandated that all private payers in the state reimburse for telemedicine services if such services would be reimbursed through an in-person visit.

[Since we reported this story, more states have introduced legislation: States removing telehealth barriers.]

While their colleagues in Washington are starting to take interest in the promises of digital health, lawmakers in several states are forging ahead with their own legislative ideas.

According to the American Telemedicine Association, seven states and the District of Columbia have seen bills introduced in the past four weeks that address coverage and reimbursement for telemedicine services. To date, 16 states have mandated that all private payers in the state reimburse for telemedicine services if such services would be reimbursed through an in-person visit.

That increase in legislative interest was highlighted in a recent article written by ATA CEO Jonathan Linkous titled "Public Policy for Telehealth in 2013: It's Time for Government to Lead or Get Out of the Way." In it, Linkous said he expects this year to be one of significant growth for the telehealth movement.

[See also: Telemedicine for all.]

"After 40-plus years of development, telemedicine has finally come of age," Linkous wrote. "Whether you call it telehealth, mHealth or remote monitoring, the deployment of telemedicine is galloping. No longer relegated to demonstration grants or experimental research, mainstream medicine has joined up with Silicon Valley, private payers and consumer groups to make use of telecommunications technology to transform the delivery of care."

According to the ATA, since the beginning of 2013:

  • The District of Columbia has seen legislation filed by Councilwoman Mary Cheh that would require private health insurers and Medicaid to cover healthcare services via telemedicine, which is defined as "the delivery of healthcare services through the use of interactive audio, video or other electronic media used for the purpose of diagnosis, consultation or treatment."
  • In Connecticut, State Sen. Joseph Crisco Jr. has filed a bill that would require health insurers to cover services provider through "telecommunications technology."
  • In Florida, State Rep. Mia Jones has introduced a bill that would require insurers, including Medicaid, to provider coverage for telemedicine, extend Medicaid coverage for telemedicine to homecare services, provide coverage under the state plan or a waiver for home health services provided to eligible people with chronic conditions, and create a framework to allow for consults with practitioners and professionals in other states.
  • In Mississippi, State Sen. Terry Burton has introduced a bill that would require insurers to cover telemedicine services if they are the same as a person would get through an in-person visit; the bill would also authorize healthcare providers licensed in the state to provide treatment recommendations to a patient after a telemedicine consult.
  • In New Mexico, both State Rep. Stephen Easley and State Sen. Gerald Ortiz y Pino have filed bills requiring insurers to cover healthcare services provided via telemedicine.
  • In South Carolina, State Sens. Raymond Cleary III, Bradley Hutto and Greg Hembree have filed a bill that would require individual or group health maintenance organizations to cover telemedicine services.
  • In Indiana, State Sen. Vaneta Becker has filed a bill seeking to require Medicaid to reimburse certified home health agencies, federally qualified health centers and rural health clinics for telehealth services.
  • In Nebraska, State Sens. Amanda McGill, Brad Ashford and Annette Dubas have filed a bill that would authorize telehealth services for public school students. In addition, State Sen. Colby Coash has filed a bill that would require health insurers to cover the screening, diagnosis and treatment of autism in those under 21 years of age, as well as authorizing behavioral health treatment through telehealth. And State Sen. Peter Pirsch has filed a bill that would create a Telehealth Behavioral Services Program for youths involved in juvenile justice programs.

[See also: 5 ways telemedicine is driving down healthcare costs.]

In his article, Linkous decried the legislative barriers that have impeded the advance of telehealth.

"Since ATA was launched in 1993, the leading barriers to the deployment of telemedicine in the U.S. have almost all involved government policy: Reimbursement by Medicare and Medicaid, state-based standards of care and professional licensing, device regulation and telecommunications policy, just to name a few. To date, government has been telehealth's lagging partner," he wrote.

Linkous then predicted that 2013 would be a banner year for telehealth. He noted the 16 states that have adopted telehealth legislation as well as the 14 states that provide some coverage for telemonitoring and seven that cover video-based home care. He also highlighted California Rep. Mike Thompson's recently introduced Telehealth Promotion Act, new rules issued by the Federal Communications Commission regarding the rural health program, and impending regulations from the Food and Drug Administration governing mobile medical devices.

"So 2013 will be chock-full of activity," Linkous concluded. "It is a year for federal and state governments to play catch-up with the rest of the health and technology sectors by either supporting the use of telemedicine or at least by ceasing to be a roadblock in its pathway to the future."