The in-person care services telemedicine reimbursement bill aims to make telemedicine reimbursement equal to in-person care services. Senator Elder Vogel brought the bill to the Pennsylvania Senate on June 28, 2017 to define major components of telemedicine and to set telemedicine licensing requirements. Pennsylvania is bound to be the next state to allow complete telemedicine reimbursement equality for care services. The legislation requires all healthcare payers to provide telemedicine reimbursement if the same services are paid in person.
The bill will ensure that all telehealth services provide reimbursement under the ancillary service plans. The group or individual health insurance plans provide exclusive coverage for vision and dental services. The healthcare services a person purchases through the ancillary plans cannot be absent from the coverage because they were done through telemedicine.
Pennsylvania Department of Human Services will offer medical assistance for reimbursement of the fee for service, medical assistance and managed care programs or general healthcare done through telemedicine under Medicaid.
Healthcare providers must follow strict guidelines set to enable them to receive payments for telemedicine. Providers must establish a provider-patient relationship using appropriate diagnostic tests and virtual exams to give an accurate diagnosis. The provider can use an interactive audio without video IF after carefully reviewing the medical records of the patient.
The provider will give equivalent healthcare to the person. The bill also states that the provider must have an emergency action plan during the telemedicine consultation. Apart of the emergency action plan includes verifying the location of the patient and disclosing the identity of the providers. It also includes obtaining informed consent and establishing a diagnosis and treatment plan. The healthcare provider can create an EHR record using the records of the visit.
The legislation will enhance statewide care delivery using proper payment providers that include Hospital and Health system Association of Pennsylvania (HAP). HAP will ensure the technology provides greater access to quality care irrespective of where the patient is living in the commonwealth.
HAP supports telemedicine as a way of improving healthcare delivery and encourages other hospitals to support the bill so that telemedicine can become a viable care solution. Telemedicine reimbursement gives providers the financial support to enable them to pursue telemedicine care as a means of delivering care to under-served and remote communities in the state.
Similar legislation is before other state legislation and has been passed by other states as well to empower providers to consider telemedicine. The bill offers numerous benefits to patients across the country and strengthens the US Healthcare system.