Telemedicine coverage laws often confusing to providers, experts say

Share this content:

State telemedicine laws may leave healthcare providers in a state of billing confusion over what services are covered, some observers say.

The issue primarily lies in the way that state lawmakers draft telemedicine laws, based on different requirements for coverage and payment parity. Coverage parity requires insurance companies to cover telemedicine services at the same level as face-to-face services, while payment parity requires those companies to pay both telemedicine and in-person providers the same.

The discrepancies can leave laws unable to “accomplish what a lot of healthcare providers believe they do,” Nathaniel Lacktman, an attorney for the Telemedicine Industry Team at Foley & Lardner LLP, told Bloomberg Law in a story published Wednesday.

“Lawyers can do to language what a steam table will do to vegetables,” Lacktman said. “Sometimes the final versions of these laws are so wilted that it simply confuses and frustrates healthcare providers because they don't actually offer meaningful coverage or payment parity.”

On top of state legislation addressing telemedicine coverage, federal proposals have also entered the fold, including one to improve telemedicine for stroke patients that was marked up by the House Energy and Commerce Committee earlier this month.

Experts also told Bloomberg that telemedicine hasn't displayed the type of cost savings some have hoped, but that may change.

“The cost savings for telemedicine will likely be realized more in the long term,” said Emily Wein, a lawyer with Baker, Donelson, Bearman, Caldwell, & Berkowitz PC. “Because a patient saw her primary care physician through telemedicine, she received care early and her condition, which might have required more acute care and perhaps for a longer period of time, didn't get worse.”