Foley & Lardner LLP today released its nationwide research survey of telehealth commercial payer statutes, reviewing telehealth statutes across all 50 states. The survey is intended to help hospitals, telehealth entrepreneurs, and remote patient monitoring companies better understand the current landscape. It also includes model legislative language intended to assist policymakers to advocate for change to improve access and coverage of telemedicine and virtual care services.
The survey found that as of October 2019, 42 states and Washington, D.C. maintain some form of telehealth commercial payer law. However, in some states, such as Florida, Massachusetts, and Michigan, the law does not actually require plans to cover telehealth services. Alabama, Idaho, North Carolina, Pennsylvania, South Carolina, West Virginia, Wisconsin, and Wyoming still have no telehealth commercial payer laws.
Foley’s 2017 Telemedicine and Digital Health Survey found that at the time of the survey, one of the biggest barriers to adoption was limited or unclear reimbursement for telemedicine and digital health services. While reimbursement remains a major concern in the industry, the progress on a state-by-state basis over the past two years has been impressive.
“Patients and providers are embracing virtual care services more than ever before, and savvy health plans look at coverage as an opportunity – a competitive differentiator – and not a threat,” said Nathaniel M. Lacktman, chair of the firm’s national Telemedicine and Digital Health Industry Team. “This is particularly true for plans that compete for membership, such as Medicare Advantage plans offering members subsidized Apple watches for remote patient monitoring. In 2020, we anticipate more efforts among states to amend their prior telehealth coverage laws to keep pace with the industry’s growth.”
Foley’s 50-state survey breaks down variances in telehealth commercial statues state-by-state, including which states have commercial payer statutes in place, which have coverage parity and payment parity, site limits for coverage and reimbursement, among other analysis.
Foley’s full 50-state survey of state telehealth commercial payer statutes can be found here.
Foley’s Telemedicine and Digital Health Industry Team helps clients embrace emerging issues in telemedicine, enabling them to provide innovative care for patients in new markets around the block and around the world.
By taking advantage of technological advances, both traditional healthcare providers and the new wave of virtual care entrepreneurs have the chance be at the forefront of health care delivery by expanding their service offerings online and sharing their insight with patients, regardless of geography. With this opportunity comes challenges, as the laws and regulations struggle to keep up with the pace of innovation. It is critical to consult with a legal services provider with the experience and resources to help you grow your business while managing the evolving issues associated with this emerging field.
Our attorneys have the experience necessary to assist with telemedicine program assessment, development, and implementation, nursing hotlines and pharmacy call centers, and multi-state, web-based health care tools and services. We also are well-positioned to provide counsel on operational issues, including payer credentialing, patient verification, and medical record management.