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Washington State Lawmakers to Debate 4 Separate Telehealth Bills

Bills now before Washington state lawmakers call for payment parity for telehealth, a training curriculum for using telemedicine, credentialing guidelines and a Project ECHO program addressing students with mental health issues.

Source: ThinkStock

By Eric Wicklund

- Washington state lawmakers will be taking up no less than four telemedicine bills this legislative session, thanks to one state senator who sees telehealth as a priority in the Pacific Northwest.

“It’s a challenge for people who live in areas to get adequate health and mental health care where there isn’t easy access to care providers, particularly specialists,” Republican State Sen. Randi Becker said in a recent press release. “This includes many of my constituents because there isn’t a hospital in my district. The last thing you want to do when you are sick or suffering from mental illness is travel hours to see someone qualified to treat you. Telemedicine closes that distance and allows the health care system to do a better job making patients well.”

Three bills were reviewed this week by the Senate Health and Long Term Care Committee. They are:

SB 5385, which targets payment parity. The bill seeks to have payers reimbursed for telemedicine and asynchronous (store-and-forward) telehealth services at the same rate as in-person care. It would also eliminate a requirement that any asynchronous telehealth services be accompanied by “an associated office visit between the covered person and the referring health care provider.

SB 5386, which focuses on training standards for healthcare providers using telemedicine. The bill seeks to establish a telemedicine training program by 2022 that includes education on how to use the technology and all applicable state and federal laws, liability, informed consent and any other necessary guidelines. All providers would have to complete this program every four years.

SB 5387, which applies to telemedicine credentialing. The bill, if passed, would enable healthcare providers using telemedicine to extend the physician’s privileges to the health system in which the patient is located, provided both locations agree to the service.

“Demand is very high for telemedicine and has the potential to save $6 billion a year in health care costs for insurance companies,” Becker said in the press release. “In fact, 93 percent of patients who have used telemedicine say it lowered their health care costs. We should be doing everything we can to expand services and improve access.”

A fourth bill introduced but not yet assigned a hearing date calls for using telemedicine to treat middle- and high-school-aged youths with mental health issues.

SB 5389 would, if passed, direct the University of Washington to use a virtual platform to train school staff on how to identify students at risk of suicide, substance abuse or violence. UW would use the Project ECHO program, creating a hub-and-spoke telemedicine platform so that participants could log on for regularly scheduled interactive training sessions hosted by experts at the university.

The bill also calls for the creation, through Project ECHO, of a regularly updated directory of psychiatrists who use telemedicine and are able to work with at-rick students. It then mandates that schools in the state create a telemedicine station so that at-risk students can conduct at least two telehealth sessions with a psychiatrist from that directory.

Also, the bill mandates that all school nurses, school social workers, school psychologists and school counselors complete a training program of at least three hours on identifying at-risk students that includes guidance on using telemedicine. That program would also be incorporated into the certification process for teachers.

Becker has long been an advocate for telehealth. Bills sponsored by her were passed into law in 2015 and 2016 that, respectively, established payment requirements and originating site definitions for telemedicine and added the patient’s home as an originating site.

Two bills introduced by Becker last year, one calling for payment parity and the other allowing the consumer to choose where to receive telehealth services, failed to make it out of the Legislature. A later bill co-sponsored by her did become law; it directed the state’s Collaborative for the Advancement of Telemedicine to review payment practices and make recommendations for improved parity across providers – a precursor to this year’s payment parity bill.

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