Page 9 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Purpose

Patients and health care enthusiasts across the country want to know how their state compares to
other states regarding telemedicine. While there are numerous resources that detail state
telemedicine policies, they lack a state-by-state comparison. ATA has created a tool that
identifies state policy gaps with the hope that states will respond with more streamlined policies
that improve health care quality and reduce costs through accelerated telemedicine adoption.

This report fills that gap by answering the following questions:

 “How does my state’s telemedicine policies compare to others?”
 “Which states offer the best coverage for telemedicine provided services?”
 “Which states impose barriers to telemedicine access for patients and providers?”

It is important to note that this report is not a “how-to guide” for telemedicine reimbursement.
This is a tool aimed to serve as a reference for interested parties and to inform future policy
decision making. The results presented in this document are based on information collected
from state statutes, regulations, Medicaid program manuals and fee schedules, state employee
handbooks, and other federal and state policy resources. It is ATA’s best effort to interpret and
understand each state’s policies. Your own legal counsel should be consulted as appropriate.

Overview

Telemedicine is getting increasing attention from lawmakers around the country. Policymakers
seek to reduce health care delivery problems, contain costs, improve care coordination, and
alleviate provider shortages. Many are using telemedicine to achieve these goals.

Over the past three years the number of states with telemedicine parity laws – that require private
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insurers to cover telemedicine-provided services comparable to that of in-person – has doubled.
Moreover, Medicaid agencies are developing innovative ways to use telemedicine in their
payment and delivery reforms resulting in 48 state Medicaid agencies with some type of
coverage for telemedicine provided-services.

Driving the momentum for telemedicine adoption is the creation of new laws that enhance access
to care via telemedicine, and the amendment of existing policies with greater implications.
Patients and health care providers are benefitting from policy improvements to existing parity
laws, expanded service coverage, and removed statutory and regulatory barriers. While there are
some states with exemplary telemedicine policies, lack of enforcement and general awareness
have led to a lag in provider participation. Ultimately these pioneering telemedicine reforms
have trouble reaching their true potential.

Other areas of concern include states that have adopted policies which are limiting in scope or
prevent providers and patients from realizing the full benefits of telemedicine. Specifically,
artificial barriers such as geographic discrimination and restrictions on provider and patient
settings and technology type are harmful and counterproductive.

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American Telemedicine Association
2015