Report: Despite progress, telehealth still faces disparate Medicaid policies

Telemedicine consultation
Most states have basic coverage for telemedicine services, but the details vary widely. (Getty/AndreyPopov)

Medicaid regulations in all but two states offer reimbursement for some form of telemedicine, but those policies vary widely from state to state, often limiting the services available to patients. 

Massachusetts and Rhode Island were the only two states without Medicaid reimbursement for live video telehealth visits, according to a report from the Center for Connected Health Policy. Among those that do have a policy, several have expanded regulations to allow for remote patient monitoring as well as store and forward, where patients can send digital images and data to a telemedicine provider.

The update echoes a recent report by the American Telemedicine Association (ATA) indicating that telemedicine progress is “a mix of strides and stagnation.”

RELATED: Telehealth’s payment conundrum persists as innovation marches forward

But the report also notes that Medicaid regulations often limit telehealth services to certain geographic areas, medical facilities or specialties. More states are passing legislation that directs medical boards to adopt practice standards to address issues such as online prescribing. As a result, telemedicine has emerged as a top concern for medical boards in the coming year.

Thirty-five jurisdictions have laws governing private payer coverage, most of which include parity laws for the type of services covered but not necessarily coverage amounts. The number of states with private payer regulations has increased since 2014 but has leveled off over the last year.

Payment has been a long and arduous battle for the telehealth industry, and Medicaid policies, in particular, were highlighted in a keynote address by Pamela Peele, Ph.D., chief analytics officer at the University of Pittsburgh Medical Center (UPMC), at the ATA’s annual conference. UPMC recently launched statewide access to telemedicine services.

Meanwhile, patients and healthcare executives are both eager to tap into the potential benefits of telehealth. A survey released by Nemours Children’s Health System found that although just 15% of parents have used telemedicine services for their child, 64% plan to. Parents said they would be most willing to use the service to treat conditions like pink eye, rashes or cold and flu.

RELATED: Is the telehealth sector headed for a bubble?

A survey released last month showed that 83% of executives were planning to invest in telehealth, citing competitive advantages and expanded market reach as the primary reasons.

Suggested Articles

Humana filed suit Friday against more than a dozen generic drugmakers alleging the companies engaged in price fixing.

Ochsner Health System is partnering with Color to launch a population health pilot program to integrate genetic information into preventive care.

Medicare Advantage open enrollment kicked off last week, and insurers are taking new approaches to marketing a slate of supplemental benefit options.