Senate, House move closer on telehealth

TALLAHASSEE, Fla. – In a move that could signal health-care negotiations between the chambers, two Senate panels have passed proposals that bring the Senate closer to the House on the issue of telehealth.

The Senate Health and Human Services Appropriations Subcommittee agreed Tuesday to allow insurance companies to use out-of-state physicians in their networks for telehealth. Meanwhile, a separate Senate panel approved a tax break for insurance companies and HMOs that use telehealth.

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Both moves brought the Senate closer to the House on creating a framework for telehealth, a priority of House Speaker Jose Oliva, R-Miami Lakes, and other House leaders.

The Senate Health and Human Services Appropriations Subcommittee approved an amendment to a telehealth bill (SB 1526) that included allowing insurance companies and HMOs to use out-of-state providers in their telehealth networks so long as the providers register with the state.

The use of out-of-state physicians is opposed by groups such as the Florida Medical Association, the Florida Osteopathic Medical Association and the Florida Dental Association.

The amendment also does not contain payment “parity,” which would require insurers to reimburse health care providers for offering services via telehealth as though the services were provided face to face. The House bill also does not include a parity requirement.

An earlier version of the Senate bill contained payment parity, which is a top priority in any telehealth bill for groups such as the Florida Medical Association, according to Naples physician Corey Howard, president of the influential physicians group.

Bill sponsor Gayle Harrell, R-Stuart, told members of the Senate panel -- -as well as lobbyists in the room Tuesday -- that she was “doing some alignment with the bill in the House at this point. And I have to say that it is still a work in progress.”

While the panel approved the amendment, Chairman Aaron Bean, R-Fernandina Beach, announced that the amendment would travel separately with the bill.

That is a procedural move, which would mean the amendment would remain in play only if it is approved by its next committee, the Appropriations Committee. Without such approval, the pre-amended version of the bill would remain intact.

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 services.

While many hospitals and other health providers already use telehealth, lawmakers have struggled for years to agree on a regulatory framework.

The House has made its proposal (HB 23) part of a package of health-care bills that are priorities for Oliva. But even with the amendments approved by the Senate panels Tuesday, the chambers continue to have differences that would have to be negotiated before the scheduled May 3 end of the legislative session.

The House bill would create, beginning Jan. 1, tax credits for insurers and HMOs that cover services provided by telehealth. State economists have estimated that the tax break would total $31.4 million the first year it is in effect and grow to as much as $35.4 million annually by state fiscal year 2023-2024.

The Senate Finance and Tax Committee on Tuesday approved a tax bill (SB 1112) that included a telehealth tax credit, though it isn’t completely aligned with the House version.

While the House bill would establish the tax credits permanently for insurers and HMOs, the Senate would offer the tax break for a limited time. Under the Senate bill, the break would be effective “on or after January 1, 2020, and before January 1, 2023.”