More states have passed telehealth parity laws, but fine print holds back adoption

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The majority of states have enacted telehealth parity laws, but imprecise language has left room for interpretation.

Over the last seven years, the number of states that have telehealth parity laws has increased threefold. However, nuances within the language of those laws have stymied telehealth adoption.

Fueled by cheaper and more advanced technology, greater access to broadband and a spike in Americans with health insurance, 23 states and the District of Columbia have adopted telehealth parity laws since 2010, according to a report (PDF) from the Center for Connected Health Policy. Prior to 2010, just eight states had enacted such laws.

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However, broader support at the legislative level hasn’t necessarily increased adoption, in part because the language in many of those state laws is ambiguous and subject to interpretation. Amid that legislative leeway, payers have adopted disparate policies that prompt confusion among patients and providers.

“There is a broad misconception that, because telehealth private payer laws are in place in many states around the country, telehealth is achieving its promise of providing the same patient benefit and payment as in-person care,” the authors write. “The reality is that many private payer laws have been weakened by their lack of clarity and often contain clauses that may negate much of the intent of the legislation.”

For example, some parity laws restrict telehealth live video, excluding two other modalities—store-and-forward and remote patient monitoring. In other instances, the language of the law doesn't include succinct language for payment parity. That was the case in New York, where Excellus BlueCross BlueShield told providers telehealth services would be reimbursed at half the rate of an in-person visit. The authors worried that the isolated incident could be “the start of a new trend.”

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Ultimately, the center recommended policymakers user explicit language to ensure reimbursement for all modalities and limit reimbursement confusion.

Payment has been a historic struggle for the telehealth industry, but it hasn’t stopped providers from making significant investments out of concern they will be left behind in the rush to integrate the new technology into patient care. Half a dozen bills have been introduced to the House and Senate this year, including the popular CONNECT for Health Act, but it’s unclear whether Congress will push any of them forward.