Page 3 Shaping Your Telehealth Strategy 2014 Ernst & Young LLP

“We must ensure that our regulatory environment appropriately
balances the exciting advances in technology for patients,
while still maintaining safeguards that allow innovation. To put
it in perspective, the legal structure around telehealth was
established in 2000, when cell phones were still just phones.”
— Former US Senator Tom Daschle

states. The NCSL reports that 19 states and the
District of Columbia now require private insurance Exhibit 1. Recent telehealth developments at the national and state levels
plans in the state to cover telehealth services.
Arizona will join this list in January 2015. • The Telehealth Modernization Act, HR 3750, seeks to establish a federal standard for telehealth
Nontraditional payers for telehealth services range and clear up the confusion from myriad state policies.
from charitable organizations, long-term care and • The TELEhealth for MEDicare (TELE-MED) Act of 2013, HR 3077, would allow Medicare
community health providers to self-insured groups providers to treat patients electronically across state lines without having to obtain multiple state
and agencies serving special popuations. medical licenses.
• The 21st Century Care for Military & Veterans Act, HR 3507, would expand access to telehealth
Complying with multiple state laws services for veterans and their families.
Differing state policies raise the challenge of • The Centers for Medicare & Medicaid Services announced changes to Medicare’s 2014 physician
violating state licensing and prescribing laws. A fee schedule to expand coverage incrementally for telehealth services.
physician who sees a patient through telehealth • The Alliance for Connected Care was launched recently by former US Senators Tom Daschle,
in another state must then comply with the local Trent Lott and John Breaux. The group will focus on raising awareness about the benefi ts of
laws in the state where the patient is located. telehealth, while at the same time pushing for regulations that will not impede patient access
With 50 different states and sets of laws, multiple to care.
compliance factors must be considered. Physicians
need to check the current and pending legislation
in the states in which they practice.

Ensuring privacy and security Exhibit 2. States with coverage for telehealth services
As telehealth services are offered, more sensitive
patient data is held and transmitted electronically —
opening the door to potential privacy and security
breaches. Federal legislation requires health
care organizations to ensure the security of their
data from all “reasonably anticipated threats.”
Specifi cally, the Health Insurance Portability and
Accountability Act (HIPAA) Security Rule mandates
that organizations put in place safeguards to
ensure the confi dentiality, integrity and availability
of electronic protected health information.
Health care organizations need to implement
telehealth in a way that establishes rigorous
security measures for reducing risks of telehealth
data breaches — from data transmission that
may be intercepted by third parties to the risk of
information technology (IT) support staff or other
personnel becoming party to a videoconferencing
session. Also, data temporarily stored on
telehealth devices such as digital diagnostic tools Medicaid and private insurance coverage for telehealth
needs to be protected adequately from potential Medicaid coverage for telehealth
security breaches.
Private insurance coverage for telehealth
No required coverage for telehealth/no data

Source: National Conference of State Legislatures, 2014.

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