Lawmakers in Florida are considering requiring private health insurers to cover telehealth services.
State Senator Arthenia Joyner, a Democrat from greater Tampa, is sponsoring a bill that would make Florida the 20th state to require private insurers to cover telehealth services, starting in 2015.
Joyner's bill would require reimbursement for remote consultations, on a basis equivalent to in-person consultations with physicians, with allowable co-pays and deductibles.
The bill would also direct the Florida Department of Health to lead an interagency study on "options for implementing telemedicine services and coverage, including multi-payer coverage and reimbursement, for stroke diagnosis, high-risk pregnancies, premature births, mental health services, and emergency services."
Joyner, an attorney and longtime trustee of University Community Hospital (a part of the Florida Hospital Tampa Bay Network), is taking up a cause that others have tried to pass unsuccessfully in previous years.
The Florida Medical Association supports the bill and efforts to expand reimbursement for tele-consults, but the idea has not gained much momentum, and with limited public payer coverage of telehealth services, the technology has not been widely used in Florida..
Providers in five counties in Florida are set to see Medicare reimbursements for telehealth services cuts as a result of new data including them in federally-designated metropolitan statistical areas, areas categorized as urban that aren't eligible for Medicare telehealth reimbursement.
In Florida's Medicaid program, telehealth reimbursement is limited to use for Medicaid-eligible children in underserved regions of the state enrolled in the Children's Medical Services Network, under a managed care waiver with the Centers for Medicare & Medicaid Services.
Florida's 3.5 million seniors might benefit from expanded tele-consults, although likely few of them live in the rural areas outside of the federal metropolitan regions.
As technology evolves ahead of the law, Joyner's bill shows how lawmakers and stakeholders like the Florida Medical Association have to craft what is basically health reimbursement policy, the definitions of telehealth, telemedicine and mobile health sometimes being confusing.
"Telemedicine services," as Joyner's bill defines it, includes "synchronous video conferencing, remote patient monitoring, asynchronous health images, or other health transmissions supported by mobile devices, such as mHealth, or other telecommunications technology used for the purpose of diagnosis, consultation, treatment, transfer of medical data, or exchange of medical education information by means of audio, video, or data communications." The term telemedicine-services, the bill notes, "does not include an audio-only telephone call, e-mail message, or facsimile transmission."