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 Licensure Compacts
• Telehealth Practice Standards
• Disciplinary Guidelines
• Behavioral Health
• Regulatory Licensing

A CLOSER LOOK

Finalized Legislation and Rulemaking

• Alaska adopted a final rule creating new standards for optometrists providing telehealth services. To provide telehealth services, optometrists must: establish an optometrist-patient relationship verbally, in writing or in-person; verify the patient’s identity; maintain patient confidentiality; provide telehealth services at the same quality as in-person services; diagnose patients at the time of the patient visit; maintain complete and timely records; and perform additional examinations, in addition to telehealth, when dispensing prescription eyewear.

Legislation and Rulemaking Activity in Proposal Phase

Highlights:

• In Wisconsin,
  
  • Three Interstate Compact bills advanced through the first chamber:
    
    • SB 196 would enact the Counseling Compact;
    • SB 391 would enact the Social Work Licensure Compact; and
    • SB 197 would enact the Audiology and Speech Pathology Compact.
  • The legislature is also considering AB 364, which advanced through the second chamber.
    
    • AB 364 would amend the Wisconsin tax code by adopting certain Internal Revenue Code provisions relating to high-deductible health plans (HDHPs) under the Consolidated Appropriations Acts of 2022 and 2023. Specifically, AB 364 authorizes individuals, covered by an HDHP, to claim a state income tax deduction for contributions to a health savings account, even if the plan has a $0 deductible for telehealth or remote services. The tax deduction would be available for taxable years beginning after 2021.
• In Ohio, SB 90, a bill to enact the Social Work Licensure Compact (the Compact), passed through the first chamber. While Missouri is currently the only state to officially enact the Compact, Ohio is one of six states with pending legislation to join the Compact.
• Oregon proposed a rule to implement and clarify SB 232. The Oregon Legislature passed SB 232 to enact certain exemptions for telemedicine licensure, clarify that the “temporarily” definition includes patients in Oregon for business, vacation or education, and authorize out-of-state physicians or physician assistants to provide telemedicine intermittently to Oregon patients when the healthcare professional has an established patient relationship. The proposed rule amendments align with these updates.

Why it matters:

• Hybridization of Healthcare. Alaska’s final rule is an example of the further acceptance of hybrid healthcare models. While the new initiative authorizes optometrists to provide telehealth services to established patients, optometrists in the state must combine telehealth with other forms of examination, likely in-person, to dispense eyewear prescriptions to patients.
• Modernizing Licensure Infrastructures. The legislative activity in Wisconsin, Ohio and Oregon facilitates the provision of services across state lines by standardizing licensing requirements for healthcare professionals. The streamlined licensure process also enables a greater number of healthcare professionals to provide specialized medical care to patients residing in remote or underserved areas.
• Incentivizing Telehealth. Wisconsin’s proposed rule, AB 364, highlights the intersection of fiscal policy and healthcare innovation by leveraging tax strategies to promote the integration of telehealth services. The tax code amendment not only benefits individual taxpayers but also serves as an incentive for healthcare providers and insurers to expand cost-effective telehealth offerings.

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