Trending in Telehealth is a new series from the McDermott Digital Health team in which 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

• Prescribing

• Health Practitioner Licensing

• Behavioral Health

A CLOSER LOOK

Finalized Legislation & Rulemaking: 7

• Wyoming has signed into law a bill to join the Interstate Compact for Licensed Professional Counselors.

• Virginia has had significant activity over the past week:

  • The state has enrolled the Audiology and Speech-Language Pathology Interstate Compact (HB 2033). The bill will become law if signed by the governor or if the governor does not act within 30 days of the date of adjournment under the terms of the state constitution.

  • Virginia has also enrolled a bill (HB 2374) prohibiting pharmacies and pharmacists from refusing to fulfill prescriptions based solely on the fact that the prescriber used a telemedicine platform to provide services.

  • In addition, the state’s legislators have enrolled another bill (HB 1754) that modifies telemedicine exceptions for out-of-state doctors of medicine or osteopathy, physician assistants, respiratory therapists, occupational therapists or nurse practitioners. Specifically, under HB 1754, if such a practitioner with whom the patient has previously established a practitioner-patient relationship is unavailable when the patient seeks continuity of care, another practitioner of the same subspecialty at the same group practice with access to the patient’s treatment history may provide continuity of care using telemedicine services until the practitioner with whom the patient has a previously established relationship becomes available.

• Texas has adopted rules to implement Code § 531.02161(b)(4), which requires Texas Health and Human Services to ensure that, if cost effective, clinically effective and allowed by federal law, a Medicaid recipient has the option to receive certain services, including occupational therapy, physical therapy and speech-language pathology, as a telehealth service. The adopted rules require initial eligibility and personal assistant services assessments to be completed in person unless certain conditions exist, in which case the assessment may be completed by telehealth, telephone or video conferencing.

• In Washington, the two final rules concerning telehealth addressed in detail in last week’s post have gone into effect.

Legislation & Rulemaking Activity in Proposal Phase: 40

Highlights:

• In Virginia, a Senate bill (SB 802)—the companion bill to a previously enrolled House bill (HB 1433)—has passed both chambers. The bill aims to enact the Counseling Compact for licensed professional counselors. The state has also passed in both chambers a bill (SB 1418) that modifies the state plan for medical assistance; more information about this bill can be found in an earlier post this month.

• In Utah, a bill has passed both chambers that removes restrictions on the provision of remote mental health therapy and remote substance use disorder counseling.

• In West Virginia, a bill has passed both chambers that requires hospitals to have a trained healthcare provider available, or a transfer agreement as provided in a county plan, to complete a sexual assault forensic examination. “Available” includes, but is not limited to, having access to a trained sexual assault forensic examination expert via telehealth.

• In Maryland, proposed rules relating to the provision of telehealth for specialists are up for comment. Specifically, one proposed rule would create a telehealth chapter for chiropractic medicine, defining licensure requirements, standards and patient evaluation requirements. The other proposed rule has the purpose of setting out new regulations for massage therapists concerning the practice of telehealth.

Why it matters:

• There continues to be elevated activity surrounding licensure compacts. 2023 has seen an uptick in legislative activity by states seeking to ease out-of-state licensure barriers through the use of interstate compacts. As more physicians and other healthcare professionals are practicing across state lines through telemedicine, the need for licensure portability has continued to rise.

• The new bills coming out of Virginia are aimed at addressing barriers to telehealth licensure, prescribing and continuity of care. Virginia has proposed to tackle the licensure issue through the compacts mentioned above. The state’s bills would also prohibit blanket restrictions on telehealth prescribing by pharmacies and allow certain out-of-state providers already practicing telemedicine to work with their group practices to cover care for existing patients.

• West Virginia’s bill on sexual assault forensic exams demonstrates the ways in which telehealth can be used to improve access to care and quality of care for survivors of sexual assault. By establishing the use of telehealth for the delivery of forensic exams, more adolescent and adult survivors may access care for sexual assault. Programs leveraging telehealth can provide medical assistance, consultation and expert forensic sexual exams to otherwise underserved areas, in turn providing survivors with high-quality physical, emotional and forensic care that they may otherwise be unable to access.