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

• Medical Cannabis

• Mental Health

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Iowa enacted HF 671, adopting the Professional Counselors Licensure Compact.

• Minnesota enacted HF 100, permitting the medical sale and use of cannabis through the state’s registry program. HF 100 permits remote pharmacist consultations by secure videoconference, telephone or other remote means, as long as the pharmacist engaging in the consultation is able to confirm the identity of the patient and the consultation adheres to patient privacy requirements that apply to healthcare services delivered through telemedicine. A Minnesota licensed physician, physician assistant or advanced practice registered nurse (APRN) must determine on a yearly basis if the patient continues to have a qualifying medical condition for enrollment on the Division of Medical Cannabis registry.

• Missouri passed a final rule establishing the Telehealth Dental Pilot Project for Medically Underserved Populations to examine new methods of extending dental care to residents in assisted living facilities, intermediate care facilities, residential care facilities and skilled nursing facilities, and homebound special needs patients. This rule permits the supervision of dental assistants and dental hygienists using telehealth technology.

• Oklahoma enacted SB 12, creating a mental health transport revolving fund for the Department of Mental Health and Substance Abuse Services. This law permits telemedicine assessments of patients when assessments are requested by sheriffs or peace officers. The state’s criminal code defines the term peace officer as “any sheriff, police officer, federal law enforcement officer, tribal law enforcement officer, or any other law enforcement officer whose duty it is to enforce and preserve the public peace.” Okla. Stat. tit. 21 § 99.

• Vermont enacted three telehealth-related laws:

  • H 62 adopts the Interstate Counseling Compact to facilitate interstate practice of licensed professional counselors with the goal of improving public access to professional counseling services.

  • H 86 adopts the Audiology and Speech-Language Pathology Interstate Compact, which streamlines the licensure process for audiologists and speech-language pathologists and allows the use of telehealth technology to facilitate increased access to audiology and speech-language pathology services.

  • H 282 adopts the Psychology Interjurisdictional Compact, which regulates the day-to-day practice of telepsychology and streamlines the licensure process for psychologists.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• Connecticut progressed HB 6768, which would permit physicians, APRNs and physician assistants to certify a qualifying patient’s use of medical marijuana and provide follow-up care using telehealth if they comply with other statutory certification and recordkeeping requirements.

• Louisiana progressed two bills:

  • HB181 would allow coroners to use telehealth when conducting an examination for an emergency mental health commitment.

  • HB 41, which passed the second chamber, would require health plans to provide equivalent coverage and payments for telehealth occupational therapy services as for in-person services, unless the plan and the provider agree otherwise.

• New Hampshire progressed HB 532 in the second chamber. The legislation would add naturopathic doctors to the list of providers authorized to provide consultation services and follow-up care via telehealth.

Why it matters:

• There continues to be elevated activity surrounding licensure compacts. This year has seen an uptick in legislative activity by states seeking to ease out-of-state licensure barriers through the use of interstate compacts. This week, Vermont adopted three compacts, and Iowa adopted the Professional Counselors Licensure Compact.

• States continue to progress and pass legislation around the qualification of patients for medical cannabis and the prescription of medical cannabis using telehealth. This week, Minnesota enacted legislation permitting remote pharmacy consultation for medical cannabis, and Connecticut progressed legislation that would permit telehealth certification of patient medical marijuana use.

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