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Virginia Lawmakers Pass Bill Requiring Insurance Coverage for Remote Patient Monitoring

Virginia lawmakers have taken new steps to expand the use of remote patient monitoring among the State’s residents, with both the House and Senate unanimously passing bipartisan legislation ensuring that commercial health plans will cover remote patient monitoring services. The bill now heads to the office of Governor Ralph Northam for signature.

The legislation (HB 1970 and SB 1221) amends Virginia’s current telehealth commercial insurance coverage law (Va. Code § 38.2-3418.16) to expressly add remote patient monitoring as a covered service.  It defines remote patient monitoring as follows:

“ ‘Remote patient monitoring services’ means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.”

Prior to this bill, Virginia had sought to advance telemedicine and digital health in the State, including promulgating forward-looking telemedicine guidelines.

Remote patient monitoring is positioned to become the next big thing in patient-centered digital health care. User-friendly software and equipment already exist; there simply has been little third party reimbursement historically to drive adoption. This is quickly changing however, led by CMS’ addition of three new remote patient monitoring codes for 2019. In addition to the three new codes, Medicare also covers a fourth remote patient monitoring code.

Ensuring that payers and health insurance plans pay for remote patient monitoring as a covered member benefit will incentivize providers to invest in these technologies. This will equip them to better monitor and manage patient care needs, allowing patients to avoid unnecessary hospitalizations, and more proactively manage chronic conditions.

Entrepreneurs and companies offering remote patient monitoring technologies and services should take steps now to understand these new billing opportunities under Medicare and state laws. With the new CPT codes live, remote patient monitoring will become an area of significant upside potential over the coming years. Hospitals and providers using remote patient monitoring and other non-face-to-face technologies to develop patient population health and care coordination services should take a serious look at these new codes, and keep abreast of developments that can drive recurring revenue and improve the patient care experience.

© 2019 Foley & Lardner LLP

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About this Author

Nathaniel Lacktman, Health Care Attorney, Foley and Lardner Law Firm
Partner

Nathaniel (Nate) Lacktman is a partner and health care lawyer with Foley & Lardner LLP, and a Certified Compliance & Ethics Professional (CCEP). His practice focuses on health care compliance, counseling, enforcement and litigation, as well as telemedicine and telehealth. Mr. Lacktman is a member of the firm’s Health Care Industry Team which was named “Law Firm of the Year — Health Care Law” for three of the past four years on the U.S. News – Best Lawyers® “Best Law Firms” list. 

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