State laws are rapidly changing to be more accommodating to
telehealth, notes the American Telemedicine Association (ATA). As mHealth
Intelligence first reported, the organization conducted a survey this
year to see what has changed, if anything, with states’ adoption of telehealth
laws since 2017. The survey noted several things, but the most prominent trend
discovered by the survey is not the most comforting. Specifically: Despite substantial
progress towards improving telehealth coverage and reimbursement throughout the
country, “each state is doing its own thing with connected care.” This
presents a unique challenge for telehealth providers wishing to practice in
multiple states. And even though the report saw an overall growing support for
telehealth, some states are at a loss to broaden telehealth implementation
statewide due to a lack of authority and resources.
Here are just some of the main points from the full report, 2019 State of the States Report: Coverage and Reimbursement, which can be found on the American Telemedicine Association web site. The report can be broken down into about five main categories: patient setting, technology, provider types, Medicaid coverage, and private payer coverage. In regards to patient setting, since the 2017 ATA survey, a small number of states have changed their rules regarding originating sites, but the larger majority do not give any specific location as to where a patient must be in order to receive medical attention through telehealth. The technology allowed to facilitate a telehealth interaction has also changed since 2017, and more states are permitting the use of asynchronous store-and-forward and remote patient monitoring: “According to the ATA, the eight most common medical specialties allowed by states to use telehealth are physicians, physician assistants, nurse practitioners, licensed mental health professionals, occupational therapists, physical therapists, psychologists and dentists.” Many states are now mandating that Medicaid cover telehealth services as they would in person, and more than half of the states are requiring reimbursement for telehealth services to be the same as it would be for an in-person service. Lastly, more states regulate private payer coverage for telehealth, with 16 states requiring payment parity.
The ATA survey, as mHealth Intelligence sums up, “points to a slowly improving landscape and a move toward more coverage and reimbursement,” “evidenced by the news that 40 states and the District of Columbia have ‘adopted substantive polices or received awards’ to improve their telehealth rules since 2017.” The survey should is a good resource for practitioners and other telehealth providers on what is happening in their states, and perhaps a source of hope for the future of telehealth; however, as the landscape is quickly changing, providers will need to stay abreast of state legislation and medical board policies.