- After passing the Colorado House of Representatives and Senate, an important piece of telehealth legislation now awaits the signature of the state's governor to become law.
In late January, the telehealth bill (HB 15-1029) for statewide expansion of telemedicine garnered overwhelming support from state representatives in two separate roll call votes — 63-2 and 58-6 — in favor of the yeas. Although the bill faced some opposition in the Colorado Senate, its margin of victory in late February was still more than two to one in favor of enacting the legislation as law: 24-10 and 25-9.
The bill awaiting Governor John Hickenlooper's signature primarily aims to remove population and insurance coverage restrictions on telehealth services beginning in the next year.
"Starting January 1, 2016, the bill removes the population restrictions and precludes a health benefit plan from requiring in-person care delivery when telemedicine is appropriate, regardless of the geographic location of the health care provider and the recipient of care," the current version of the bill reads. "A provider need not demonstrate that a barrier to in-person care exists for coverage of telemedicine under a health benefit plan to apply."
Additionally, the legislation carries three important requirements for carriers, which:
• Must reimburse providers who deliver care through telemedicine on the same basis that the carrier is responsible for coverage of services delivered in person;
• Cannot charge deductible, copayment, or coinsurance amounts that are not equally imposed on all terms and services covered under the health benefit plan; and
• Cannot impose an annual or lifetime dollar maximum that applies separately to telemedicine services.
The revisions to Colorado law places telehealth services on par with those delivered in person by healthcare organizations and providers and calls on health benefit plans to no longer limit coverage to in-person visits.
The onus remains on providers to determine the appropriateness of using telehealth services to provide care for patients, who themselves retain the right to refuse telehealth services if they so choose.
According to the bill, reimbursement must include the cost of the originating site to transmit telehealth services unless "the originating site does not include private residence at which the covered person is located when he or she receives health care services through telehealth."
Moreover, the deductibles associated with telehealth services must not exceed those of in-person services.
Health plans have until Jan. 1, 2017, to make all necessary changes prescribed by the law if enacted.
While the bill places numerous requirements on health plans, it apparently has their support. "We see it as a win-win. It’s a priority to modernize our ability to use all the tools that are available to us. If we have this technology, and we can’t use it, it does no one any good — particularly in a state like Colorado that is so rural," Ben Price, Executive Director, Colorado Association of Health Plans, told The Colorado Statesman in February.
Despite the potential benefits of HB 15-1029, Price already foresees the need for additional legislative action if telehealth is to have greater impact on healthcare delivery in Colorado.
"What this bill doesn’t cover, and what we either need the Board of Medicine and the Board of Pharmacy to take care of, or a bill to take care of, is pharmacy prescribing; and then that the relationship between patient and physician can be established via telehealth," he explain. "Right now, that relationship has to be initially established with a face-to-face meeting. We’re exploring whether there should be a discussion about expanding this bill."
Progress of HB 15-1029 is available here.