Telehealth Thwarted by Lack of Legislative Clarity

Telehealth Thwarted by Lack of Legislative Clarity

A study by the Center for Connected Health Policy (CCHP) finds that ambiguous state laws regulating telehealth continue to restrict the expansion of the healthcare delivery method.

“Expansion of the use of telehealth to deliver care has not moved as rapidly or expansively as state policymakers may have envisioned,” the report stated. Lack of clarity in the language of private payer laws provide discretion to each private payer  to establish disparate policies that may prove restrictive, the study found. The study also said,  “Lack of distinction or clarity regarding he type of modality of telehealth to be covered is another factor that contributes to the slow uptake of telehealth care.”

Telehealth and States

So far, 31 state states and the District of Columbia have enacted telehealth private payer laws. Based on a scoring scale CCHP developed for the study, Minnesota is the only state receiving a a perfect score on all 14 criteria. All states included live video in their definition of telehealth, but store-and-forward and remote patient monitoring appeared less frequently. It is less likely these are recognizable costs in these states.

State laws tended to not include limitations on reimbursement on where the patient is located at the time of service based on geography, site, or the type of provider and services. Federal Medicare program rules restrict these facets in some way, CCHP said. Only three of the 32 states and districts included an explicit mandate for equal payment regardless of whether the service was delivered in person or via telehealth.

Recommendation

CCHP recommends policymakers and advocates may want to:

  • Consider explicit language detailing the exact intent of policymakers, such as ensuring all modalities are to be reimbursed by private payers.
  • Ensure payment parity language is included if the intent of policymakers is to have telehealth reimburse at the same rate as face-to-face services.
  • Consider inclusion of an educational component for providers and patients.
  • Consider a robust, comprehensive telehealth policy with the state Medicaid program.
  • Work with state licensing boards to create telehealth policies allowing licensee the flexibility to utilize technologies in delivering care while taking into consideration the patient’s safety.
Brad Ericson

Brad Ericson

Director of Publishing at AAPC
Brad Ericson, MPC, CPC, COSC, has been director of publishing for more than 10 years. Before AAPC he was at Optum for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.
Brad Ericson

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Brad Ericson, MPC, CPC, COSC, has been director of publishing for more than 10 years. Before AAPC he was at Optum for 13 years and Aetna Health Plans prior to that. He has been writing and publishing about healthcare since 1979. He received his Bachelor's in Journalism from Idaho State University and his Master's of Professional Communication degree from Westminster College of Salt Lake City.

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