NEW ORLEANS – Telehealth regulation and reimbursement are hot topics at the state and federal levels, as the benefits and value of using technology to remotely deliver health care are proving hard to ignore.
In the last year, more than 200 telehealth-related laws were introduced at the state level and 64 at the federal level, according to Lisa Smith Mazur, a partner in the law firm of McDermott Will & Emery and a speaker at the recent Home Health Technology Summit.
“We’re seeing a lot of evolution in regulation and reimbursement—things are improving,” said Mazur, whose practice focuses on digital health.
Mazur said the regulatory concerns with telehealth that persist are around the lack of a direct clinical setting and the potential lack of jurisdictional reach.
“Accordingly, standards of care and licensure have been a primary focus of regulatory concerns and development,” she said.
But while concerns are still being worked out, the benefits of telehealth are being recognized.
“Professional associations are coming to the table and looking at telehealth as a solution and they’re encouraging providers to use it,” Mazur said. “Each of the different stakeholders is coming together.”
The current state of reimbursement for telehealth is not great, said Mazur, but things are looking up. Medicare, with its traditional high barrier to reimbursement, is slowly expanding, but Medcaid still looks at telehealth as experimental and has scattered and inconsistent requirements for reimbursement, she said. Commercial payers were initially resistant to telehealth, but they have been steadily more accepting, she said.
An area that is breaking open is the self-pay, Mazur said.
“For someone with a high-deductible health plan, it’s sometimes cheaper and more attractive to just pay out of pocket for some health care,” she said.
Mazur believes payment reform for telehealth is on the horizon with new payment models like the Children’s Health Insurance Program (CHIP), the Medicare Access and CHIP Reauthorization Act (MACRA) and the 21st Century Cures Act.