As of October, 42 US states and the District of Columbia have statutes in place regarding commercial insurance coverage for telehealth, according to a survey report published this week by law firm Foley & Lardner.
While this tally signal an improvement in the telehealth reimbursement landscape over the last few years, the authors of the report warned of state-to-state variance in the language of these laws that limit their impact.
“For example, four states have telehealth coverage laws on the books that do not actually mandate health plans to cover services delivered via telehealth (Florida, Illinois, Massachusetts, and Michigan),” they wrote in the report.
Meanwhile, laws that address telehealth payment parity — in other words, reimbursement rates equal to those paid out for equivalent in-person services — are far less common among the states. Of the 16 states with laws directly handling telehealth reimbursement, only 10 states (Arkansas, Delaware, Georgia, Hawaii, Kentucky, Minnesota, Missouri, New Mexico, Utah, and Virginia) had laws that the authors considered to provide payment parity.
Still, the authors were hopeful that these numbers would increase in the coming years.
“We predict that 2020 will yield more states enacting new telehealth insurance coverage and payment parity laws or amending current laws to better account for the current state of telehealth,” they wrote. “For example, California recently revisited its prior telehealth coverage law, which only had coverage parity, and enacted a new section requiring both coverage and payment parity for telehealth services. The payment parity provision in the new California law (as well as Georgia’s law) represents some of the best-in-class model language because it levels the field by statutorily setting payment parity as the baseline while expressly allowing providers and plans to voluntarily negotiate alternate payment rates and depart from the baseline.”
The survey also noted increasing coverage for asynchronous telehealth or remote patient monitoring technologies. Here, 24 states have laws mandating coverage for “store and forward” asynchronous telehealth, while 13 instruct commercial plans to cover remote patient monitoring.
WHY IT MATTERS
By rolling out these statues, lawmakers have substantial influence on the reimbursement and, subsequently, widespread adoption of telehealth services. Foley & Lardner’s tally suggests that there’s plenty of room for more states to push commercial insurers toward these technologies, and also highlights the need for strong language in both new and existing legislation.
THE LARGER TREND
This steady increase of lawmaker support for telehealth echoes the conclusions of another survey from Epstein Becker Green, which noted that many new telehealth laws are bipartisan efforts driven by the US’ ongoing opioid epidemic. And beyond state legislature, major government-backed initiatives from the FCC, USDA and other federal agencies have also been laying the groundwork for new telehealth services targeting underserved populations.