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Policy Library

Make Telehealth Available For All Those Who Need It

Telehealth has become a necessity in response to the COVID-19 pandemic, but has not been available to all who need it. In addition to in-person options, it can expand healthcare, including mental and behavioral services, for rural communities, parents, caretakers, working people, people who cannot leave home,and other communities underserved by existing in-person medical services. The Expanding Healthcare Through Telehealth Act ensures that telehealth options are covered by insurance in addition to in-person care.

The National Landscape

Passed in:

Colorado (1234), New Hampshire (12), Virginia (123)

Introduced in:

Arizona, Hawaii, Minnesota, Wisconsin

In The News

“As the nation gingerly begins to reopen, many providers say that remote therapy is working so well and offers such convenience to their patients that they will continue with it even after the pandemic.”
“‘If telehealth was not available, I fear that we would have gotten to her diagnosis too late, and the cancer would have spread’ said Dr. James Weber, CEO of Texas Digestive Disease Consultants, where Ramos works. ‘Telehealth access most certainly allowed us to take care of this patient and likely save her life.’”
“‘Telemedicine can be an equalizer in the sense that it allows greater distribution of the good stuff medicine has to offer across geography and socioeconomic levels,’ said Hanson, of Penn. Virtual visits may be more accessible for people who lack transportation, can’t take off work, or don’t have child care — barriers that disproportionately affect low-income communities.”

Partners

  • Patient advocates
  • Rural communities
  • Healthcare professionals

Opposition

  • Health insurance providers
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FAQ

Who does this help?
Affordable telehealth options benefit everyone who would like convenient access to medical care, particularly benefiting people in rural and underserved communities, and those whose personal obligations too often lead to foregoing healthcare services. Telehealth is also an effective and efficient form of receiving mental health services and other medical services for patients who have frequent visits or who generally find appointments more comfortable at home or in familiar spaces.
Is this high cost for the state government?
No, this bill focuses on ensuring that private insurance providers provide the same coverage and reimbursement for telehealth as they do for in-person services which will reduce overall healthcare costs as fewer people forgo needed services and inconvenient in-person visits.
Print

Model Policy

SECTION 1 (TITLE):
This act shall be known as the Expanding Healthcare Through Telehealth Act.

SECTION 2 (PURPOSE):
This act expands the definition of telehealth services and provides coverage and reimbursement parity for telehealth services.

SECTION 3 (PROVISIONS):

(a) It shall be the policy of the state to promote telehealth and mitigate geographic or economic discrimination in the delivery of healthcare telehealth services provided that such services are performed by a healthcare practitioner or professional acting within the scope of practice of such healthcare practitioner or professional.
(b) Definitions. As used in this Act:
  • (i) “Telehealth services” means healthcare services delivered by means of real time two-way audio, visual, or other telecommunications or electronic communications, including the application of secure video conferencing or “store and forward” transfer technology to provide or support healthcare delivery, which facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient's healthcare by a healthcare provider practicing within his or her scope of practice as would be practiced in-person with a patient, and legally allowed to practice in this state, while such patient is at an originating site and the healthcare provider is at a distant site, including
  • (1) clinical care;
  • (2) health education;
  • (3) health administration;
  • (4) home health;
  • (5) mental health services;
  • (6) substance abuse treatment;
  • (7) facilitation of self-managed care and caregiver support; and
  • (8) remote patient monitoring.
  • (ii) “Distant site” means a site in STATE at which a healthcare provider is legally allowed to provide telehealth services.
  • (iii) “Originating site” means a site in STATE at which a patient is receiving telehealth services.
  • (iv) “Store and forward” means the transmission of a patient's medical information either to or from an originating site or to or from the provider at the distant site, but does not require the patient to be present and is not required to take place in real time.
  • (v) "Carrier" means an insurance company, health service corporation, hospital service corporation, medical service corporation, or health maintenance organization authorized to issue health benefits plans in this State.
(c) STATE Medicaid programs shall provide coverage and payment for expenses incurred in the delivery of healthcare through telehealth services. The coverage shall be provided to the same extent as for any other healthcare services.
(d) A carrier that offers a health benefits plan in this STATE shall provide coverage and payment for expenses incurred in the delivery of telehealth services. The coverage shall be provided to the same extent as for any other healthcare services.
(e) No carrier shall exclude a service for coverage or reimbursement solely because the service is provided through telehealth services.
(f) No carrier shall impose any annual or lifetime dollar maximum on coverage for telehealth services other than a maximum that applies to in-person care.
(g) A carrier shall apply the same copayment, coinsurance, or deductible amount to telehealth services and the amount shall not exceed the amount applicable to those services when provided through in-person care.
(h) No carrier may limit a physician’s choice of technological platform for providing telehealth services and shall not require a particular technological platform to receive reimbursement.
(i) No carrier may limit the type of originating or distant site to withhold or reduce coverage or reimbursement.
(j) Telehealth services shall conform to the standard of care applicable to the telehealth service provider’s profession.