Welcome to another edition of Regulatory Roundup, a monthly blog where I summarize the latest regulatory updates affecting the telehealth industry. Let’s take a look at what happened in April.
Federal
US House Bill 7383 – Continuing Medical Education Access – Introduced
This bill would establish a program to ensure primary care physicians and other providers at federally qualified health centers (FQHCs) and rural health clinics (RHCs) have access to accredited continuing education. It also would provide training and support to allow providers to practice at the top of their license and improve care for patients in underserved areas.
US House Bill 7236 – Availability of Medicaid Services – In Energy and Commerce Committee
This bill seeks to guide states on expanding the provision of mental, emotional, and behavioral health services to Medicaid beneficiaries. It would include descriptions of best practices for running effective programs, service provision for underserved communities, and recruitment and retention of providers.
One year after enactment, the secretary of Health and Human Service must issue guidance to states on best practices to sustain and enhance the availability of telehealth services covered by state plans or waivers of such plans.
By State
Alabama House Bill 423 – The Practice of Medicine – Enacted
The enacted bill allows physicians to establish a physician-patient relationship without a prior in-person visit. It also requires a physician or practice group that provides telehealth services more than four times in a 12-month period to the same patient for the same medical condition without resolution; the physician shall do one of the following:
- See the patient in person within a reasonable time, which shall not exceed 12 months.
- Appropriately refer the patient to a physician who can provide the in-person care within a reasonable amount of time, which shall not exceed 12 months.
- Each pregnancy shall be considered a separate or new condition.
- The term “practice group” shall mean, at a minimum, a group of providers who have access to the same medical records.
- The Board of Medical Examiners, by rule or otherwise, may provide for exemptions to the requirement that are no more restrictive than the provisions of this article.
Minnesota Senate Bill 3501 – Physician Assistants (PAs) – Failed & Indefinitely Postponed
This would have added physician assistants to specific healthcare and insurance statutes. It would have ensured that all benefits provided by a policy for medical treatment or services must include services provided by PAs. It would have also allowed PAs and advanced practice registered nurses to verify disabilities in certain circumstances.
Mississippi Senate Bill 2738 – Revise Telemedicine Coverage – Enacted
This bill revises the definition of telemedicine to match the law requiring health insurance and employee benefit plans to cover and reimburse telemedicine when properly coded. The updated definition of telemedicine reads as follows:
(d) “Telemedicine” means the delivery of healthcare services such as diagnosis, consultation, or treatment through the use of HIPAA-compliant telecommunication systems, including information, electronic and communication technologies, remote patient monitoring services and store-and-forward telemedicine services. Telemedicine, other than remote patient monitoring services and store-and-forward telemedicine services, must be “real-time” audiovisual capable. The Commissioner of Insurance may adopt rules and regulations addressing when “real-time” audio interactions without visuals are allowable, which must be medically appropriate for the corresponding healthcare services being delivered.
New Hampshire Senate Bill 382 – Telehealth Licensure Requirements – In 2nd Committee
This bill would require out-of-state healthcare professionals providing telehealth to be licensed, certified, or registered by the appropriate NH licensing body when treating patients located in the state. This requirement does not apply to out-of-state physicians providing consultation services to a physician licensed in the state that bears responsibility for the patient’s care.
Rhode Island Regulation – Licensure and Discipline of Physicians – Effective 4.24.22
While the definition of telemedicine includes asynchronous adaptive interview and store-and-forward, the standard of care indicates that “Asynchronous evaluation of a patient, without contemporaneous real-time, interactive exchange between the physician and patient, is not appropriate.”
After the first violation, physicians are subject to fines not to exceed $1,000.
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