Massachusetts Lawmakers Debate Compromise Telehealth Bill

December 24, 2020 - Massachusetts lawmakers are forging ahead on a telehealth bill that would mandate payment parity for primary care and chronic care management for the next two years and make payment parity permanent for behavioral health services.

S.2984, unveiled today following days of haggling between the House and Senate, would also eliminate a requirement that a provider perform an in-person exam before being able to prescribe medications via telehealth. And it would keep in place other emergency measures enacted by Governor Charlie Baker during the coronavirus pandemic until 90 days after the state of emergency ends.

The bill is being rushed through Beacon Hill in an effort to have it on Baker’s desk for a signature before January 5, 2021, when the legislative session ends.

It puts Massachusetts – long at the back of the list of telehealth-friendly states – firmly in the middle of efforts to continue telehealth momentum past the pandemic. Some states have already voted to make coverage permanent, while others have OK’d legislation that follows alongside the federal government’s efforts to continue the momentum, with expanded coverage and access that ends in a year or two or when the state of emergency concludes.

Just two years ago, the commonwealth’s House and Senate both approved telehealth bills, but couldn’t agree on a compromise bill that would have passed both chambers. One of the chief sticking points was payment parity, a concept opposed by many payers who want to negotiate their own reimbursement rates with providers.

Last year Baker unveiled a massive telehealth bill that would have established a regulatory framework for connected health and mandated payment parity. That effort was derailed by the coronavirus, though Baker included several provisions in an executive order this past March to expand telehealth access and coverage during the COVID-19 crisis.

With the bill introduced this week, lawmakers are hoping to have a framework in place that improves access and coverage at least through the pandemic and gives them a platform to work with payers and other parties on future legislation.

Payment parity for telemental health isn’t a contentious issue. With substance abuse rates at epidemic proportions and many people struggling with depression and anxiety, states and payers have moved to expand coverage for behavioral health, including ensuring that telehealth services are reimbursed at the same rate as in-person services.

But parity for primary care, chronic care management, emergency care and other services isn’t so cut-and-dried. Some have argued that parity might be good for a short period of time to drive adoption among providers, but in the long term payers and providers need to negotiate their own rates because it hasn’t been proven that virtual care has the same value as in-person care.

Asked for comment by the Boston Globe, Blue Cross Blue Shield of Massachusetts spokesperson Amy McHugh said the insurer is ready to work with lawmakers “on transitioning to a post-COVID-19 landscape that continues this progress.”