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:

• Reproductive Health
• Telehealth Practice Standards
• Disciplinary Guidelines
• Behavioral Health
• Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

• In California, the governor signed the Nursing Facility Resident Informed Consent Protection Act of 2023. The new legislation amends the bill of rights for patients in skilled nursing facilities and establishes that healthcare professionals must disclose all material information regarding the administration of psychotherapeutic drugs to the patient to obtain the patient’s informed consent. Under the law, healthcare professionals may use remote technology, including telehealth, to obtain consent. The willful or repeated violation of these provisions will be punishable as a misdemeanor. However, the State Department of Public Health, in consultation with interested stakeholders, will not penalize facilities until December 31, 2025, when the Department plans to publish its standardized informed consent form.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

• Connecticut’s Department of Consumer Protection proposed a rule to expand the prescribing authority of pharmacists. The rule would authorize licensed pharmacists who undergo the necessary training to prescribe emergency and hormonal contraceptives to patients. The rule would require pharmacists to assist patients with a Department-issued and interactive “screening document,” which includes questions to determine whether a hormonal or emergency contraceptive is clinically appropriate for a patient, age-appropriate health screening information, and a treatment algorithm for hormonal or emergency contraceptives. The screening document’s “treatment algorithm” is generated based on the clinical history entered by the patient, and it sets forth the steps of a treatment pathway and outlines when a referral to a practitioner is recommended. Licensed pharmacy technicians who undergo the necessary training can assist with the screening process, but ultimately the prescribing pharmacist must decide whether to issue the prescription or refer to a practitioner.
• In Pennsylvania, HB 1300 passed the second chamber. If signed by the governor, the bill would allocate additional funds to the state’s Behavioral Health Commission for Adult Mental Health. It would also increase access to behavioral health via telemedicine services by providing funds for providers to purchase equipment such as computers, tablets, webcams, mobile devices, and telemedicine carts and kiosks; securing funds to assist with training and technical assistance for telemedicine services; providing grants to primary-care practitioners and organizations using telemedicine to deliver behavioral health integration services; and allocating additional funds for providers to purchase or maintain Healthcare Insurance Portability and Accountability Act (HIPAA)-compliant software, platforms, secure Wi-Fi hotspots and increased broadband speed and training beyond what is offered by the Department of Human Services.

Why it matters:

• Continued Demand for Mental Health Initiatives. Pennsylvania’s proposed rule highlights ongoing demand for behavioral and mental health services. Increasing resources and funding for telemedicine services will give more patients convenient access to behavioral health services.
• Enhancing Patient Rights and Transparency. California’s recently enacted legislation augments patient rights within skilled nursing facilities. The law not only safeguards vulnerable individuals, but also emphasizes transparency in medical decisions.
• Innovation in Prescribing. Connecticut’s Department of Consumer Protection is pioneering a new approach to contraceptive prescriptions. The proposed interactive screening document for prescribing pharmacists would streamline the process of prescribing emergency and hormonal contraceptives. However, as with any algorithm, the developers would need to ensure that the treatment algorithm did not inadvertently disadvantage patients from certain backgrounds because of unconscious biases.