Trends in Telehealth highlights state legislative and regulatory developments that affect healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate virtual care.

Last week’s trend:

  • Interstate compacts
  • Compensation requirements
  • Professional standards

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Final Legislation and Rulemaking:

  • I Colorado, SB 24-168 Signed by the governor, it requires reimbursement for remote monitoring for outpatient services for certain Medicaid members. The bill also creates a grant program to provide grants to outpatient health care facilities in rural areas to help with the cost of providing telehealth remote monitoring, recognizing the cost of setting up these programs. These parameters will come into effect from July 1, 2025. The bill also requires the state to cover continuous glucose monitors for Medicaid members.
  • Florida Implemented HB 855, which addresses teledental treatment, specifically dental care delivered via telehealth requires a disclaimer that an in-person visit is recommended prior to telehealth treatment. This bill will come into effect from July 1, 2024.
  • Mississippi Final a leadership which removed the restrictions for telehealth visits with a Level IV or V diagnosis and management code to be reimbursed by the state’s Medicaid program.
  • Tennessee Enacted several bills related to telehealth:
    • HB 2857: In the realm of general health care insurance laws, Bill Tenn. Revises the definition of “provider-based telemedicine” in Code Ann. § 56-7-1003 to remove requirement that patient establish provider-patient relationship through in-person visit within 16 months prior to telehealth visit; An in-person visit is still required, but does not need to be within the 16-month look-back period. The bill came into effect on May 28, 2024.
    • HB 2318: The bill allows a physician assistant who works entirely via telehealth to arrange for a physician assistant to request a review of the physician assistant’s charts or records completed by electronic means in accordance with HIPAA. Can arrange any required visits by a collaborating physician at any remote site. Compared to a clinic setting. The bill also removes telehealth as an option. The bill came into force on 28 May 2024.
    • HB 2147: The Tennessee Medicaid program, TennCare, is now required to cover complex rehabilitation visits that are performed via telehealth. It is effective from July 1, 2024.
    • HB 2808: Tennessee now requires that health care services provided to inmates for treatment of human immunodeficiency virus (HIV) be provided via telemedicine, if requested and to cover the treatment. Copayments are made through various state programs, including TennCare. This bill will come into effect from July 1, 2024.
  • Vermont made law by H 861 Which requires parity for health care services provided via telemedicine, which applies to health care insurance plans. This bill will come into effect from January 1, 2025.
  • Several states have enacted compact legislation:
    • Colorado signed HB 24-1002which implements the Social Work Licensing Compact.
    • Connecticut Implemented HB 5058Join the Nurse Licensure Compact.
    • New Hampshire Implemented SB 318Entering into the Social Work Licensure Compact.
    • Ohio Implemented SB 90Entering into the Social Work Licensure Compact.
    • Vermont Implemented H 247adoption of the Occupational Therapy Licensure Compact.
    • Tennessee Implemented HB 2405which implements the Social Work Licensing Compact.
    • Tennessee Also implemented HB 1863which implements the Dietitian Licensure Compact, becomes the third state to enter into the compact.

Legislation and rulemaking activity in the proposal stage:

Highlights:

  • I Washington DCsigned by the mayor. B 25-0545, which includes a new “telehealth” section in the General Health Professions Act. It now clearly states that a practitioner-patient relationship can be established through telehealth, involving both synchronous and asynchronous technologies. It has now passed congressional review and, if passed, will go into effect on June 28, 2024.
  • LouisianaOf HB 896 It passed another chamber last week, which would create a remote patient monitoring program and details surrounding coverage under the Louisiana Medicaid program. It now goes to the governor for signature.
  • Louisiana Also sent HB 888 After approval by the Senate, the governor to sign, which will enter the state into the Social Work Licensure Compact.
  • Montana proposed a rule which would harmonize the standards for home health services with existing federal guidelines at 42 CFR 440.70. This will enable face-to-face appointments through telemedicine. Previously, this rule did not address telehealth. Hearing will be held on June 13, 2024 with comments on June 21, 2024.
  • gave New York Assembly passed. A6799Bwhich establishes a drug-induced movement disorder screening education program, and specifically includes services provided through telehealth.

Why this is important:

  • Interstate compacts continue to grow, with smaller compacts seen expanding in 2024.. We continue to see states actively adopting interstate compacts. During the week of May 28 – June 3, seven new bills were introduced, including states in various compacts. This demonstrates the value that states are finding in compacts to help address health care workforce shortages. In the Social Work Licensure Compact alone, four new states have enacted bills in the past two months, and the Dietitian Compact now has three fully-adopted members with Ohio pending legislation. These compacts are not yet as widely adopted as nursing and physician compacts, but they are growing rapidly.
  • States continue to revise reimbursement requirements for telehealth at both the Medicaid level and generally applicable health plan laws. This month, Colorado, Tennessee, Mississippi and Vermont finalized or implemented changes to how they pay for telehealth services. These states are pushing for clear reimbursement guidelines and, in particular, reimbursement equity for services provided through telehealth. These changes are usually in rules specific to the type of services, for example, Tennessee’s new reimbursement requirements under the state’s Medicaid program for complex rehabilitation care provided via telehealth. HB 2147. However, states are taking broader steps to address telehealth reimbursement. of Vermont H 861 Require telemedicine to be paid at the same rate as in-person care, a sweeping overhaul of the rules governing health care insurance plans. Another interesting development this week was the addition of grant programs in addition to reimbursement requirements in Colorado. SB 24-168Regarding remote monitoring of outpatients. States have continued to focus on telehealth reimbursement since the start of the pandemic, and based on this week’s activity, we expect requirements and standards to continue to evolve.
  • Standards of practice for care delivered through telehealth are being streamlined. States continue to make changes to harmonize telehealth standards across practice areas. This is demonstrated by Proposed Rule in Montana that aligns home health services standards with federal guidelines at 42 CFR 440.70, which, if adopted, would allow the use of telehealth services. This week also saw big changes at the program level in Louisiana. HB 896 Heading to the governor for signature, it would create standards for remote patient monitoring and reimbursement requirements around the program. Additionally, this week saw both major changes to practice standards (as seen in Louisiana and Washington, DC) and small practitioner-specific or specialty-level changes (as seen in Montana and Tennessee). are provided. This comparison emphasizes the importance of being aware of changes at the general health provider level, reimbursement requirements, and changes at the level of specific provider types to ensure that telehealth services provide All revised practice standards should be considered while doing so.



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