ATA: Telemedicine reimbursement, access remain a mixed bag

Since May, many states dropped a letter grade when it comes to physician practice standards on telemedicine use, but there has been a "mix of strides and stagnation" when it comes to reimbursement for the services, according to two updated reports from the American Telemedicine Association.

Alabama leapt from having one of the lowest composite scores in the ATA's May report to being one of the leading states for telemedicine standards and licensure. It received an "A" in physician-patient encounter, telepresenter and informed consent, and a "B" in licensure and out-of-state practice. The reason for the jump is a move by the board to repeal all telemedicine laws; standards are the same as in-person care, the report finds.

However, six states that received an "A" in the previous report dropped to a "B." Those included Delaware, Indiana, Maine, South Carolina and Virginia. Arkansas and Texas have the lowest scores, the report says.

The reason for the lower grades this time around include states "creating new laws that impact access to care ... while others are amending existing policies with greater implications."

The improvement on reimbursement is more notable, with 11 states adopting policies that improve coverage and reimbursement and only two states implementing policies that restrict coverage (Delaware and Rhode Island).

"Overall, there are more states now with above average grades, 'A' or 'B,' including Iowa which improved from an 'F' to 'B,' than reported in September 2014," the reimbursement report notes.

Since the 2014 report, eight states have enacted telemedicine parity and, of the 29 that have, 22 and the District of Columbia had the highest grades for allowing state-wide coverage without restrictions.

The ATA added that "coverage of specialty services for telemedicine under Medicaid is a checkered board and no two states are alike."

These reports come on the heels of the publication of a final rule by the Centers for Medicare & Medicaid Services clarifying requirements for face-to-face encounters for Medicaid beneficiaries to be eligible to receive home health services, which now allow use of telehealth for such encounters.

In addition, providers like Philadelphia-based Jefferson Health and private payers like Anthem are increasingly turning to telemedicine to innovate care delivery, as a recent FierceHealthIT special report explores.

To learn more:
- get the reports

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