A new year, new legislation, new legal issues. New York rang in 2015 by becoming the 22nd state to enact a telehealth parity law. The law requires that deductibles, co-insurance, and other coverage conditions for telemedicine be treated the same as payments for typical in-person hospital visits. As such, commercial insurers will be required to cover telehealth and telemedicine services, starting at the end of this year. The new law is an exciting development for patients, especially in rural areas, who have previously had limited options in health services. For payers and providers, however, questions remain about the feasibility of this law and how it could impact the entire healthcare reimbursement landscape.
Telehealth and telemedicine have been among the most significant developments in healthcare delivery in decades. Though the terms telehealth and telemedicine are often mistakenly used interchangeably in everyday conversation, they in fact refer to separate modes of delivery, as made explicit by the New York law. Under the statute, “telehealth” means healthcare delivery services through “communications technologies consisting of telephones, remote patient monitoring devices or other electronic means.” The electronic communications facilitate the assessment, diagnosis, consultation, treatment, education, and management and self-management of care while the patient is at the “originating site”—the place where the patient is located when services are provided—and the healthcare provider is at a “distant site.” Telehealth also encompasses non-real-time means of “communicating” health data, and includes devices that transmit a patient’s vital signs to the health care provider. “Telemedicine,” on the other hand, refers to real-time two-way audio-visual communication aimed at assessment, diagnosis, consultation, etc. Thus, telemedicine is more akin to a typical doctor’s visit, with the patient interacting with the healthcare provider as if in the examination room. Continue reading