Trending in Telehealth highlights monthly state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists, and technology companies that deliver and facilitate the delivery of virtual care.
Trending in March:
- Youth counseling and mental health services
- Insurance coverage
- Interstate compacts
A CLOSER LOOK
Proposed Regulations and Legislation:
- In Hawaii, the House proposed House Bill (HB) 951 to allow a patient seen in person by another health care provider in the same medical group as the prescribing physician to be prescribed opiates for a three-day supply or less via telehealth.
- Tennessee proposed Senate Bill (SB) 231 to require health benefit plan coverage of speech therapy, both in person and via telehealth.
- Oklahoma proposed amendments revising the office location requirements for tele-dentistry. While dentists were previously required to maintain office locations in Oklahoma, the amendment increases flexibility by allowing dentists to maintain office locations in Oklahoma or in states adjacent to Oklahoma, so long as the offices are located within 50 miles of an Oklahoma border of a state with an interstate dental and dental hygienist compact.
- Both chambers of the Tennessee legislature passed SB 1122 to create a youth mental health service program, which includes the use of telehealth.
- Both chambers of the Maryland legislature passed SB 94, an amendment that would require Medicaid to cover maternal health self-measured blood pressure monitoring for all eligible recipients. Specifically, the program must cover the provision of validated home blood pressure monitors and reimbursement of health care providers and other staff time used for patient training, remote patient monitoring, transmission of blood pressure data, interpretation of readings, and the delivery of co-interventions.
- Also in Maryland, the House proposed an amendment that would allow certain out-of-state providers to deliver clinical professional counseling services via telehealth to students. Among other changes, the amendment removes limitations that previously capped counseling services at five days per month and 15 days per calendar year.
- West Virginia’s SB 299 would require legislative telehealth rules to include a prohibition on prescribing or dispensing gender-altering medication.
- In Colorado, the Department of Regulatory Agencies and the Medical Board proposed a rule imposing requirements for physicians and physician groups entering into collaborating agreements. Physicians must actively practice medicine in Colorado and, for purposes of the rule, practicing medicine based primarily on telehealth technologies does not constitute as “actively practicing medicine.”
Finalized Regulatory and Legislative Activity:
- Virginia passed HB 1945, requiring that each school board consider developing and implementing policies that allow public school students to schedule and participate in telehealth services and mental health teletherapy services during regular school hours with parental consent. The bill mandates that any such policies developed by a school board must (i) require each school to designate a location for student use for such telehealth appointments, (ii) implement measures to ensure the safety and privacy of any student participating in a telehealth appointment, and (iii) prohibit any student from being subject to disciplinary measures for participating in an appointment during regular school hours.
- The Mississippi governor signed SB 2415 into law, mandating that health insurance plans cover telemedicine services to the same extent as in-person consultations. Similarly, the bill requires that all health insurance and employee benefit plans in Mississippi reimburse out-of-network providers for telemedicine services under the same reimbursement policies applicable to other out-of-network providers.
- North Dakota adopted an amendment revising telehealth licensure requirements for optometrists. Notably, the bill removes previous certification requirements, permits licensed optometrists to use telemedicine to provide care, and imposes new informed consent obligations.
- Utah finalized three telehealth bills:
- HB 39 requires the US Department of Health and Human Services to contract with a telehealth psychiatric consultation provider to offer consultation services to staff responsible for inmates’ psychiatric care.
- SB 64 allows medical providers to electronically renew a recommendation to a medical cannabis patient cardholder or guardian cardholder using telehealth services.
- HB 281 clarifies that only licensed psychologists, social workers, and counselors can provide mental health services in school settings, except as provided in a student’s individualized education plan or Section 504 accommodation plan, and other students may not be present when services are provided. Additionally, the school or provider must obtain written parental consent before providing or facilitating telehealth or another health care service to a student within a public school.
- Virginia passed SB 1041, enabling healthcare providers to conduct telehealth sexual assault forensic examinations for victims of sexual assault if a forensic examiner is not readily available.
- Colorado enacted HB 1132. The bill creates the military family behavioral health grant program to provide grants to local nonprofit organizations for the establishment and expansion of community behavioral health programs that provide behavioral health services to service members, veterans, and family members of service members and veterans. The bill requires the program to reimburse providers for telehealth visits at the same rate as in-person visits.
- In Ohio, the Department of Mental Health and Addiction Services finalized a rule regarding mobile response and stabilization services (MRSS), structured intervention and support services designed for people under the age of 21 who are experiencing emotional symptoms, behaviors, or traumatic circumstances. The rule delineates the circumstances in which MRSS can be delivered using a telehealth modality, including, but not limited to, when the young person or family requests telehealth services or there is a contagious medical condition present in the home.
Compact Activity:
- Several states have advanced licensure compacts. These compacts enable certain healthcare professionals to practice across state lines, whether in person or via telemedicine. The following states have introduced bills to enact these compacts:
- Dietitian Licensure Compact: South Carolina, North Dakota, Iowa, and Oklahoma
- Counseling Compact: New Mexico
- Social Work Licensure Compact: North Dakota
Why it matters:
- As youth mental health concerns rise, states increasingly turn to telehealth. Virginia, Tennessee, Utah, Maryland, and Ohio all advanced legislation or regulations to expand youth access to telehealth services, particularly for virtual counseling services in schools. Telehealth providers may be well-positioned to collaborate with teachers, caregivers, and school counselors to bridge gaps in youth healthcare.
- States are increasingly adopting coverage parity legislation. Tennessee proposed a bill requiring health benefit plan coverage of speech therapy services provided via telehealth while Mississippi enacted broader legislation mandating health insurance coverage of telehealth services to the same extent as in-person services. These coverage parity initiatives improve telehealth access by ensuring that providers are equally incentivized to provide virtual and in-person services.
- States continue to expand practitioners’ ability to provide telehealth services across state lines. Expanding interstate licensure compacts improves access to qualified practitioners, particularly in underserved and rural areas. These compacts also enhance career opportunities and reduce the burdens associated with obtaining multiple state licenses.
Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team works alongside the industry’s leading providers, payors, and technology innovators to help them enter new markets, break down barriers to delivering accessible care, and mitigate enforcement risk through proactive compliance.