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
• Expanding Telehealth

A CLOSER LOOK

Finalized Legislation and Rulemaking:

• In South Carolina, the governor signed H 4159, the South Carolina Telehealth and Telemedicine Modernization Act, which establishes uniform baseline standards for all professionals licensed by a licensing board in the state providing services via telehealth. The act also revises the provisions of the Medical Practice Act related to telehealth, including addressing ongoing telehealth treatment provided by an out-of-state physician not licensed in South Carolina, as well as implementing standards for licensees solely providing services via telehealth (including evaluation, recordkeeping, follow-up care and prescribing standards).

Legislation & Rulemaking Activity in Proposal Phase:

Highlights:

• In Arizona, SB 1267 passed the first chamber. If enacted, the bill would permit physical therapists to supervise physical therapy assistants through certain telehealth modalities.
• In Colorado, HB 24-1048 passed both chambers. If enacted, the bill would specify that an in-person, physical examination of an animal is required to establish a veterinarian-client-patient relationship and would extend that relationship to other licensed veterinarians who share the same physical premises if those other veterinarians have access to and have reviewed the patient’s records. It would also permit veterinarians, with consent of the client, to provide veterinary services—including prescribing medication—via telemedicine to clients and patients located in Colorado with an established veterinarian-client-patient relationship. The bill establishes recording-keeping, confidentiality, and privacy requirements related to the use of telehealth and empowers the Colorado State Board of Veterinary Medicine to issue rules further regulating the use of telehealth. It also permits a license veterinarian to utilize tele-supervision of veterinary personnel if certain conditions are met.
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• In Hawaii, HB 2079 passed the first chamber. If enacted, this bill would, among other things, allow a practitioner who is licensed in Hawaii to prescribe schedule III and IV controlled substances, including testosterone, for the purpose of providing gender-affirming care while the practitioner is located outside the State and without conducting an in-person consultation with the patient, provided that the practitioner prescribes the controlled substances via a synchronous audio-visual telehealth interaction.
• In Idaho, HB 684 passed the first chamber. If enacted, the bill would permit telebehavioral health services to be provided on public school premises.
• In Kentucky, SB 111 passed the first chamber. If enacted, the bill would require health benefit plans, limited health service benefit plans, Medicaid, and state health plans to provide coverage for speech therapy provided via telehealth.
• In Kentucky, SB 255 passed the first chamber. If enacted, the bill would establish requirements and standards for providing social work services via telehealth.
• In Mississippi, HB 177 and SB 2157 both passed the first chamber. If enacted, these bills would enter Mississippi into the Dietician Licensure Compact and the Psychology Interjurisdictional Compact, respectively.
• In Oklahoma, HB 3330 passed the first chamber. If enacted, the bill would require that any person seeking renewal of a behavioral health certificate or license issued by certain state boards to report information related to the provider’s use of telehealth.
• In Oklahoma, HB 4041 passed the first chamber. If enacted, the bill would amend the requirement for a dentist using telehealth to have an office located in Oklahoma to also allow that office to be adjacent to Oklahoma and within fifty (50) miles of an Oklahoma border of a state with an interstate dental and dental hygienist compact.
• In Washington, SB 5821 passed both chambers. If enacted, the bill would amend existing standards for establishing provider-patient relationship related to audio-only coverage requirements. The bill defines an established relationship to include a provider of audio-only telemedicine who has, among other things, seen the patient in-person or through real-time interactive audio and video technology at least once in the last three years or an audio-only provider to whom the patient was referred by a physician who had seen the patient, in-person or through real-time interactive audio and video technology, at least once in the past three years.
• In Washington, SB 5481 passed both chambers. If enacted, the bill would create professional practice standards for health care practitioners that provide telemedicine services and establish requirements for out-of-state health care practitioners.
• Several states advanced legislation that would enact the Social Work Licensure Compact: In Kentucky (HB 56) and South Carolina (H 4365) legislation to enter the compact passed the first chamber, and in Virginia (HB 326), legislation to enter the compact has passed both chambers.

Why it matters:

• States continue to increase activity surrounding licensure compacts for a variety of health professionals. These state efforts ease the burdens of the licensing process and demonstrate a desire to facilitate multijurisdictional practice without giving up authority over professional licensure.
• States continue to amend and clarify professional practice requirements for telehealth. With the increase in the delivery of care through virtual modalities, legislatures are adopting standards governing telehealth practice across multiple health professions and revising existing standards to reflect current technologies and practices.

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