- A total of 42 states and Washington, D.C. have passed laws encouraging health insurance plans to cover telehealth services, although the specific provisions in the laws vary, according to a new report from law firm Foley & Lardner.
- Far fewer states — just 16 — address reimbursement specifically. Of those, ten states have payment parity requiring health insurers pay the same rates for virtual and in-person services, while the remainder set a rate ceiling, floor or outline instructions for negotiating payment rates.
- When it comes to regulating specific virtual services, 24 states mandate coverage for store-and-forward telehealth, which involves gathering information about a patient and transmitting it to another site typically for consultation with a specialist. Meanwhile, 13 states mandate coverage for remote patient monitoring.
Telehealth services from virtual office visits to remote patient monitoring have the potential to give consumers access to convenient and efficient healthcare services, particularly for people who live in geographic areas with few healthcare providers.
Consumers are beginning to see value in these services. Telehealth usage has grown from less than 5% nationally in 2012 to 45% in 2017, according to a white paper from FAIR Health.
Overall, consumer experience with virtual consultations seems to be positive, according to a survey released recently by J.D. Power. The survey of nearly 8,300 consumers also found that 85% of telehealth users were able to completely resolve their medical issue as a result of a virtual visit.
Although laws in many states inhibited the growth of telehealth services in the past, many state governments now are passing laws encouraging the adoption of virtual services. That's a "sea change compared to a decade ago," according to the Foley & Lardner lawyers.
Nonetheless, there are significant differences among the state laws and some barriers remain, the study found.
For example, four of the 42 states with laws addressing telehealth services (Florida, Michigan, Illinois and Massachusetts) do not specifically require payers to cover telehealth services. Eight other states have not passed a telehealth statute: Alabama, South Carolina, North Carolina, West Virginia, Pennsylvania, Wisconsin, Wyoming and Idaho.
And some states still restrict where patients can be located physically — such as to a medical clinic — to participate in a virtual visit. In addition to Washington, D.C., those states are Arizona, Florida, Tennessee, and Washington.
On the other end of the spectrum, 25 states have adopted provisions prohibiting health insurers from charging their beneficiaries larger deductibles, copays or coinsurance for telehealth services than they do for in-person consultations.
Overall, the Foley & Lardner lawyers wrote, "the trend is towards favorable treatment for telehealth."