Gearing Up for a Busy Fall at the Capitol – Telemedicine

State legislators will soon return to the Capitol, and we’re expecting a very busy legislative session during the next few months.

On Sept. 9, 2015, the Pennsylvania Medical Society (PAMED) held a media call-in to discuss some of the important health care-related issues on tap this fall.

As you can imagine, there’s a wealth of items on our fall agenda. In Part 3 of our series on the hot topics discussed during the media call-in, learn more about PAMED’s efforts to ensure appropriate patient safeguards and standards and support coverage and insurance payments for telemedicine services in Pennsylvania from Dennis Olmstead, PAMED’s director of legislative affairs. His talk from the media call-in also is available on our website.

“The use of telemedicine continues to expand nationally and in Pennsylvania, said Olmstead. “Therefore, we felt the need for patient safeguards and standards and the need to support coverage and insurance payments.”

The PAMED Board recently approved draft legislation from PAMED’s Telehealth Task Force, which is aimed at addressing barriers to telemedicine in Pennsylvania and bringing clarity to the expanded use of telemedicine in the commonwealth.

Provisions in the draft legislation include:

  • Participation Eligibility — A variety of health care providers would be eligible to participate in telemedicine/telehealth in addition to physicians. The draft legislation offers as examples the Medicare list of eligible providers. Providers would be required to practice within their scope subject to state licensure laws and regulations.
  • Licensure—Physicians and other eligible providers who provide telemedicine/telehealth care to patients in Pennsylvania would be required to be licensed in Pennsylvania with limited specific exceptions. An important principle is that the practice of medicine occurs in the state where the patient is located.
  • Professional Liability Coverage—Professional liability coverage requirements would apply to providers of telemedicine/telehealth.
  • Evaluation and Treatment of the Patient—A proper provider-patient relationship would need to be established if such action would otherwise be standard acceptable medical practice in the provision of the same service not delivered via telemedicine/telehealth. A list of minimum requirements is outlined to include a virtual face-to-face examination, and, if necessary, incorporates peripherals and diagnostic tests with limited specific exceptions.
  • Informed Consent and Privacy Practices—Providers would need to comply with informed consent rules as they relate to telemedicine/telehealth as well as follow all privacy practices, such as the Health Insurance Portability and Accountability Act (HIPAA).
  • Medical Records—Providers would be required to maintain a complete medical record of the patient’s care in accordance with the standards applicable to traditional face-to-face encounters for documentation, maintenance, and transmission of records.
  • Fraud and Abuse—Providers would be required to follow all applicable state and federal statutes and regulation for fraud and abuse.
  • Coverage of Telemedicine Services—Health insurers would be required to provide coverage for the cost of health care services provided through telemedicine/telehealth on the same basis that the insurer would for the provision of the same service provided through in-person consultation or contact.
  • Medicaid Program—Telemedicine/telehealth coverage would be required to be provided by Medicaid, HealthChoices Physical Health Managed Care Organizations, and HealthChoices Behavioral Health Managed Care Organizations.

Part 2 of our media call-in coverage discussed PAMED’s efforts to streamline the credentialing process and promote physician-led, team-based care in Pennsylvania and Part 1 discussed the state budget, medical marijuana, liability protections for physician volunteers, and the liability/negligence standard in the emergency department, and PAMED’s efforts on behalf of Pennsylvania physicians and patients.