As expected, Arkansas lawmakers have approved legislation that would allow doctors in that state to use telemedicine – but only after first establishing a face-to-face relationship with a patient.
The Arkansas House approved the bill, SB133, shortly after shooting down House Bill 1747, a more expansive bill that didn’t include the in-person requirement. The state’s Senate had already voiced its support for SB133, making that bill the more likely of the two to see success.
The bill also establishes that the state is facing an emergency in not being able to provide adequate healthcare in underserved areas, thus enabling the law to take effect the moment it’s signed by Gov. Asa Hutchinson.
Among the most restrictive telemedicine legislation in the country, the new law allows doctors to use certain forms of telemedicine – including video, online and telephone consults – “to provide or support healthcare delivery that facilitates the assessment, diagnosis, consultation or treatment of a patient’s healthcare while the patient is at an originating site and the healthcare professional is at a distant site.” This would be allowed only after doctor and patient establish a “professional relationship;” exceptions are made for life-threatening situations or where the doctor was only offering “generic” advice.
The law would also ban abortions by telemedicine and the use of store-and-forward technology.
The new law also establishes that telemedicine visits be reimbursed at the same rate as an in-person visit. This includes both private health plans and Medicaid.
In Idaho, meanwhile, the state Senate has approved HB189 by a 31-3 vote, establishing the “Idaho Telehealth Access Act.” The legislation would allow for telehealth services once a provider has documented “a patient’s relevant clinical history and current symptoms to establish the diagnosis and identify underlying conditions and contraindications to the treatment recommended.” It allows for video, online and phone-based consults, but not treatment based solely on an online questionnaire.
Earlier this month, Florida lawmakers introduced HB 545, which would allow doctors to connect with patients via video. That bill had to be modified to allow insurers to negotiate their own reimbursement rates with providers after earlier bills that mandated equal reimbursements for online and in-person care were rejected.
Among other states debating telemedicine/telehealth legislation, Minnesota, Missouri and Colorado are looking at bills that would require payers to reimburse for telemedicine, including video visits. In Texas, meanwhile, the state’s medical board will decide next month whether to change its rules that prohibit physicians from prescribing medications to patients based on a phone or online consult, before seeing the patient in person.
As of February 2015, at least 23 states and the District of Columbia have laws on the books that require private payers to reimburse telemedicine services at rates equal to in-person visits, according to the American Telemedicine Association. In addition, as of September 2014, the Center for Connected Health Policy says, Medicaid programs in 46 states reimburse for live video consults. Some also reimburse for store-and-forward services, remote patient monitoring and hosting telemedicine services.
Date: March 30, 2015