As emergency response measures have significantly expanded patient access to virtual care during the pandemic, states are enacting laws to make telemedicine coverage more permanent over the long term. Several states have taken a closer look at regulations over the past two years, and all but seven now have some requirements on the books of how commercial insurers should cover and pay for telemedicine.
For example, West Virginia passed a law last March requiring insurers to provide the same telemedicine services that they would personally cover from July. Previously, the state did not have such requirements.
In Arizona, a new law requires commercial insurers to cover more forms of telemedicine, such as: B. Remote patient monitoring and asynchronous visits. Payers must also cover telemedicine visits of all specialties, according to the legislation that was signed in 2019 and came into force this year.
In a new report, Foley and Lardner LLP detailed the changes to commercial telemedicine insurance laws for 2021.
“In the period since our 2019 report, the legal situation for reimbursement of telehealth services has improved significantly,” the report’s authors write. “However, the quality and effectiveness of these laws varies greatly from state to state.”
Overall, the majority of states have some form of coverage under which commercial insurers must cover telemedicine services. In fact, however, fewer states indicate how much health plans should be paid for these services.
The number of states with laws reimbursing telehealth services increased from 16 states in 2019 to 22 states in 2020. A portion of them – 14 states – now require insurers to pay the same amount for telemedicine visits as they do for face-to-face visits .
States also lifted restrictions on the patient’s place of origin, which would have required them to be in a specific clinical setting in order for virtual visits to be covered. Now Tennessee is the only state with original location requirements, though lawmakers relaxed those requirements in a bill passed in August.
In more states, insurers are also required to cover asynchronous visits, e.g. For example, if a patient’s GP shares an X-ray or laboratory reports with a specialist. In some cases, patients may also be able to send questions and self-assessments to a provider who can review them later.
It is important to note, however, that the parity requirements do not apply to any telemedicine modality: monitoring patients remotely or using devices such as connected blood pressure monitors or glucometers to track patient health at home. Although Medicare now covers some types of remote patient monitoring, only 17 states require commercial health plans to cover them, according to the report.
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