'Telehealth' plan teed up for approval

After years of failing to reach agreement, Florida lawmakers could be poised to pass legislation to establish a framework for “telehealth.”

The Senate on Friday positioned for a vote the House’s telehealth bill (HB 23) after adding amendments by Senate Health Policy Chairwoman Gayle Harrell, R-Stuart.

Telehealth, which is also known as telemedicine, involves using the internet and other technology to provide services to patients remotely. Telehealth is not a type of health care service but rather is a mode to deliver services.

While many hospitals and other providers already use telehealth, lawmakers have tried to put together a regulatory framework that addresses issues such as insurance and payments.

“We are going to provide the quality, cost, access and delivery of health care in Florida in the most efficient way using the 21st Century technology,” Harrell said, explaining the need for the bill. “We really have been a little behind the curve here in Florida, in really expanding the use of something that is so, so important.”

As amended, the House bill would allow licensed out-of-state health care providers who register with the state to offer telehealth to Florida residents.

But the bill contains exceptions. For example, health-care providers who are responding to emergency medical conditions wouldn’t be required to register.

Nor would providers who work in consultation with Florida health-care professionals who would have ultimate authority over diagnoses and care of patients.

Telehealth has developed amid technological advances, but the state Agency for Health Care Administration in 2016 issued survey findings that showed uneven use. The results showed that 45 percent of hospitals said they provided telehealth, while only 6 percent of practitioners, such as physicians, did.

A state-created task force submitted a report in October 2017 recommending ways to jump-start telehealth.

Chief among those recommendations was a requirement that insurance companies reimburse physicians for telehealth services. Physicians promote the notion of “parity,” or a requirement that they be reimbursed the same amounts for telehealth services as they get for providing in-person services.

But insurance companies oppose putting into law requirements on what to pay providers.

The payment issue has been a stumbling block in past efforts by lawmakers to pass telehealth legislation.

The amended House bill would modify the state’s current insurance laws to make clear that contracts signed by HMOs and insurers with telehealth providers are “voluntary.”

The contracts would have to establish mutually acceptable payment rates or payment methodologies for services provided through telehealth. Only telehealth providers could “initiate” contracts that reimburse telehealth differently than for face-to-face health care delivery.

Though the House at one point championed a $30 million tax break for insurance companies that reimburse providers for telehealth, that provision isn’t in the bill. The Senate could pass the measure Monday and send it back to the House for final approval.

The 2019 regular legislative session is slated to end May 3.