States Require Private Insurers and Medicaid to Cover Telehealth Services in Wake of Public Health Crisis
To build upon temporary legislative efforts to address telehealth coverage for COVID-19, multiple states have recently passed or proposed permanent legislation to require broader telehealth reimbursement by both private and public payers to extend beyond the public health emergency. State actions have varied widely in scope and duration, but a major focus of legislation has been to remove barriers to care including restrictions on originating sites. New York, for example, has passed legislation (Senate Bill S8416) that, in part, expands reimbursement for audio-only telephone communications. Vermont has proposed legislation (H.723) that would require all insurers to cover and reimburse health care and dental services delivered via telemedicine to the same extent as in-person services, including by store-and-forward means. Rhode Island has similarly introduced legislation (Senate Bill No. 2525 SUB A) to require insurers to permanently cover telehealth services, expand telehealth services to include audio-only telephone conversations, and reimburse telemedicine services at rates not lower than in-person services. Michigan (House Bill 5412) passed legislation to require both Medicaid and private insurers to cover telemedicine and remote patient monitoring services, both during the COVID emergency and after for patients located at any originating site. It is likely that many states in the coming months will revisit private insurance mandates and state Medicaid plan coverage for telemedicine services, which will open the doors to reimbursement for digital health providers across the entire sector.