There are two big pieces of pending legislation in Pennsylvania that could change the way telemedicine happens there. One is the state’s parity law, which would secure greater reimbursement security for telehealth providers!
The other bill concerns the Interstate Medical Licensure Compact, which would help physicians and patients in Pennsylvania have greater cross-state access.
The use of telehealth is rapidly expanding in response to the COVID-19 emergency. Starting March 1, 2020 and for the duration of the COVID-19 Public Health Emergency (PHE), Medicare will make payment for services furnished to beneficiaries in all areas of the country in all settings. Many other health insurers have also updated their telemedicine policies in response to the crisis.
Additionally, the HHS Office for Civil Rights (OCR) will waive penalties for HIPAA violations against health care providers that serve patients in good faith through everyday communications technologies, such as FaceTime or Skype, during the COVID-19 nationwide public health emergency.
The Pennsylvania Medical Society (PAMED) has created a telehealth reference sheet to help physicians, practices, and health care organizations navigate telehealth and e-visits.
HARRISBURG – The Senate today approved legislation that promotes telemedicine as a way to overcome barriers to quality patient care created by distance and reduce the costs of those services, according to the bill’s prime sponsor, Sen. Elder Vogel (R-Beaver).
“No one was even remotely aware of COVID-19 and the impact that it could have on our society when I first introduced this bill. But, if we take nothing else away from this pandemic, we now fully understand the critical need for this tool,” said Senator Vogel. “This bill is about building the infrastructure for telemedicine. It’s about establishing who gets paid for what and how to affordably increase the access to healthcare.”
Telemedicine is a rapidly growing component of health care, and many health care professionals and hospitals in Pennsylvania are already providing services via telemedicine. However, currently none of the health care professionals’ licensure acts explicitly authorize or regulate practice via telemedicine.
Senate Bill 705 specifically defines “telemedicine” as “the delivery of health care services provided through telecommunications technology to a patient by a health care practitioner who is at a different location,” and allows anyone with a medical license or otherwise regulated by Pennsylvania law to provide telemedicine services. Each of Pennsylvania’s licensure boards will develop regulations within the scope of practice and standard of care, with the rules taking into consideration model policies and clinical guidelines for appropriate use of telemedicine, as well as providing for patient privacy and data security standards compliant with federal and state law.
In Pennsylvania, many health insurers already provide coverage for some form of telemedicine, but coverage varies by location and health care service. Forty states have statutes that require private insurers to cover telemedicine in the same way they cover in-person health care services. All 50 states’ Medicaid programs cover some health care services delivered via telemedicine, and Pennsylvania’s Medicaid program, known as Medical Assistance, has been reimbursing for some health care services via telemedicine since at least 2007.
Senate Bill 705 provides clarity regarding insurance company reimbursement for telemedicine services, requiring a health insurance policy to provide coverage for medically necessary telemedicine delivered by a provider who delivers a covered service via telemedicine consistent with the insurer’s medical policies. The legislation prohibits a health insurance policy from excluding a health care service for coverage solely because the service is provided through telemedicine, and stipulates payment for covered services provided via telemedicine shall be negotiated between the provider and health insurer, with those agreements to be filed with and subject to state Department of Health review.
“Telemedicine will vastly improve the availability of health care options for people in rural or urban areas, lower the cost of health care and strengthen the bond between patients and their doctors,” Senator Vogel said. “Telemedicine is especially vital for patients who suffer from chronic illness, seniors who are homebound and families who live in rural areas where they would have to travel a far distance to receive medical care. We need to make this option available for all Pennsylvanians.”
The legislation now heads to the state House of Representatives for consideration.