While more than half of the country has enacted telemedicine parity laws, restrictions on the types of telemedicine technology that are covered by health insurance often prevent patients from being able to use remote services, according to the American Telemedicine Association (ATA).
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Telemedicine parity means that telemedicine encounters are covered by health plans at similar rates as in-person visits. But lack of reimbursement by insurance payers — Medicare, Medicaid and commercial payers — has long been a barrier to telemedicine use. However, improvements are on the way — it is expected that Medicaid programs in all 50 states will cover some form of telemedicine in 2017.
Today, 31 states and the District of Columbia have telemedicine parity laws — up from 21 states in 2014, the first year of the ATA’s 50 State Telemedicine Gaps Analysis. Twenty-four of those states and D.C. have no restrictions on what type of technology can be used. However, 20 states either have no telemedicine parity laws or have several “artificial barriers” to parity.
Despite the ubiquity of smart phones, five states prohibit the use of “video phone” or “cell phone video” for telemedicine: Idaho, Missouri, New York, North Carolina and South Carolina. Idaho, North Carolina and South Carolina cover interactive audio-video, or videoconferencing, only. North Carolina requires a provider to be on premises with the patient and South Carolina requires a telepresenter — typically a nurse who is trained to use the technology — for all audio-video encounters. South Carolina also does not cover remote patient monitoring (RPM) for chronic disease management in the patient’s home.
“Artificial barriers” such as technology type — including RPM — are “harmful and counterproductive,” and prevent patients from being able to realize the benefits of telemedicine, the ATA said in its analysis.