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:

• Insurance and Medicaid reimbursement
• Professional standards

A CLOSER LOOK

Proposed Legislation & Rulemaking:

• The California governor vetoed AB 2339, which would have expanded the definition of “asynchronous store and forward” for Medicaid purposes to include asynchronous electronic transmission initiated directly by patients, including through mobile apps. The bill would have allowed Medicaid providers to establish a provider-patient relationship using asynchronous store and forward when the visit related to sensitive services.
• The District of Columbia gave notice of a proposed Medicaid state plan amendment. The amendment would allow DC Medicaid to cover and reimburse for new remote patient monitoring (RPM) preventive services for eligible pregnant and postpartum individuals who are at risk of experiencing pregnancy-related morbidity or mortality issues. This amendment would include coverage for medically necessary monitoring devices, initial set-up and patient education on such devices, and collection and interpretation of the results by a healthcare professional.
• The Texas Medical Board proposed repealing and replacing its telemedicine regulations. The proposed regulations are pared down from the current regulations, addressing only licensure and requirements for prescribing, and affirming that telemedicine medical services, including supervision, delegation, and posting of notices regarding filing a complaint, must be in compliance with Tex. Occ. Code C 111 and the Medical Practice Act.
• At the federal level, the US House of Representatives approved the bipartisan HR 6033, which would create a task force focused on access to healthcare information technologies for non-English speakers. The bill would create best practices for:
  • Facilitating and using interpreters during telemedicine visits.
  • Providing accessible instructions for how to use telecommunication systems.
  • Improving digital patient portals for non-English speakers.
  • Integrating the use of video platforms that enable multi-person video calls via telecommunications.
  • Providing patient materials, communications, and instructions in multiple languages. This would include text message appointment reminders and prescription information.

The bill defines “health information technology service providers” to include electronic medical record companies, RPM companies, and telehealth and mobile health vendors.

Finalized Legislation & Rulemaking:

• Delaware enacted SB 301, which requires public universities to provide access to medication for the termination of pregnancy and emergency contraception. Although the medication and contraception must be provided onsite, the consultation to provide them may be performed through telehealth services.
• Illinois enacted HB 4475, which amends the Insurance Code to address mental health and substance use parity requirements. The act provides that insured individuals have the right to select the provider or facility of their choice and modality, whether the care is provided via in-person visit or telehealth, for medically necessary mental health and substance use care.
• The US Senate issued a joint resolution, Res.840, supporting the designation of September 15 – 21, 2024, as Telehealth Awareness Week.

Why it matters:

• States are increasing access to and coverage for telemedicine services. DC Medicaid is seeking to expand access to and Medicaid coverage of RPM services for pregnant and postpartum women, while Illinois addressed coverage for telehealth services in its new mental health and substance use parity laws.
• Legislation is slowing as we approach the election, and many states have concluded their legislative sessions for the year. As typical in an election cycle, legislative activity has slowed, including activity related to telehealth. Many states’ legislative sessions have come to an end. For example, the California legislative session ended August 31, 2024, with September 30, 2024, as the last date for the governor to sign or veto bills.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care, and mitigate enforcement risk through proactive compliance.