Telehealth Panel Eyes Insurance, Licensing

Oct 4, 2017

To increase the use of telehealth in Florida, a panel is recommending that insurance companies be required to reimburse health-care providers for telehealth services and that the Legislature authorize participation in interstate “compacts” that make it easier for doctors and other providers to be licensed in a variety of states.

The Telehealth Advisory Council held a two-hour-plus teleconference Tuesday, with members reviewing a draft copy of a 32-page report that will be sent to the governor and Legislature later this month.

Agency for Health Care Administration Secretary Justin Senior, the chairman of the advisory council, said a copy of the report would be posted publicly and that another meeting will be held before the panel votes on the final version.

“I really appreciate all the work that has gone into this. I really think it's coming together nicely,” Senior told members of the council.

Telehealth, at least in part, involves using the internet and other technology to provide services to patients remotely. The Legislature for years grappled with telehealth and how it should best be used and regulated. In 2016, lawmakers passed a bill creating the advisory council and directed it to survey the current level of telehealth participation in the state, identify obstacles and make recommendations on how those obstacles can be eliminated.

Recommendations in the report run the gamut, from making clear that a practitioner/patient relationship can be established through telehealth to providing a definition for telehealth.

Perhaps the most controversial recommendation, though, is that the Legislature requires insurance companies to reimburse health-care providers for telehealth services as though the care were provided face-to-face.

Moreover, the draft report also recommends that insurance companies cover services provided via telehealth if the same services are covered for in-person visits.

The advisory board recommendation applies to commercial insurance coverage only. The report recommends, however, that the state support changes being considered by Congress that would make Medicare coverage of telehealth services less restrictive.

With regard to Medicaid, the advisory council is recommending that the state amend its Medicaid rules and allow reimbursement to providers for more telehealth services. Currently, Medicaid rules allow for reimbursement of live video conferencing only.

Advisory council member and Leon County EMS provider Kim Landry told The News Service of Florida on Monday that the recommended mandates on insurance companies should go a long way to increasing access to telehealth services.

“Reimbursement has been an issue,” he said, noting that he doesn't expect every provider to gravitate toward telehealth but that the promise of reimbursement will help sway some physicians.

As of September, 34 states and the District of Columbia had established health-insurance parity laws to address gaps in coverage for telehealth services, according to the draft report. But only three of the states with telehealth parity laws explicitly mandate that the reimbursement for telehealth services be the same as for in-person care.

The advisory council worked with the Office of Insurance Regulation, the Department of Health and the Agency for Health Care Administration in polling insurance companies, facilities and providers about telehealth.

The findings showed that only 6 percent of practitioners in Florida reported using telehealth, which was below the national average of 16 percent.

Those who did offer telehealth services were recent converts, with 55 percent reporting doing so for the first time in the last year.

The poll also showed hospitals in Florida lagged behind their peers nationally in the use of telehealth. While 45 percent of hospitals responding to the Florida survey reported using telehealth, that was less than the 52 percent of hospitals (with another 10 percent in the process) in a 2013 national poll.

Results of the Florida survey showed that for health care practitioners, the top barriers for telehealth were financial. Practitioners were concerned about the required investments, adequate reimbursement for services and a financial return.

In addition to tackling reimbursement, the advisory council also weighed in on licensure requirements, recommending that “health care practitioners be licensed in Florida prior to being allowed to provide care to a patient in Florida.”

To make the licensure process easier, the council is recommending that the Legislature authorize Florida to participate in multi-state practitioner licensure compacts so long as the eligibility requirements for licensure equal or exceed the state's existing requirements.

The advisory council also is recommending that, similar to the boards of medicine and osteopathic medicine, the various health-care regulatory boards and councils be given specific authority to develop rules necessary to implement telehealth.