Another disconnect coming on telehealth?


TALLAHASSEE, Fla. – House and Senate committees are moving ahead with bills that would establish a regulatory framework for “telehealth.”

But similar to past years, the legislative chambers are at odds about what should be done.

Over the objections of the state’s largest health insurance company, the Senate Health Policy Committee this week gave the nod to a bill that would require insurers and HMOs to reimburse physicians for services provided via telehealth if those services would be reimbursed for in-person treatment.

The bill (SB 1526) is sponsored by Senate Health Policy Chairwoman Gayle Harrell, R-Stuart.

But insurance lobbyist Paul Sanford told the committee that the bill interferes with the free market and that government interference could cause the costs of health care to increase.

“We would recommend that you revisit the idea of the payment parity provision in this legislation,” said Sanford, who lobbies for the state’s largest health insurer, Florida Blue, as well as the Florida Insurance Council.

But Naples physician and Florida Medical Association President Corey Howard said the reimbursement requirement --- commonly known as payment parity --- was one of the biggest parts of the bill.

“We absolutely need to make sure that the providers for the service get paid for it so we can continue to expand it,” Howard said.

Howard also pointed to issues such as the federal Health Insurance Portability and Accountability Act, better known as HIPAA, which sets standards for patient privacy.

“Telemedicine is something that is evolving as we speak now,” he said. “But it has to be in a very specific platform, and it has to be safe and HIPAA compliant. And when you do this, it’s just as if we were seeing the patient right in front of you.”

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.

Though the use of telehealth has become increasingly common, the House and Senate in recent years have looked at passing a regulatory framework but have been unable to reach agreement.

This year’s Senate proposal contrasts with a bill (HB 23) that has been moving in the House. That measure contains no parity mandate. It also would give upward of $35 million in recurring tax breaks to insurance companies and would allow for the use of out-of-state health providers in networks.

In addition to the parity mandate, the Senate bill also has other provisions endorsed by physicians, including a prohibition on HMOs requiring customers to seek referrals or prior approval from telehealth providers.

It also would ban Medicaid managed-care plans from including telehealth providers as part of meeting their network adequacy requirements.