Trending in Telehealth highlights state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate the delivery of virtual care.

Trending in the past week:

• Professional Practice Standards

A CLOSER LOOK

Finalized Legislation & Rulemaking

• A law creating the Continuum of Care Program in Arkansas went into effect on July 31, 2023, permitting care coordination of certain reproductive health services to be conducted via telemedicine.

• Illinois updated the Hearing Instrument Act, allowing patients 18 years or older to be evaluated for a hearing aid prescription via telehealth. Patients who are 17 years or younger still must have an in-person visit to obtain a prescription. These updates are not effective until January 1, 2024.

• The Medical Care Program in Maryland adopted updated standards for physical therapy services provided via telehealth. This update generally aligns those requirements with broader telehealth standards in the state.

• Massachusetts passed an emergency rule permitting mobile crisis intervention care to be provided via telehealth and still be eligible for reimbursement under government health care programs. These emergency measures went into effect on August 1, 2023, and will be made permanent pending federal approval.

• Oklahoma revised the standards surrounding community mental health centers (CMHCs) and certified community behavioral health clinics to add telehealth encounters to the definition of “face to face” visits. This term is used to determine psychotherapy or therapy services provided by CMHCs, which provide certain assessments and emergency services throughout the community.

• The Kentucky Board of Optometric Examiners updated telehealth standards for optometrists, including regulations permitting the provision of services by optometrists physically located outside of Kentucky, via telehealth in certain situations.

• Kentucky also passed an emergency rule to address the shortage of social workers. Unlike optometrists, social workers must be physically located within the Commonwealth to use telehealth to care for Kentucky patients.

• Texas passed an amendment to the physical therapy practice standards for early childhood intervention care, which permits certain previously onsite-only care to be conducted via telehealth.

• New standards related to the use of telemedicine within the practice of occupational therapy in Wisconsin have gone into effect as of August 1, 2023. To note, the initial regulations proposed were not fully accepted, the Wisconsin Occupational Therapists Affiliated Credentialing Board adjusted the regulations after the public comments.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• The Alabama State Board of Pharmacy proposed remote pharmacy work regulations to align with the general pharmacy standards in Ala. Code §34-23-30(a), detailing which pharmacy activities can occur outside the physical pharmacy or facility.

• Similar to the emergency rule detailed above, Kentucky proposed new standards for social workers using telehealth when not licensed in the Commonwealth. This proposal is likewise partially motivated the shortage of social workers.

Why it matters:

• As we’ve seen in prior weeks, states continue to focus on creating or amending professional practice standards to incorporate telehealth. The proposed and adopted rules in Wisconsin, Illinois, Kentucky and Oklahoma support expanded use of telehealth in more services, and by different types of providers. Kentucky’s update to optometrist standards, its proposed update to social worker standards, and Wisconsin’s update to occupational therapy standards all create new opportunities for telehealth practice.