While acceptance of telehealth services continues to grow, obstacles remain that limit participation of providers and patients. These barriers, according to EBG, are:
- State parity laws remain loose and ineffective. Telehealth parity laws are intended to ensure the same coverage of services provided in person. Yet the laws themselves are often not very robust, simply stating telehealth services must be medically necessary (in order to be covered) or that payors should not exclude services solely because they were provided through telehealth.
- 20% of U.S. states lack parity laws. Telehealth parity laws are currently in effect in 39 states and the District of Columbia. Momentum came to a halt last year, as payers, providers, and legislators in several states could not reach agreements on reimbursement levels.
- Treatment options are limited. The Ryan Haight Online Pharmacy Consumer Protection Act of 2008 prohibits remote prescribing of controlled substances (except under very restricted exemptions), unless an in-person examination between the prescribing physician and the patient has taken place.
Progress to continue into 2020
Current events and issues, such as the opioid epidemic, have put more pressure than ever before on federal and state legislators to pass laws that promote access to telehealth services. Providers should continue to monitor developments in federal and state laws, regulations, and policies to capitalize on telehealth opportunities while maintaining compliance with applicable laws.
According to EBG, areas for opportunity and expansion include:
- State professional licensure boards beyond state Boards of Medicine expanding access to telehealth services.
- Medicare reimbursement for telehealth services to treat opioid use disorder.
- DEA regulations that would allow for the long-awaited “special telemedicine registration,” which would enable physicians to prescribe controlled substances without conducting a prior in-person examination first, to become a reality.
Lerman says that healthcare executives can benefit from reviewing EBG’s survey because it provides both a micro and macro view of the changes in the healthcare landscape if they were to adopt telehealth technology into their care delivery models.