A bill introduced in the U.S. House seeks to establish a federal definition of telehealth and clear up the confusion from myriad state policies.
"Telehealth is a major contributing factor to increased health care quality, convenience, and lower costs. However, there currently are 50 separate sets of rules as to what type of care can be provided. This often leaves both providers and patients in a state of uncertainty," Reps. Doris Matsui (D-Calif.) and Bill Johnson (R-Ohio) announced Tuesday. "The Telehealth Modernization Act will provide guidance to states as they look to utilize telehealth technologies in the safest, most secure manner possible."
They said they based the bill on legislation passed in California. The California legislation, for instance, updates the definition of telehealth to include store-and-forward technology, such as communications systems that work like emails with attachments, and to cover home monitoring of patients.
The California law also broadens the scope of licensed healthcare professionals allowed to practice telehealth. While it does not require a physician to have first met the patient in person, the law requires physicians to have access to the patient's medical history, have an interactive conversation with the patient, and document the evaluation and treatment.
Peter Antall, medical director of the Online Care Group, a primary care group that delivers telehealth nationally, told InformationWeek the myriad state laws make it difficult.
"It really is a patchwork when it comes to telehealth. We have 50 different states and 50 different viewpoints on what's appropriate telehealth and what isn't. We also have 50 different pharmacy boards. In some states, there is telehealth legislation; in other states, there isn't," Antall said.
The Centers for Medicare & Medicaid Services announced changes to Medicare's 2014 physician fee schedule to incrementally expand coverage for telehealth services. Reimbursement has been a primary barrier to the widespread use of telehealth. Another has been licensure. The TELEhealth for MEDicare (TELE-MED) Act of 2013, also in the House, would allow Medicare providers to treat patients electronically across state lines without having to obtain multiple state medical licenses.
Yet another bill in the House--the 21st Century Care for Military & Veterans Act (H.R. 3507)--would expand access to telehealth services for veterans and their families.