Telehealth Policies Gain Steam in State and Federal Governments

By Yara Souza, contributor

In response to pressures to control costs, improve quality and expand coverage, momentum to accelerate the use of telehealth is rising on a state and national level.

One prominent example is newly crafted legislation that would allow doctors to apply for interstate licensure, effectively expanding their ability to provide patient care via telehealth across state lines. Legislation developed by the Federation of State Medical Boards (FSMB) and supported by the Obama administration would allow the creation of multi-state compacts for the licensing of doctors, according to 
The New York Times. The initiative also has received bipartisan support in Congress. If approved, it would represent the biggest piece of change in medical licensing in decades. 

Bruce Carothers, Vice President of Telehealth Solutions for AMN Healthcare, said that the current patchwork of state-by-state regulation on licensing would dramatically improve if the FSMB effort is successful, and that could greatly improve the practice of telehealth. He noted that more states are adding coverage policies for telehealth.

“More than 20 states now mandate commercial insurance payer reimbursement for some telehealth services, which has grown from only 10 states just a few years ago,” Carothers said.

The FSMB also recently developed a 
comprehensive document of model state regulations that would create uniform definitions and protocols for telehealth while removing regulatory barriers to telehealth adoption. Carothers said that the model policies, if widely adopted, would streamline and standardize policies on how state medical boards regulate telehealth.

Other recent advancements in telehealth policy include: 

  • Proposed payment and services changes: The Centers for Medicare & Medicaid Services (CMS)plans to expand reimbursement for new telehealth services in 2015 under the Medicare Physician Fee Schedule. As part of the proposed update, payment rates would be up for public input before they are set. The CMS proposed adding annual wellness visits and psychotherapy as services that can be offered via telehealth for Medicare beneficiaries.
  • Calls for change: Powerhouses Qualcomm and Intel, accountable care organizations (ACOs) and trade groups such as the American Telemedicine Association, the Telecommunications Industry Association and the Alliance for Connected Care have penned letters to newly confirmed Secretary of Health and Human Services Sylvia Matthews Burwell, calling for timely attention to telehealth reform. They refer to currently pending bills such as HR 3077, the Telemedicine for Medicare Act, which would enable doctors and nurses to treat patients via telehealth across state lines without multiple state medical licenses.  
  • Technological upheaval: In addition to state medical boards and various industry groups, the Federal Communications Commission is becoming increasingly involved in supporting technological infrastructure updates to support telehealth. According to mHealthNews, a project has been launched to fund broadband connectivity in rural areas to be used for telehealth, which could connect rural providers, urban specialists, research centers and health information exchanges. 

Attention to the expansion of telehealth through these regulatory and technological changes is clearly increasing, Carothers said. 

“Healthcare has always been a late adopter of technology, but this is changing rapidly alongside CMS incentives to adopt electronic medical records systems, as well as dramatic growth in smartphone/iPad use by younger physicians and nurses,” he said.