Page 16 Unlocking The Potential of Physician to Patient Telehealth Services The Information Technology & Innovation Foundation

address this barrier but have so far failed to produce a widely-accepted solution. If states fail
to adopt an interstate agreement within the next 18 months allowing health care providers
with out-of-state licenses to practice medicine nationally, then Congress should adopt a
uniform national license for telehealth that would be required to be accepted in all states.
For those concerned about infringing on state’s rights, the legislation could have a sunset
provision if states later create a multi-state compact adopting a nationwide licensing
standard. Since Medicare maintains a national record of certified physicians, the federal
government would be able to easily maintain a list of state-licensed physicians.

One bill in Congress would circumvent the state licensing requirements for Medicare
patients. H.R. 3077, the TELE-MED Act, would allow Medicare providers licensed in one
state to provide services to Medicare beneficiaries in another. Given the potential for
telehealth services to lower health care costs, and the importance of keeping costs down for
Medicare, this legislation is also a good first step towards enabling national telehealth
services immediately.

Create Technology- and Location-neutral Insurance Payment Policies
Telehealth services should be covered by insurers if an equivalent in-person service is
provided and they should be reimbursed at the same rates. Technology-neutral payment
policies will encourage health care providers to provide patients health care services in the
most economically efficient manner. In addition, insurers should abandon policies that
limit telehealth to rural populations. To accomplish this, at the federal level, Congress
should require Medicare to modify its reimbursement policies to meet these conditions,
and at the state level, state legislatures should adjust their policies for Medicaid and private
insurers.

Promote Interoperability Among State Prescription Drug Monitoring Programs
Most states have implemented prescription drug monitoring programs that can help
identify abuse among prescribers or patients; however, states differ in what they monitor
and whether they share data. To ensure these programs work effectively once telehealth is
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adopted nationally, and that aggregate data can be analyzed, states will need to be able to
exchange data in a standardized format. To that end, HHS should work with the states to
develop interoperable standards for these databases and require that the data be available
for aggregate analysis. This will help ensure that telehealth does not enable easier access to
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controlled substances.

Fund Research to Continually Improve the Quality and Lower the Cost of
Telehealth Programs
As noted earlier, because of the fast-paced progress in new technology and services, the
evidence base for telehealth is compelling but still incomplete. As new telehealth services
are offered to a wide variety of patients, it will be important to ensure that patients
continue to receive a high level of care. In addition, it will be important to discover best
practices for providing telehealth services and to education physicians about these practices.
To ensure this happens, the federal government should continue to fund research to
identify best practices in telehealth services, evaluate telehealth services and ensure patients

THE INFORMATION TECHNOLOGY & INNOVATION FOUNDATION | MAY 2014 PAGE 16