TALLAHASSEE, Fla. – Insurers could get tax breaks worth as much as $30 million and use out-of-state health providers in their networks under a House bill meant to champion the use of “telehealth” in Florida.
Members of the House Health Quality Subcommittee this week approved the bill (HB 23) and included a tax credit for insurers and HMOs willing to reimburse health providers for telehealth services. The tax credit --- in an amount equal to one-tenth of 1 percent --- could be applied against corporate income taxes or insurance premium taxes.
Rep. Carlos Guillermo Smith, an Orlando Democrat who was one of only two members of the panel to oppose the measure, said he didn’t think the state needs to give an incentive to insurance companies and HMOs for agreeing to reimburse for the services.
“Thirty million is a fairly large budget hole,” he said.
Florida providers and hospitals lag behind their peers nationally in the use of telehealth, according to a state-created telehealth advisory task force. Telehealth, a term insurance companies have coined, 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 the services.
There’s little dispute about the definition, but there is dispute about the name. Physicians prefer to call this mode of health-care delivery “telemedicine.”
The Legislature has for years grappled with telehealth and how it should best be used and regulated.
In December 2016, the Agency for Health Care Administration issued the findings of a survey it conducted with the state insurance department and the state health department. The results showed that 45 percent of hospitals responding to the survey said they provided telehealth, while only 6 percent of practitioners, such as physicians, did.
House Speaker Jose Oliva, R-Miami Lakes, has included expanding the use of technology as a priority in pursuing an overall agenda to lower health-care costs.
But disagreements between insurance companies and physicians were on display Tuesday when the bill was considered by the House panel.
Jeff Scott, general counsel of the Florida Medical Association, told lawmakers that Florida physicians support telemedicine and that state medical boards have adopted rules to regulate its use for in-state and out-of-state providers.
“The foundation for telemedicine is in place,” he said, adding, “the major impediment to expanding telemedicine is the reluctance of insurance providers to fully pay for this service. For telemedicine to reach its full potential in Florida, the issue of payment parity needs to be addressed.”
The Telehealth Advisory Council, in a 2016 report to the Legislature, recommended that the state pass a parity requirement. Essentially, the mandate would require health plans to pay practitioners and facilities for services at rates that are equivalent to reimbursement rates for the same services if performed face-to-face.
According to a 2018 report from the Center for Connected Health Policy, 39 states and the District of Columbia have laws that govern telehealth reimbursement policies.
But Scott noted that the House bill doesn’t have a mandate. Meanwhile, it contains a provision that would allow out-of-state providers to be included in insurance-company and HMO networks.
The providers would have to meet certain requirements and register with the state health department. But Scott said that didn’t go far enough to protect patients.
Bill sponsor Clay Yarborough, R-Jacksonville, indicated, however, that he favors using incentives to encourage insurance companies, rather than issuing mandates.
“That’s not the approach that I’m poised to take, where we are going to force (insurance companies) to do it,” Yarborough told The News Service of Florida following the meeting. “As time goes on, given that more providers are going to want to do telehealth, they’ll eventually have that realization that we need to do this anyway. Right now, it’s a kick-start to incentivize them to do it.”