Partner Nathaniel Lacktman, Chair of Foley’s national Telemedicine & Digital Health Industry Team, was quoted in the mHealth Intelligence article, “New Telehealth Bills Address Coverage, Store and Forward, RPM,” about the new legislation introduced by New Mexico’s legislature (SB 354). The bill aims to hold payers to the same coverage standards for telemedicine as they do for in-person care. It would prevent payers from imposing any “unique restrictions” on telehealth, including originating site restrictions, and would compel them to reimburse providers “on the same basis and at least the same rate” for comparable in-person care.
The bill would enable payers to charge a deductible for virtual care as long as the deductible, co-payment or co-insurance doesn’t exceed that charged for in-person care, and it would prevent payers from setting an annual or lifetime dollar cap on telehealth coverage “other than an annual or lifetime dollar maximum that applies in the aggregate to all items and services covered under the health insurance plan, policy or contract.” The bill would also prohibit payers from limiting that coverage to providers who are part of the health plan’s provider network.
“Ensuring that payers and health insurance plans pay for remote patient monitoring as a covered member benefit will incentivize providers to invest in these technologies,” Lacktman noted. “This will equip them to better monitor and manage patient care needs, allowing patients to avoid unnecessary hospitalizations, and more proactively manage chronic conditions.”