All but eight states introduced at least one bill related to telemedicine to their state legislature in 2015, according to a new report from the National Conference of State Legislatures. State lawmakers floated a total of 200 bills across the country.
The report is meant to explore the benefits and risks of telehealth for state legislatures, as well as to provide an overview of the status of reimbursement in telemedicine in various states. NCSL's definition of telemedicine includes video visits, store and forward, remote patient monitoring, and mobile health, though they note that different states define the category differently.
The Federation of State Medical Board’s proposed interstate licensing compact accounted for some of the bills passed this year. Eleven states (Alabama, Idaho, Illinois, Iowa, Minnesota, Montana, Nevada, South Dakota, Utah, West Virginia and Wyoming) passed the medical licensure compact language in 2015, all by large margins. Only seven states needed to pass the compact to put it into effect.
In addition to state actions in 2015, the federal government introduced two bills that could supersede local laws for VA and Medicare patient populations. The TELEmedicine for MEDicare Act of 2015 (TELEMED Act) and the Veterans E-Health and Telemedicine Support Act of 2015 would create an interstate license, similar to a driver’s license, for practicing medicine on VA and Medicare populations.
All states but Rhode Island offer some kind of Medicaid reimbursement for telemedicine under Medicaid, according to the report, and nearly all reimburse for live video visits. Nine states—Alaska, Arizona, California, Illinois, Minnesota, Mississippi, New Mexico, Oklahoma, and Virginia—reimburse for store and forward services and 17 reimburse for some kind of remote patient monitoring.
Of the states that mandate Medicaid reimbursement for telehealth, 32, plus the District of Columbia, have telehealth parity laws that say services performed via telehealth have to be reimbursed at the same rate as the in-person version of the service. Twenty-three states and DC have “full parity” which extends to both coverage and reimbursement.
Of course, different states place different restrictions on what telemedicine they reimburse. Some make a distinction between types of providers, excluding behavioral health providers, for example. Others require a particular originating site, where the patient has to be located to receive reimbursement, and some still restrict telemedicine reimbursement to rural areas.