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 two weeks:

• Medicaid coverage
• Maternal health

A CLOSER LOOK

Finalized Legislation and Rulemaking

• Alaska finalized regulations that implement 2022 legislation (HB 265) requiring the state Medicaid program to provide coverage for telehealth services. The regulations set out requirements related to coverage and payment through Medicaid for services provided via telehealth, including requirements for modalities and providers.
• Maryland finalized regulations for the state Medicaid program that update the final date for which telehealth includes audio-only telephone conversations. The final date has been moved from June 30, 2023, to June 30, 2025, in line with legislation enacted in May 2023. The regulations also broaden eligibility for remote patient monitoring services by removing the requirement that the participant be at high risk for avoidable hospital utilization.
• Maryland also finalized regulations for the state Medicaid program that update the requirements for urgent care centers, including requirements for supervision and services provided via telehealth.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

• California passed AB 1478 in the first chamber. The bill would require the Department of Public Health to maintain a public database of referral networks for community-based mental health providers and support services addressing postpartum depression and prenatal care, including information on mental health providers and support groups that allow for patient-driven care access through telehealth and virtual care.
• Colorado proposed a rule that would authorize the use of electronic consultation (eConsults) in the state Medicaid program. eConsults would take place through the authorized eConsult platform, which is currently in the process of being implemented by the Colorado Department of Health Care Policy and Financing. eConsults would involve an asynchronous interaction between a primary care provider and a specialty provider in order to obtain the specialty provider’s expert opinion. Specialty providers would be reimbursed only for eConsults that occur on the approved eConsult platform. More information regarding the eConsult Platform, currently scheduled to go live in winter 2024, is available here.
• Texas proposed a rule that would extend the eHealth Advisory Committee (eHAC) for an additional two years. eHAC advises the Health and Human Services Commission Executive Commissioner and Health and Human Services agencies on strategic planning, policy, rules and services related to the use of health information technology, health information exchange systems, telemedicine, telehealth and home telemonitoring services, and is scheduled to sunset December 31, 2023.

Why it matters:

• States continue to adopt rules addressing the use of telehealth in state Medicaid programs. Much of this regulatory activity is focusing on clarifying and expanding coverage for telehealth services in state Medicaid programs, as well as addressing temporary rules that were put in place during the COVID-19 state of emergency.
• Telehealth may be one avenue for states to address the maternal healthcare crisis. As the proposed California legislation demonstrates, one way to address perinatal health outcomes and disparities, as well as increase access to maternal healthcare providers, is by publicizing and increasing access to telehealth resources.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated.