The following article, written by Kristina G. Maranges, was published by the Florida Bar Health Law Section Winter 2017 Newsletter.
On October 31, 2017, the Telehealth Advisory Council issued its recommendations to Florida Governor, Rick Scott, and the Florida Legislature on how to increase the use and accessibility of services provided via telehealth. The report comes on the heels of a state and national shortage of healthcare practitioners to serve our country’s growing and aging population. Echoing HHS’s designation of telehealth as a means or method of delivering healthcare, not a type of healthcare service, and noting Florida regulations include multiple definitions of “telemedicine” but no definition of “telehealth” and these terms are commonly used interchangeably, the Council recommended a definition of “telehealth” to replace all existing definitions. “Telehealth is defined as the mode of providing health care and public health services through synchronous and asynchronous information and communication technology by a Florida licensed health care practitioner, within the scope of his or her practice, who is located at a site other than the site where a recipient (patient or licensed health care practitioner) is located.”
Recognizing the lack of adequate insurance coverage and reimbursement for healthcare services as barriers to the delivery and growth of telehealth services, the Council next recommended the Florida legislature require both coverage and reimbursement parity, excluding Medicare plans. Specifically, insurance policies must provide coverage for health care services delivered via telehealth if coverage is available for the same service provided in-person without the imposition of any additional conditions for coverage of services by the insurer,, and payment rates must be the equivalent to rates for comparable in-person services. Regarding Medicaid, the Council recommended the Agency (1) modify its telehealth fee-for-service rule to include coverage of store-and-forward (transmission of recorded health history like X-rays and photos through a secure electronic communications system to a practitioner who uses the information to evaluate the case or render a service outside of a real-time or live interaction) and remote patient monitoring (personal health and medical data collection from an individual in one location via electronic communications technologies, which is transmitted to a provider in a different location for use in care and related support) modalities; and (2) develop a model that would allow Medicaid Managed Care plans to utilize telehealth in order to meet network adequacy.