Virtual care and telehealth services are becoming more popular among patients, owing to their ease and capacity to improve access to healthcare. According to the Advisory Board’s 2017 Virtual Visits Consumer Choice Survey, 77% of consumers would consider seeing a healthcare professional virtually. Virtually nearly one-fifth of respondents (19%) had previously seen a provider.
Despite the increased interest in telehealth, the law has not yet caught up with the technology. States have their telehealth licensure, reimbursement, and consent legislation, as well as their definitions of what qualifies as telehealth. Before engaging in telehealth services, it is essential for practitioners and patients to understand the telehealth laws in their state. But before that, what IS telehealth?
Electronic and telecommunications technology to deliver clinical healthcare services, patient education, public health, and health administration is a broad definition of telehealth. It’s commonly confused with telemedicine, while the latter usually refers to the practice of medicine over the internet. Videoconferencing, remote patient monitoring and store-and-forward are all examples of telehealth. Although mobile health (mHealth) and telehealth have some overlap, the two terms should not be used interchangeably because mHealth is only available through mobile devices like smartphones and tablets.
Telehealth licensing differs from state to state. Most states need physicians to be licensed to practice in the state where the originating site is situated, while others require the healthcare practitioner to have a valid license in the state where the patient is located, according to HealthIT.gov. To put it another way, if the healthcare practitioner is in Arizona but the patient is in Maine, the provider must have a valid Maine license.
However, work toward permitting physicians to practice in many states is being done. The Interstate Medical Licensure Compact (IMLC) is a treaty between 29 states, the District of Columbia, and Guam that allows licensed physicians to practice medicine across state lines if they meet specific eligibility standards. The Compact streamlines the application process by utilizing information from a physician’s state of principal license (SPL).
However, the IMLC does not currently include all states. According to the Minnesota Medical Association, Minnesota passed legislation to join the Compact in 2015, but it now has to approve two new acts to meet new federal law enforcement background check criteria. In May of this year, New Jersey introduced Compact legislation, but it is not yet a member state.
According to the Center for Connected Health Policy (CCHP), nine state medical or osteopathic boards issue telehealth special licenses or certificates that allow out-of-state providers to provide services via telemedicine in a state where they are not located or allow providers to deliver telehealth services if certain criteria are met.
When it comes to telehealth, there’s also the issue of reimbursement to consider. While all 50 states and the District of Columbia reimburse for some live video under the Medicaid fee-for-service model, only 21 states and the District of Columbia reimburse for remote patient monitoring. Remote patient monitoring is described as the collection of medical data from patients in one location and electronic transmission of that data to a healthcare provider in another location using telehealth technologies.
Only 11 Medicaid programs in the United States reimburse for store-and-forward services, which allow for the electronic transmission of medical data such as digital photographs and pre-recorded movies.
Finally, according to Medicaid rules or regulations, informed consent is required in 38 states. Informed consent implies that the patient is aware of the facts and hazards associated with telehealth services.
It’s not as simple as requesting a virtual consultation with a healthcare physician to use telehealth. As technology advances, rules are continuously changing, making it challenging to stay up with the most current requirements. Fortunately, more states are embracing telemedicine, increasing patient access to healthcare providers across the country.