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House bill would provide telemedicine standards for providers, insurers

House bill would provide telemedicine standards for providers, insurers


Rep. Donny Lambeth is taking the first crack at establishing state telemedicine policies.

Lambeth, R-Forsyth, and a leading health care expert in the General Assembly, submitted House Bill 967 during the opening days of the 2018 session.

Telemedicine has been defined for the bill’s purpose as “the use of interactive audio, video or other electronic media for the purposes of diagnosis, consultation or treatment.”

Demand for telemedicine has grown in recent years, with the service particularly aimed at individuals who live in rural areas and/or who have difficulty getting to an urban hospital.

The bill follows up on House Bill 283, which was signed into law by Gov. Roy Cooper in July.

While HB283 required the state Department of Health and Human Services to recommend a telemedicine standards policy by Oct. 1, 2017, HB967 fleshes out what some of those standards could be.

For instance, the bill would allow licensed health care providers to offer telemedicine services to any patient in North Carolina. It requires that providers gain the written consent of the patient before providing services.

The bill would require DHHS to establish licensing standards, credential processes and prescribing standards for telemedicine providers by Sept. 1, 2019.

The bill also makes recommendations on standards of care, including holding providers and medical equipment to the same standards as an in-person visit, how to securely handle patient medical records via telemedicine, and how to manage and record prescriptions of controlled substances.

Also in the bill is language requiring DHHS and the state Insurance Department to set telemedicine quality of care and reimbursement standards by Sept. 1, 2019, as well as DHHS and the state Department of Information Technology on advancing telemedicine access in the state through broadband initiatives.

“Telemedicine is the future of health care, particularly for the provider communities’ ability to reach out into our rural areas of North Carolina, who often have limited access to care, particularly specialists,” Lambeth said.

This bill is a result of the oversight committee supporting the work of health secretary Dr. Mandy Cohen.

Lambeth said the passage of HB 283 helped legislators “gain a better understanding of the benefits of telemedicine.”

“I have had good support and will be working to continue the work to educate my colleagues,” Lambeth said. “This is a short session, so we may not have time to handle many bills this session, but I am encouraged.”

There have been efforts, which have not advanced, to put telemedicine and other digital services on equal insurance coverage and reimbursement footing with other health-care services.

Covered telemedicine services tend to include psychiatry, psychotherapy, behavioral health, diabetic counseling, genetic counseling, inpatient and outpatient counseling, evaluations and provider-to-provider consultation.

An amendment to HB283 by Sen. Joyce Krawiec, R-Forsyth, requires DHHS to study the Psychology Interjurisdictional Compact and its impact on the delivery of psychology services via the telemedicine model. The compact represents what some states have done to bridge the gap between what health insurers will and won’t pay for telemedicine.

Some health care providers acknowledge that some insurers pay for telemedicine services, while others do not. Insurers that have not covered telemedicine tend to question whether the service provides a cost savings to consumers.

Blue Cross and Blue Shield of N.C. covers telemedicine if “there is a medical decision being made as an online medical evaluation and via a secure channel. We’ve covered telemedicine visits since their infancy.”

Rep. Verla Insko, D-Orange, and co-primary sponsor, said health insurers “prefer to let this technology develop without a state policy framework by negotiating directly with providers for rates.

“Physicians want insurers to pay office visit rates for all telehealth encounters,” Insko said.

Insko said 30 states already have a telehealth policy. 336-727-7376 @rcraverWSJ

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