Page 4 ATA State Telehealth Policy Toolkit Coverage and Reimbursement

(d) The department shall not require a health care provider to document a barrier to an in-person visit
for Medi-Cal coverage of services provided via telehealth.
(e) For the purposes of payment for covered treatment or services provided through telehealth, the
department shall not limit the type of setting where services are provided for the patient or by the health
care provider.

PRIVATE INSURANCE COVERAGE

Twenty-seven states and the District of Columbia have enacted laws mandating the coverage of telehealth-
provided services under private health insurance plans:

Arizona (2013) Maryland (2012) Oklahoma (1997)
Arkansas (2015) Michigan (2012) Oregon (2009)
California (1996) Minnesota (2015) Tennessee (2014)
Colorado (2001) Mississippi (2013) Texas (1997)
Georgia (2006) Missouri (2013) Vermont (2012)
Hawaii (1999) Montana (2013) Virginia (2010)
Indiana (2015) Nevada (2015) Washington (2015)
Kentucky (2000) New Hampshire (2009) Washington, DC (2013)
Louisiana (1995) New Mexico (2013)
Maine (2009) New York (2014)

Considerable progress has been made over the past few years, but not without its challenges. Many commercial
insurers continue to oppose legislative proposals that require them to cover services when not provided in-
person at a rate comparable to that of in-person services, even when they offer such services themselves.

TALKING POINTS IN SUPPORT OF TELEHEALTH

ATA is starting to identify and publicize summaries of the leading research studies on the cost effectiveness,
quality of care and patient acceptance of telemedicine. In addition, some leading, validated studies have been
identified by many of ATA’s Member Groups. This information is available on the ATA web site at
http://www.americantelemed.org/docs/default-source/policy/examples-of-research-outcomes---telemedicine's-
impact-on-healthcare-cost-and-quality.pdf?sfvrsn=4.

Empower consumer choice -- Patients should be able to choose how they receive a covered service, including
considerations for their urgency, convenience and satisfaction. They should not be penalized with higher
deductibles, co-payments or coinsurance relative to that of in-person services.

Reduce disparities in access to care -- Many people have a difficult time accessing in-person healthcare due to
mobility limitations, major distance or time barriers, and transportation limitations (lack of a car or public
transit.) Telehealth enables this vulnerable population to receive critical and life-saving treatment regardless of
economic means, physical ability, or residence.

Enhance physician availability -- Many areas already have a shortage of needed health care providers. This is
exacerbated by state policies that do not allow interstate practice of medicine and require all clinicians to obtain
multiple state licenses. Moreover, patients in some areas may lack readily accessible providers within their
payer/insurance network. Despite the health insurance reforms that are taking place, these problems are only
expected to worsen. Telehealth and policy changes that improve network adequacy and allow interstate
licensure can reduce provider practice costs, improve their productivity, and facilitate triaging for specialty care.

Improve quality of care – In many cases telehealth can improve key health status indicators within a state. It is
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American Telemedicine Association
www.americantelemed.org