Telehealth in the United States: A Year in Legislation

As more states recognize the value of telehealth, the United States remains a patchwork of laws surrounding reimbursement for services. Some states have pushed toward comprehensive laws with wide definitions and guarantees of payment from both private and government insurers, while others still have yet to put anything on the books. Christine Calouro, of the Center for Connected Health Policy noted that, surprisingly, rural states are not always at the forefront. North Dakota, for example, passed its first private payer telehealth law in 2017—and South Dakota still does not have one.

Despite the disparities, Calouro said progress has been encouraging. “From all of the laws I’ve seen this year, none of them have really been restricting telehealth. They’ve all been expanding what’s allowable,” she told Healthcare Analytics News. In the future, she said, the goal should be not to look at telehealth as its own unique means of care, but rather an inherent tool for providers, a guaranteed element of the healthcare system.

Here’s a look at some of the successes and failures of state-level telehealth policy in 2017. All information derived from LegiScan's online database unless otherwise noted.

Status: Failed

Description: This bipartisan bill was intended to “ensure that every policy that is issued, amended or renewed in this State shall provide professional liability coverage for telehealth services in the same manner as the coverage is provided for in-person.” The bill initially passed the state House, but the Senate sent it back, ultimately quashing the proposal. (Photo credit: www.maine.gov.)

Bill: New Mexico HB87

Status: Vetoed

Description: House Bill 87 would have created a diabetes committee to study and enact public health measures to treat and prevent diabetes. A key element of the bill was the creation of a statewide telehealth program “to assist primary care health care providers in delivering best-practice health care for underserved populations.” Despite passing the state Senate, the bill was killed by the governor.

Bill: Kentucky HB450

Status: Failed

Description: Kentucky’s House Bill 450 would require private health plans to cover telehealth services “to the same extent as though provided in person” and would “prohibit health benefit plans from requiring providers to be physically present with a patient.” Introduced in February, the bill languished in committee and has since been marked a failure by the Lexis Nexis legislative database.

Bill: North Carolina HB283

Status: Passed

Description: North Carolina’s House Bill 283 orders the state Department of Health and Human Services begin study of telehealth definitions and the scope of allowable services in order to recommend a comprehensive policy to the General Assembly. The bill also provides for an exploration of how telehealth services can particularly be applied to psychiatric health.

Status: Passed

Description: Montana’s House Bill 386 expanded the state’s telehealth reimbursement policy to allow for the coverage of physical therapy delivered remotely by accredited physical therapists and physical therapist assistants. It became law in May of 2017. (Photo credit: RTC, Wikimedia Commons)

Bill: North Dakota SB2052

Status: Passed

Description: North Dakota’s Senate Bill 2051 codifies the definition of telehealth, safeguarding private plan and public employee retiree plan coverage of “interactive audio, video, or other telecommunications technology,” as well as store-and-forward, equivalent to in-person services. The bill does not cover “audio-only telephone, electronic mail, or facsimile

transmissions.”

Status: Pending

Description: Pennsylvania Senate Bill 780 looked to bolster Pennsylvania’s anemic legislative record on telehealth by providing a definition: “The delivery of health care services provided through technology to a patient by a health care practitioner who is at a different location.” The bill also notes exclusions: “the use of audio-only telephone conversation, voicemail, facsimile, e-mail, instant messaging, text messaging,” and online questionnaires. Its last movement was a referral to the state’s Senate Banking and Insurance Committee in June. The state did, however, adopt a “Health Care Information Technology Awareness Day.” (Photo credit: www.pa.gov)

Bill: Texas SB 1107/HB 2697

Status: Passed

Description: After a long legal battle, the country’s second-most populous state, which ranks 46^th in primary care providers per capita, became one of the last to embrace telehealth. The new law defines service and levels coverage of remote consultation and store-and-forward to the same extent as in-person visits.