Making a momentous step forward, last week New York Governor Andrew Cuomo signed into law a bill requiring private insurers to cover telehealth and telemedicine coverage, retroactive to January 1st, 2015 (Happy New Year!).
That was not a redundant sentence: New York has differentiated between telehealth and telemedicine in the bill, with the primary difference being that telemedicine must include real-time audio and visual communication while telehealth does not. Aside from stating that a telephone may be part of telehealth and that videoconferencing may be part of telemedicine, the examples given for each type of service seem a little arbitrary: telephones can possibly provide the real-time audio solution for a telemedicine service and store-and-forward, mentioned as an example technology for telemedicine, could certainly provide asynchronous information for telehealth. This is minor, however, and I think the intent behind mentioning technologies that really could be used by both types of service was to say that telehealth is more wellness maintenance while telemedicine is more real-time interaction and treatment.
This is quite exciting stuff. New York joins 21 other states in the country in providing “parity” between what is reimbursable by Medicare and what must be reimbursed by all other insurers. New York is also one of our most populous states, so the financial impact should be noticeable to insurers, with the likely outcome that they attempt to get ahead of the need for parity laws. (In fact, many private insurers already reimburse and encourage telemedicine, even without laws in place forcing them to do so. This is largely a financial decision for them, and the results have been positive.)
However, what I like most is that this new law appears to strike down Medicare’s site requirements, which most people view as overly conservative and cumbersome. Many of the telemedicine services Medicare offers reimbursement for come attached to requirements for being rural, for example, ignoring scenarios such as: What if someone lives in an urban environment but is bed-ridden with no form of transportation to a medical center aside from an ambulance? What if a patient lives in the suburbs with only limited access to public transportation and medical issues that preclude long bus rides? Not only are the site requirements denying access to care for many disabled and elderly policy holders, but also increase costs for perfectly able policy holders (time off work, gas or fares), providers (fewer patients seen, office or ER overhead, costs for occupied beds, ambulance costs), and insurers by extension. The site restriction may not be the most celebrated feature of the law, but I believe long term, it will be as important as the parity portion.
To read the bill itself, which is remarkably short (you have to appreciate the efficiency of state laws versus federal laws—it’s only three pages long), click here.
For more commentary, visit the following links:
FierceHealthIT: New York enacts telehealth parity law
Health Care Law Today: Look at What New York Did With Telemedicine to Bring in the New Year
iHealthBeat: New N.Y. Law Requires Insurers To Reimburse for Telehealth Services
EHRIntelligence: New York State Signs Telehealth Parity Bill into Law