Trending in Telehealth is a new series from the McDermott digital health team in which we highlight state legislative and regulatory developments that impact the healthcare providers, telehealth and digital health companies, pharmacists and technology companies that deliver and facilitate the delivery of virtual care.

Trending in the past week:

• Telehealth pilot programs

A CLOSER LOOK

Finalized Legislation & Rulemaking

• Nebraska enacted LB 227, which amends the definition of the “practice of dietetics and nutrition” to include telehealth services.

• Nebraska enacted LB 50, which requires the state court administrator to create a pilot program to use physical space and information technology resources within Nebraska courts to serve as points of access for virtual behavioral health services for individuals at court. The pilot program is intended to provide access to confidential, reliable and safe behavioral health treatment via telehealth for individuals involved with the criminal justice system as defendants, probationers or victims in criminal proceedings.

• Nevada enacted AB 432, which amends state optometry laws to establish requirements for synchronous and asynchronous optometry telemedicine and remote patient monitoring in optometric practice. The law imposes an established patient requirement for certain optometric telemedicine services, meaning that an optometrist must have conducted an in-person “comprehensive evaluation” of the patient within two years before the date of the service. Exceptions to the comprehensive evaluation requirement include synchronous services where the performing optometrist has access to records of a comprehensive examination conducted by another optometrist and certain limited asynchronous evaluations solely to determine whether a comprehensive evaluation is necessary. The law permits optometrists with out-of-state licenses to conduct the limited asynchronous services without a Nevada license. Finally, the law specifically imposes the comprehensive exam requirement with respect to patients who are located outside of the state and are treated by optometrists licensed in Nevada.

• Oregon enacted SB 232, which allows out-of-state physicians or physician assistants who are not licensed in Oregon to provide care to patients located in Oregon, specifically when the out-of-state physician or physician assistant has established a provider-patient relationship with the patient in Oregon temporarily for the purpose of business, education, vacation or work and such patient requires direct medical treatment by the out-of-state physician or physician assistant. Out-of-state physicians or physician assistants may also provide care for patients with whom they have an established provider-patient relationship to provide temporary or intermittent follow-up. The law further clarifies that the practice of medicine using telemedicine occurs where patient is physically located.

Legislation & Rulemaking Activity in Proposal Phase

Highlights:

• Connecticut progressed SB 1075 in the second chamber. The legislation would require the state’s Department of Public Health to establish, in collaboration with a hospital in the state, a Hospice Hospital at Home pilot program to provide hospice care to patients in the home through a combination of in-person visits and telehealth. If passed, the law would require the Department of Public Health to create the pilot program by January 1, 2024.

• Maine progressed LD 223 in the second chamber to amend Maine Medicaid rules to reimburse and allow providers of home health services and private duty nursing and personal care services to contract with pharmacists to provide medication evaluation or consultation to members via telehealth or in a home visit when technology is not the most effective mode of communication.

• New York progressed S 6749 in the second chamber to permit emergency medical service personnel to provide community paramedicine using telemedicine to facilitate treatment.

Why it matters:

• States continue to progress and pass legislation establishing telehealth pilot programs across multiple departments. Pilot programs such as the program implemented in Nebraska and proposed in Connecticut are important steps to determine the best uses of telehealth and increase access to healthcare in vulnerable populations.

• States continue to progress and pass legislation expanding the use of telehealth and telemedicine in healthcare practice.

Telehealth is an important development in care delivery, but the regulatory patchwork is complicated. The McDermott digital health team works alongside the industry’s leading providers, payors and technology innovators to help them enter new markets, break down barriers to delivering accessible care and mitigate enforcement risk through proactive compliance. Are you working to make healthcare more accessible through telehealth?