Florida’s Agency for Health Care Administration (AHCA) announced, on July 27, 2016, the appointments of 13 representatives to the newly-created Florida Telehealth Advisory Council. The Telehealth Council was created through HB 7087, signed into law by Governor Rick Scott in March, largely as a fact-gathering step as the Legislature continues to consider a telehealth commercial insurance coverage and payment parity law. With a focus on telehealth insurance coverage (rather than practice standards), the legislation involves not only AHCA, but also the Office of Insurance Regulation (the agency with oversight over commercial health plans) in the process.
According to the language of HB 7087 itself, the purpose of the Telehealth Council is to conduct a research survey and generate a report with recommendations on five specific areas:
- The types of health care services provided via telehealth.
- The extent to which telehealth is used by health care practitioners and health care facilities nationally and in Florida.
- The estimated costs and cost savings to health care entities, health care practitioners, and the state associated with using telehealth to provide health care services.
- Which health care insurers, health maintenance organizations, and managed care organizations cover health care services provided to patients in Florida via telehealth; whether the coverage is restricted or limited; and how such coverage compares to that insurer’s coverage for services provided in person. This comparison must at a minimum include:
- Covered medical or other health care services.
- A description of whether payment rates for such services provided via telehealth are less than, equal to, or greater than payment rates for such services provided in-person.
- Any annual or lifetime dollar maximums on coverage for services provided via telehealth and in-person.
- Any copayments, coinsurance, or deductible amounts, or policy year, calendar year, lifetime, or other durational benefit limitation or maximum for benefits or services provided via telehealth and in person.
- Any conditions imposed for coverage for services provided via telehealth that are not imposed for coverage for the same services provided in-person.
- The barriers to using, implementing the use of, or accessing services via telehealth.
The research survey must be completed by December 31, 2016. The Telehealth Council’s report and recommendations are due to the Legislature and the Governor by October 31, 2017.
The Telehealth Council members are an impressive collection of professionals dedicated to telehealth in Florida, and deliberately represent different aspects of Florida’s health care industry. Nine members were appointed by AHCA Secretary Elizabeth Dudek and four were appointed by Florida Surgeon General Dr. Celeste Philip. In addition to Secretary Dudek and Surgeon General Philip, the other Telehealth Council members are:
Organization Representing Facilities (Hospitals)
- William Manzie, of Hollywood, serves as the Administrative Director of Telehealth Strategy for Memorial Healthcare
Organization Representing Facilities (Other)
- Matthew Stanton, of Cleveland, OH, serves as Senior Director of Distance Health for the Cleveland Clinic
Entity that Creates or Sells Telehealth Products
- Dr. Steven Selznick, of Longwood, serves as the CEO/President for Selznick Consulting a CFP Physicians Group
- Darren Hay, of Miami Beach, serves as the Senior Vice President of Ideal Life
Organization that Represents Telehealth Stakeholders
- Monica Stynchula, of St. Petersburg, serves as the CEO of REUNIONCare and is the acting state president of AARP
Health Insurer that Covers Telehealth Services
- Elizabeth Miller, CRNP, of Tampa, serves as the Chief Operation Officer of WellCare Health Plans
- Dr. Ernest Bertha, of Sunrise, serves as the Medical Director of Sunshine Health
Long-Term Care Provider
- Leslee Gross, of Coral Gables, serves as the Assistant Vice President of Operations for Baptist Health South Florida
- Dr. Kevin O’Neil, of Sarasota, serves as the Chief Medical Officer of Brooksdale Senior Living, Inc
Health Care Practitioner
- Dr. Kim Landry, of Gulf Breeze, serves as the EMS Medical Director and Chief Medical Officer for Leon County EMS and Lifeguard Ambulance Service, Inc
- Dr. Sarvam Terkonda, of Jacksonville, serves as the Site Medical Director for Connected Care in Florida for Mayo Clinic
Organization that Represents Health Care Practitioners
- Dr. Anne Burdick, of Miami Beach, serves as a Professor of Dermatology, Leprosy Program Director and Associate Dean for Telehealth and Community Outreach for the University of Miami, Miller School of Medicine
- Mike Smith, of Tallahassee, serves as the Telemedicine Program Development Director for Florida State University, College of Medicine
“Telehealth is an exciting, emerging area of medicine that will allow us to use new communication technology to improve access to care and bolster data about patient monitoring all over the world,” said Surgeon General Philip. “As we move forward with the opportunities and advancements in this field, I am honored to commend, along with the Agency for Health Care Administration, the 13 newly appointed members of our Telehealth Advisory Council who will guide telehealth services in our state.”
The Florida telehealth community looks forward to seeing the Telehealth Council’s work develop and flourish, as Florida is in the minority of states without a telehealth commercial insurance coverage or payment parity law. Currently, 31 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 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. Commercial insurance reimbursement is among the five telemedicine trends driving health care transformation in 2016 and beyond.
How to Contact the Telehealth Council
Anyone may submit information or comments to the Telehealth Council for consideration. Comments, suggestions, and documents that organizations or individuals would like for the Telehealth Council to consider can be submitted electronically through on-line comment form, emailed to [email protected], or mailed to Telehealth Advisory Council, 2727 Mahan Drive, MS #16, Tallahassee, FL 32308. Meetings of the Telehealth Advisory Council are open to the public and are noticed in the Florida Administrative Weekly.
For more information on telemedicine, telehealth, virtual care, and other health innovations, including the team, publications, and other materials, visit Foley’s Telemedicine Practice.