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:

• Interstate compacts
• Professional standards

A CLOSER LOOK

Finalized Legislation & Rulemaking:

• Arizona enacted SB 1036, entering into the Social Work Compact. Arizona is the 19th state to enact this compact.
• Arizona also signed SB 1267 into law, which revises the definition of “general supervision” to include supervision through telehealth for physical therapy services provided by physical therapist assistants.
• In Louisiana, the governor signed HB 896, the Louisiana Remote Patient Monitoring Program Law, which establishes a patient monitoring program including definitions, eligibility, and reimbursement requirements under Medicaid. It also addresses equipment and network requirements and availability, and is aimed at patients with costly, chronic illnesses. The act goes into effect August 1,
• Nevada adopted a final rule that revises social work regulations, and now clearly states that licensed social workers are not allowed to provide telehealth services to a client outside of Nevada, unless authorized under that state’s laws.
• Ohio partially adopted a rule regulating the provision of personal care activities, which includes documentation requirements when the care is provided by telehealth.

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

• New Hampshire passed to enter into the Social Work Compact. The bill heads to the governor’s desk.
• Nevada proposed a rule that would revise optometry regulations and what is required of an optometrist before providing optometry services via telehealth, such as reviewing the patient’s chart and, if prescribing ophthalmic lenses, performing a manifest refraction.
• Although not a formal rule, the Washington Insurance Commissioner is seeking feedback on amending telehealth-related rules. Specifically, the Office of the Insurance Commissioner (OIC) is considering consolidating healthcare regulations be consistent with state and federal changes. This would include amending definitions related to “established relationship” as it applies to audio-only telemedicine services. Interested parties can reach out to the OIC.

Why it matters:

• Interstate compacts continue to grow. As we’ve seen consistently, states continue to join interstate compacts. This week, Arizona became the 19th state to enact the Social Work Compact, which New Hampshire introduced legislation to enroll into. Three other states have also introduced or fully enacted legislation to enroll in the Social Work Compact this year so far.
• States are expanding the use of technology related to telehealth. Multiple states have legislation and regulations that account for difference in documentation when using telehealth or other technology, versus traditional in-person care. This week, Nevada a proposed rule that establishes standards of care specifically for providing optometry services via telehealth, and Ohio partially adopted a rule which factors in the automatic record creation of certain technologies. This push to incorporate technology is also evident in Louisiana’s passing of the Remote Patient Monitoring Act, which creates a framework for remote patient monitoring and reimbursement standards, as well as in Nevada’s prohibition on using telehealth to treat out-of-state patients without being properly licensed in that jurisdiction. As telehealth adoption increases, incorporation of the utility of technology into state rules and regulations has also increased. States seem to be taking lessons learned from the early use cases and are formally incorporating standards into their laws and rules.