Trending in Telehealth is a series from the McDermott Digital Health team where we highlight 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:

• Interstate Compacts

• Audiology and Speech Pathologists

• Behavioral Health

• E-Prescribing

A closer look:

Finalized Legislation & Rulemaking: 5

• Wyoming has officially adopted the Psychology Interjurisdictional Compact (PSYPACT).

• South Dakota has passed legislation that amends 36-37-7, which states that any person who is licensed pursuant to this chapter may provide speech-language pathology services via telehealth. Services delivered via telehealth must be equivalent to the quality of services delivered face-to-face. For the purposes of this section, the term, telehealth, has the meaning provided in § 34-52-1. The legislation also amends § 36-37-1 and removes the definition for “telepractice.”

• Washington passed two final rules concerning telehealth:

  • WSR 23-04-048: This final rule promulgates regulations to align with recently passed legislation that, among other items, touches on consent when audio-only is used and store-and-forward services. The agency revised this part of the regulations to clarify that the patient consent to billing requirement applies to audio-only telemedicine services.

  • WSR 23-04-052: This final rule consolidates the telehealth sections into one and makes a technical correction on the use of telehealth for speech language pathology. Specifically, “speech language pathology services by telemedicine when not available in person” will be removed. This was added in a rule making during the public health emergency in error. The consolidated telemedicine rules apply to all programs and will reside in new WAC 182-501-0300.

• Ohio passed a final rule concerning Medicaid reimbursement. The rule permits the use of Intensive home-based treatment (IHBT) via telehealth in accordance with rule 5122-29-31 of the Administrative Code.

Legislation & Rulemaking in Proposal Phase: 36

Highlights:

• In Tennessee, a bill has passed both chambers that prohibits the use of telehealth performed on a minor for a medical procedure related to discordance between a minor’s sex and identity.

• In Virginia, a bill has passed both chambers that modifies licensing exceptions for out-of-state practitioners utilizing telemedicine for patients within the state who are in the same specialty and who belong to the same group practice.

• Wyoming has had its bill to establish the state’s participation in the Interstate Compact for Licensed Professional Counselors pass in both chambers.

• In Utah, a bill has passed both chambers that repeals sections of law related to establishing a provider-patient relationship for purposes of prescribing. Another telehealth-related bill passed both chambers, and it allows an individual who holds a health care license from a different state to provide telehealth services to individuals located in Utah under certain circumstances. The bill also removes restrictions on the provision of remote mental health therapy and remote substance use disorder counseling.

Why it matters:

• The effort to join interstate licensure compacts continues to rise as the public emergency draws to a close. Wyoming’s enactment of its bill to enter PSYPACT, and the advancement of its bill to enter the Interstate Compact for Licensed Professional, represent a continued effort by lawmakers to improve access to care for the state’s residents. Other states have pushed to join these interstate compacts in 2023, seeking to ease the requirements for out-of-state licensed providers and, in turn, increase the network of available providers via telemedicine.

• Telehealth is increasingly being used for specialty medical needs. This week saw legislation and regulations aimed at advancing telehealth services in the context of tele-behavioral health, remote substance use disorder counseling, and tele-audiology and remote speech-language pathology. Telehealth can mitigate issues traditionally associated with seeing specialists, such as the cost of services, the shortage of providers in rural and underserved communities, the inconvenience of travel, and other disparities related to access.

• Tennessee’s legislation proposes to restrict telehealth services for gender-affirming care (GAH) for transgender youth. As noted above, telehealth can reduce access barriers for underserved populations and thus could be particularly beneficial for reaching transgender youth. Concerns, however, surrounding the appropriateness of telehealth-delivered GAH for minors and its related health outcomes remain high in various states.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott Digital Health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care and mitigate enforcement risk through proactive compliance.