As we reported earlier this year, Florida recently passed a new bill that brought significant changes to the state’s current telehealth laws—so much so that, as mHealth Intelligence first reported, Florida’s medical board voted to completely do away with their telehealth guidelines in favor of the new law. It seems likely the medical board will, in fact, abolish the telehealth guidelines they currently have. However, they are now determining whether they should draft new guidelines to support the ones in H.B. 23. The new law adds definitions for telehealth, including for asynchronous and store-and-forward services, while maintaining Florida’s prohibition of the use of e-mail, fax, and audio-only visits. Probably the most surprising thing about the new law, though, is the loophole it creates for out-of-state providers. Under H.B. 23, out-of-state telehealth providers can treat Florida residents without paying any fee to the state—and from a look at the legislative history, the loophole was not intended. As mHealth Intelligence explains, “The original bill had called for a $150 fee charged to out-of-state providers to treat Florida residents, but state statutes mandate that fees be addressed in a separate bill.” Unfortunately, the bill that contained the fee law for out-of-state providers was vetoed, thus creating the loophole.
The chairman of the Florida Board of Medicine, Steven
Roisenberg, is concerned about what the loophole means for Florida providers. “It means that the Florida physicians who pay licensing fees
here will absorb the costs of physicians who are out of state,” he said. “And
if there is a problem or complication as a result of a physician being licensed
out of state, those patients are ultimately going to be seen in the emergency
rooms and treated here in Florida at the expense of the Florida health care
system.” As a result, the medical board may put some guidelines in place to
address that concern.
As a reminder, the new law does not provide for payment parity. Payers and providers can negotiate their own rates, but providers are not mandated to cover telehealth services at the same rate as in-person care. Only about 10 states mandate payment parity, while about 36 mandate coverage parity. Like Florida, Massachusetts and Pennsylvania have struggled to get legislation passed that mandates same-rate coverage for telehealth and in-person services.