Michigan is ringing in 2017 with a new telehealth law. Governor Rick Snyder signed into law SB 0753 on December 21, 2016, imposing new telehealth practice standards, including restrictions on prescribing controlled substances via telemedicine. The new Michigan telemedicine law will take effect March 21, 2017 (a 90-day delay from signature to effective date). Previously, Michigan law and regulation was silent on delivering health care services via telehealth and virtual care technologies. The law applies broadly, not just to physicians, but to all health professionals in Michigan.
The law was not universally supported, even among pro-telehealth proponents, as they pointed out that telehealth-based care “has already been thriving in Michigan without legislation.” Indeed, despite the best intentions, providers and entrepreneurs are already seeing how artificial restrictions in state law telehealth practice standards can actually limit innovation in health care delivery, rather than foster its growth. States without telehealth practice standards can (and do) still regulate health care delivery by requiring all services – whether in-person or via telemedicine – to meet the same standard of care. That said, Michigan’s telemedicine law is succinct, not overly burdensome, and generally follows the playbook of some common practice standards seen in a number of other states.
Here is a summary of the law’s key provisions:
Curiously, the law contains a sentence expressly reiterating that it does not “require new or additional third party reimbursement for health care services rendered by a health professional through telehealth.” This language is atypical for most state telehealth practice statutes or regulations, as professional healthcare standards of practice are generally a separate and distinct issue from telehealth insurance coverage and payment parity laws. Michigan already has arguably one of the weakest, provider-unfriendly, telehealth commercial insurance coverage laws in the nation. The statute (from 2012) reads, in pertinent part:
An insurer that delivers, issues for delivery, or renews in this state a health insurance policy shall not require face-to-face contact between a health care professional and a patient for services appropriately provided through telemedicine, as determined by the insurer. […] Telemedicine services are subject to all terms and conditions of the health insurance policy agreed upon between the policy holder and the insurer, including, but not limited to, required copayments, coinsurances, deductibles, and approved amounts.
The Michigan statute affords great discretion to the insurer to determine what telemedicine services (if any) are covered and what the payment rate would be for those services. At the other end of the spectrum are telehealth coverage laws in states like Mississippi or Delaware, which make clear that health plans must allow their members/enrollees/policyholders the meaningful option to receive medical services via telemedicine or in-person. Currently, 31 states plus the District of Columbia have telehealth commercial insurance laws, although there are significant variances among these laws and oftentimes the statutory language does not actually deliver what health care providers expect or hope. Telehealth commercial insurance coverage and payment parity is an important issue for providers, and is gaining increased attention and interest across the country. For example, New York is still grappling with the unintended consequences of recently enacting a telehealth coverage law without a payment parity provision. Continued expansion in coverage and reimbursement means 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.
For more information on telemedicine, telehealth, virtual care, and other health innovations, including the team, publications, and other materials, visit Foley’s Telemedicine and Virtual Care Practice.