Policy News

How State and Federal Policy Impact the Telemedicine Field

By Vera Gruessner

- The use of telehealth tools will only expand across the country if state and federal policies continue to support the growth of the telemedicine field. Since the beginning of this century, new federal regulations began to blossom in support of expanding the utilization of telehealth tools.

Telehealth Tools

The U.S. Department of Health and Human Services Health Resources and Services Administration sent a report to Congress in which the earliest regulations of telehealth expansion were outlined.

According to the report, Congress passed the Health Care Safety Net Amendments in 2002, which provided grants to state licensing boards that would support developing state regulations and policies to reduce barriers for the telemedicine field.

The American Recovery and Reinvestment Act of 2009 brought forth funds and grants for the State of Wisconsin Department of Regulation and Licensing to further improve physician licensure portability when it comes to the telemedicine field.

“Licensure portability is seen as one element in the panoply of strategies needed to improve access to quality health care services through the deployment of telehealth and other electronic practice services in this country,” the report stated. “But licensure portability goes beyond improving the efficiency and effectiveness of electronic practice services. Overcoming unnecessary licensure barriers to cross-state practice is seen as part of a general strategy to expedite the mobility of health professionals in order to address workforce needs and improve access to health care services, particularly in light of increasing shortages of healthcare professionals.”

According to the Center for Connected Health Policy, there are no two states in the country that have the same telehealth policy even though there is some resemblance in the wording of the regulations. This could be a significant problem for the expansion of the telemedicine field especially if some states restrict physician participation in telehealth due to lack of licensure in the state the patient resides.

Some states only address portions of telehealth application in their Medicaid program documentation while others have established laws based on their telemedicine policy. These inconsistencies among state telehealth policies creates a very complex environment for healthcare providers focused on incorporating telemedicine tools in their practice, especially among hospital systems that span several states.

Currently, a total of 46 state Medicaid programs reimburse providers for utilizing some kind of live video capabilities when communicating with patients remotely. Additionally, 14 states offer Medicaid reimbursement to healthcare providers who conduct remote patient monitoring. A report from the Center for Connected Health Policy illustrates that some states put restrictions on the definition of the telemedicine field including excluding certain physician-patient communication channels such as email, phone, and/or fax. In addition, Rhode Island and New Jersey are the only states that lack a legal definition of the terms telemedicine and telehealth.

“When we talk about the regulation of telemedicine, we may point to one issue or an agency or even a group of agencies,” McDermott Will & Emery Partner Dale Van Demark told mHealthIntelligence.com. “But we have to recognize that with something like telemedicine, you're implicating a number of different laws and a number, accordingly, a number of different policy perspectives.”

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