Rep. Cecile Bledsoe

Shortly after the Arkansas House of Representatives rejected a bill that would have allowed telemedicine companies to offer services within the state, the House has passed a more limited bill, which had already cleared the Senate, increasing the allowable range of telemedicine services.

The new bill, SB133, is more restrictive than the one that was previously voted down. It allows telemedicine practitioners to be licensed as doctors in Arkansas, provided they have a pre-existing in-person relationship with their patient. Exceptions are made to this in cases of life-or-death emergency or in cases where the provider is "simply providing information of a generic nature." The bill also excludes store-and-forward technology, and abortions via telemedicine.

In addition to permitting the practice of telemedicine, the bill also requires that it be reimbursed by Medicaid and private health plans, and that they be disallowed from charging any less for telemedicine than they would for an office visit. An emergency clause allows the bill to take effect immediately after it's signed by governor, who has already indicated he will sign, according to Senator Cecile Bledsoe, who sponsored the bill.

"We want to open up good quality healthcare, access to specialists that sometimes only the urban areas have, to people in a rural community," Bledsoe said during a floor discussion of the bill. "Why would we expect people in the rural community to have less care and less quality care than we have in the urban areas?

Arkansas isn't the only state that's passed a bill broadening the possibilities for telemedicine. A similar bill passed in Idaho, another state that has traditionally lagged in telemedicine legislation. (Idaho and Arkansas are the only two states where Teladoc doesn't offer its services, because of regulations in those states.)

Idaho's HB189 lacks Arkansas's requirement that telemedicine practitioners have a pre-existing face-to-face relationship with the patient, but instead allows a "two-way audio and visual interaction" to stand in. Idaho's bill does allow store-and-forward technology, but does not allow telemedicine technology to be used for prescribing abortion drugs. The bill doesn't address reimbursement.

Finally, according to a round-up in iHealthBeat, several other states have either passed or been mulling telemedicine legislation recently: Colorado, Florida, and Missouri have all been debating bills that would expand telemedicine reimbursement within the state.