- UPDATE: Govenor Phil Scott (R.) signed S.50 into law, requiring insurance companies to pay providers the same rates for telemedicine usage as an in-person visit. The bill goes into effect on October 1, 2017.
Legislation that has been passed by the Vermont House and Senate aims to extend and regulate telemedicine reimbursement within the state. The bill includes new requirements for payers to reimburse telemedicine services, and modifies regulations related to how payers could charge beneficiaries.
If Governor Phil Scott (R) signs the legislation, S.50 will come into effect on October 1, 2017 and will apply to Medicaid and all other health insurance plans.
Under the bill, the Department of Vermont Health Access (VHA) must ensure that both the treating clinician and the hosting facility are reimbursed for the services rendered, unless the health care providers at both the host and service sites are employed by the same entity.
Along with guaranteeing clinician and facility reimbursement, payers will be required to treat telemedicine as if it were an in-person visit between a beneficiary and a provider. For example, payers can charge a deductible, co-pay, or coinsurance for telemedicine service, but charges may not exceed the amounts they would impose for an in-person visit.
Health insurance plan may reimburse for teleophthalmology or teledermatology provided through store-and-forward technology. Payers could also require a distant site health care provider to document the reason the services are being provided by store and forward means.
Payers also cannot set limits on telemedicine services, but are allowed to optionally require providers to explain why they are using telemedicine.
S.50 revisions in the Senate also contains new language that broadens telemedicine use by all types of certified health professionals
“A person, partnership or corporation, other than a facility or institution, that is licensed, certified or otherwise authorized by law to provide professional health care services in this state to an individual during that individual’s medical care, treatment or confinement,” the bill reads.
The bill is viewed by Vermont lawmakers as a way to extend access to care through telemedicine, but allows care costs to remain stable.
“A key factor behind the bill was giving people greater access to specialists in regions where they are scarce.”said Sen. Debbie Ingram-D via the VT Digger. “I think everybody thought it was a good way to provide access without raising costs astronomically,” she said.