As the COVID-19 pandemic continues, states have implemented regulatory changes related to telehealth. Telehealth and telemedicine laws by state are discussed below.

Telehealth Laws by State: Medicaid Populations

The federal Medicaid program has affected telehealth laws by state. Medicaid gives states broad authority to permit coverage for telehealth services. Before the COVID-19 emergency, many states had already implemented broad telehealth coverage. Since March of 2020, all fifty states, and the District of Columbia, have issued regulatory guidance that expands telehealth for Medicaid-eligible individuals. Medicaid programs can not only cover telehealth services, but can also rapidly scale up benefits, and adjust normal cost-sharing rules. 

Telehealth Laws by State: State Legislation and Executive Orders

Since COVID-19 was declared to be a public health emergency, states have introduced legislation to make expanded access to telehealth permanent.

The following is a summary of notable telehealth laws by state that have been implemented since March 13, 2020. The summary also contains state executive orders that have made permanent the temporarily waived restrictions around telehealth.

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Alaska. Alaska’s HB 29, effective as of March of 2020, requires insurance carriers providing coverage for in-person mental health benefits, to cover the same benefits through telehealth. This law is an example of a mental health parity law.

Colorado. SB 20-212, signed by the Governor in the summer of 2020, prohibits insurance carriers from requiring an existing patient-provider relationship as a prerequisite for telehealth treatment. The bill also requires state Medicaid programs to reimburse federally qualified health centers for telehealth services given to Medicaid recipients, at the same rate as in-person services.

Idaho. Executive Order No. 2020-13, signed by Governor Brad Little in June of 2020, makes temporarily waived restrictions affecting telehealth permanent.

Iowa. SF 226, signed by the Governor at the end of June of 2020, requires mental health professionals, treating students in a school setting, to establish a patient-provider relationship with those students.

Louisiana. Louisiana HB 449 updates the Louisiana Behavioral Health Services Provider Licensing Law and the Louisiana Telehealth Access Act, to provide for the delivery of behavioral health services via telehealth.

Maine. Maine SP 676, an emergency measure signed by the Governor in March of 2020, requires that at least some behavioral case management services covered by the MaineCare program to be delivered through telehealth, without requiring qualifying criteria regarding a patient’s risk of hospitalization or admission to an emergency room. MaineCare provides health care coverage for Maine’s children and adults who are elderly, disabled, or with low incomes.

Maryland. SB 402 and HB 448 require healthcare providers offering telehealth services to be held to the same standard of clinical care that apply to in-person settings. The new legislation also requires telehealth practitioners to provide or refer a patient for inpatient for another type of telehealth insurance, if clinically appropriate.

Michigan. Michigan HB 5412 prohibits health insurers issuing policies to Michigan residents from requiring face to face contact between a provider and a patient for services the insurer has determined are appropriately provided by telehealth. Related legislation, HB 5413, imposes the same restriction on group or nongroup healthcare corporation certificates. The certificate is evidence of an enrollee’s coverage.

Missouri. Missouri HB 1682 permits physicians to establish a physician-patient relationship via a telehealth encounter, provided the relevant clinical standard of care does not require an in-person visit. 

North Carolina. SB 361 is one of the more innovative telehealth reforms on the state level. This law enacts the “Psychology Interjurisdictional Licensure Compact,” the purpose of which is to increase public access to professional psychological services by allowing for telepsychological practice across state lines, as well as temporary in-person,face-to-face services into a state which the psychologist is not licensed to practice psychology.

New York. SB 8416, signed by Governor Andrew Cuomo in June of 2020, expands New York’s definition of telehealth and telemedicine to include audio-only forms of telehealth (i.e., telephone).

Utah. Utah HB 313 broadens the scope of what “telemedicine” is. The law also requires certain health benefit plans to provide telehealth coverage parity and commercially reasonable reimbursement for telehealth services.

Virginia. HB 1332 directs the state Board of Health to develop and implement a Statewide Telehealth Plan to promote an integrated approach to the introduction and use of telehealth services and telemedicine services. The bill requires the Plan to include, among other provisions, provisions for (i) the use of remote patient monitoring services and store-and-forward technologies, including in cases involving patients with chronic illness; (ii) the promotion of the inclusion of telehealth services in hospitals, schools, and state agencies; and (iii) a strategy for the collection of data regarding the use of telehealth services. HB 1701 directs the Department of Health to determine the feasibility of establishing a Medical Excellence Zone Program, to allow Virginia residents living in rural underserved areas to receive medical treatment via telemedicine from providers in states that border Virginia. 

Washington. SB 5385 requires telemedicine parity; the law requires health insurers to reimburse providers for telemedicine services at the same rate as health care service provided in-person.  

West Virginia. HB 4003 requires telehealth insurance coverage of certain telehealth services after July 1, 2020. 

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