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:

• Telehealth Practice Standards
• Medicaid Reimbursement
• Interstate Licensure Compacts
• Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

• In Michigan, the Department of Licensing and Regulatory Affairs promogulated, through final rule, practice standards and requirements for dentistry (including tele-dentistry under Part 6B of the final rule) found at Mich. Admin. Code R. 338.11611 to 338.11615.
  
  • Under the final rule, “telehealth” covers the use of electronic information and telecommunication technologies to support or promote long-distance clinical healthcare, patient and professional health-related education, public health or health administration. Telehealth also may include, but is not limited to, “telemedicine,” which is the use of electronic media to link patients with healthcare professionals in different locations. The final rule also allows for e-prescribing, subject to enumerated requirements.
  • The Department waived the existing requirement for in-person contact with the dentist or dental therapist once every 24 months for telehealth services, unless the dentist or dental therapist delegates or assigns duties other than radiographic imaging to allied dental personnel.
  • The Department set forth specific requirements for the informed consent process to treat remotely via telehealth. Among other requirements, the licensee must explain the alternatives, capabilities and limitations of telemedicine, and the patient may decline to receive telehealth services.
  • The Department articulated privacy standards for telehealth, including that the telehealth encounter must be secure and compliant with federal and state security and privacy regulations.
• In Washington, the state’s Health Care Authority issued a permanent rule amending the standards for Medicaid reimbursement of childbirth education classes. The permanent rule added criteria to allow reimbursement for online classes through telemedicine, subject to a one-on-one check-in with the client and qualified childbirth education provider during or after the online classes.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

• In West Virginia, the Governor’s Committee on Crime, Delinquency, and Correction modified its proposed rule on Sexual Assault Forensic Examinations to specifically include sexual assault telehealth services. The modification adds a definition for “TeleSANE” to allow certified sexual assault nurse examiners (SANE) with documented expertise to provide forensic exam guidance through telehealth technology.
• In Wisconsin, SB 1, discussed in-depth last week, continued to advance after passing through the first chamber and being recommended for concurrence during an executive session. The proposed legislation would ratify and enter Wisconsin into several interstate compacts, including the Audiology and Speech-Language Pathology Interstate Compact, the PA Licensure Compact, the Social Work Licensure Compact and the Counseling Compact.

Why it matters:

• Telehealth increasingly represents a mechanism to satisfy niche and specialty care needs. This week saw significant rulemaking activity aimed at leveraging telehealth in unique contexts, from dentistry services to childbirth education, and even sexual assault forensic care. Telehealth can mitigate access disparities traditionally associated with niche care needs, such as travel distances and provider shortages.
• Interstate licensure compacts continue to gain momentum. Wisconsin’s advancing proposal to enter several interstate licensure compacts represents a continued effort by lawmakers to improve access to care for the state’s residents. Throughout 2023, various other states have joined, or advanced proposals to join, such interstate compacts. Interstate licensure eases the requirements for out-of-state licensed providers and in turn increases the network of providers available to patients through telehealth services.