It was an active year for state telehealth legislation in 2018. Among 39 states and DC, 65 legislative bills passed in the 2018 legislative session, up slightly from 62 bills in 2017. Additionally, 49 telehealth related regulations were finalized in 38 states related to telehealth. The enacted legislation this year focused mainly on broadening Medicaid policy, establishing regulatory requirements and enacting interstate licensure compacts. In general there has been a slowing of enacted legislation addressing private payer reimbursement of telehealth. Adopted regulation focused on telehealth practice standards by professional boards.
Medicare Report Reveals Medicare Telehealth Utilization, Barriers & Opportunities
In response to a requirement in the 21st Century Cures Act to issue a report on telehealth use, barriers and opportunities in Medicare, CMS released an informational report on November 15th addressing telehealth utilization, activities by the Center for Medicare and Medicaid Innovation, and opportunities and barriers to the use of telehealth within Medicare. Utilizing data from Medicare fee-for-service between 2014 and 2016, the report revealed that although overall use of telehealth has increased, the rate of adoption is still limited. Mental health and therapy sessions were the most common service types, with beneficiaries with a mental health diagnosis among the highest utilizers of telehealth delivered services. Services targeting chronic diseases and behavior modification (such as smoking cessation) were also among the more popular telehealth delivered services. The analysis determined that there are 19 additional high volume services for outpatient and inpatient visits and therapy that are either similar to those that are already on Medicare’s list or that are typically provided in settings that do not meet Medicare’s originating site requirements that would be suitable for telehealth delivery. CMS concludes that restrictions on eligible telehealth originating sites is the greatest barrier preventing the expansion for telehealth within Medicare.
For more details and further statistics on telehealth in Medicare,
see the full report.
CCHP has released a report based on research completed between June-August 2018 which examines compliance with one specific provision in Texas enacted legislation SB 1107 (2017), which requires health benefit plan issuers (referred to as “issuers”) to adopt and display in a conspicuous manner the issuer’s policies and payment practices for telemedicine medical services and telehealth services on their websites, effective Jan. 2018. This is the first law in the country to place such a requirement on issuers. The issuers included in the sampling were chosen from the Texas Department of Insurance (DOI)’s website, and narrowed to those that were shown to hold 1 percent or more of the market share. Because many of the issuers listed were subsidiaries of other companies in the sample group, the total issuers in the sample were further tapered to 18. Three CCHP researchers examined each issuers’ website and telehealth policy (if found), scoring issuer policies utilizing a Public Health Law Research model (see report and codebook for details). The questions addressed through the research and coding process included the following: