Florida Passes New Telehealth Bill: Focus is Reimbursement

14 March 2016 Health Care Law Today Blog

After several hard-fought years of unsuccessful attempts, the Florida Legislature on Friday passed a new bill designed to set the stage for telehealth commercial insurance coverage in the Sunshine State. This is a great step forward for providers of telehealth services, as the bill will result in a formal report to the Governor and Legislature detailing – through evidence and surveys conducted by state agencies – an objective assessment of Florida’s telehealth landscape, with a particular focus on commercial insurance coverage. The bill is not an insurance coverage mandate, but it will equip Florida lawmakers with the information they need to move beyond speculation and make a truly informed decision on telehealth policy based on the actual market environment in the State.

Passage of the bill is due, in no small part, to the outstanding efforts of the Florida telehealth community, including the Telehealth Association of Florida and its dedicated members, and Florida hospitals, healthcare providers, and thought leaders committed to health innovation and access for patients.

We have written extensively on telehealth commercial insurance and payment opportunities, including highlighting different market impact between telehealth coverage statutes and telehealth payment parity laws. The new bill comes on the heels of other recent forward-thinking telehealth policies in Florida, such as the Board of Medicine’s decision to allow remote prescribing of controlled substances for treatment of psychiatric disorders.

The bill (CS/CSHB 7087: Telehealth) passed both the House and Senate near unanimously, despite the two chambers initially having very different versions of the bill. The House’s prior version would have created a special registration process enabling out-of-state healthcare providers to offer telehealth services to patients in Florida without the need for full Florida licensure. The Senate’s prior version included language regarding telehealth practice standards and remote prescribing of controlled substances.

Key Takeaway

The common thread among them, however, was key language creating a formal Telehealth Advisory Council within Florida’s Agency for Health Care Administration (AHCA). It requires Florida’s Department of Health, Office of Insurance Regulation, and AHCA to survey providers, professionals, facilities, and health plans to determine the extent that commercial health plans are actually covering telehealth services in Florida, as well as the reimbursement rates the plans are actually paying to providers. Providers and insurers that refuse to report the information can face fines and penalties. The surveys and research data must be completed and complied by June 30, 2018.

The Telehealth Advisory Council is charged with taking the data and research findings, and delivering a report to the Governor and the Legislature containing policy recommendations to increase the use and accessibility of telehealth services, as well as any barriers that should be removed. The report is due by December 1, 2018.

When preparing a draft version of the Florida legislation last Fall, the Telehealth Association of Florida drew inspiration from the federal Doc Fix Bill signed into law last April, in which the Government Accountability Office was charged with researching and preparing two reports to Congress on telehealth and the Medicare Program. Those reports, due by April 2017, will be used by Congress when considering legislative changes to Medicare coverage of telehealth services.

Currently, 29 states plus the District of Columbia have telehealth commercial insurance laws requiring commercial health insurance companies cover services provided via telehealth to the same extent those services are covered if provided in-person. Continued expansions in reimbursement mean providers can enhance telehealth offerings, both for the immediate cost savings and growing opportunities for revenue generation, to say nothing of patient quality and satisfaction. Commercial insurance reimbursement is among the five telemedicine trends driving health care transformation in 2016 and beyond.

For more information on telemedicine, telehealth, virtual care, and other health innovations, including the team, publications, and other materials, visit Foley’s Telemedicine Practice.

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