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Texas, Arkansas move to expand, define use of telehealth

Arkansas seeks approval for rule that first-time patients can be seen via video, remove ban on sharing medical history; Texas looks to broaden use.

Jeff Lagasse, Editor

By Intel Free Press [CC BY-SA 2.0 (http://creativecommons.org/licenses/by-sa/2.0)], via Wikimedia Commons

As questions about the quality of telehealth services remain, one southern state is considering allowing telemedicine vendors to operate in the state, while another will re-examine its strict limits on the practice.

Currently, Arkansas is the only state that doesn't allow direct-to-consumer telemedicine companies to operate in the state, but that may soon change. A state legislative panel on Tuesday said yes to a medical board rule that allows first-time patients to be seen via video.

The change will go into effect in about 10 days, but the same group, a subcommittee of the Arkansas Legislative Council, rejected a separate rule that changes requirements for doctors' use of telehealth. At issue is a ban on using forwarded medical histories to help establish a new patient relationship. It would prevent non-video based providers, like Teladoc, from being able to see patients in the state. The rule will go back to the Arkansas State Medical Board for a public hearing, since the ban on medical histories was adopted at the last minute in a June meeting before being finalized.

Teladoc Government Affairs Chief Claudia Tucker told Arkansas Public Radio that the company would seek a change to the law early next year.

[Also: Health Affairs lays out telehealth debate in new briefing, shows concerns over quality and reimbursement]

Meanwhile, in the Lone Star State, the Texas e-Health Alliance is circulating the latest version of its telemedicine legislation. The group, along with doctors, hospitals and insurers, hopes to present it to Texas lawmakers for consideration early next year. There are a handful of changes from a version passed around last month, including an added mandate that various licensing boards coordinate telemedicine rules. Texas has historically limited telemedicine vendors from seeing patients.

Telehealth supporters say the process, where a doctor consults a patient using tools such as video chats and mobile monitoring devices, can help lower hospital readmissions tied to chronic conditions, according to Health Affairs. Proponents also point to a decrease in the unnecessary use of emergency appointments, brought about through remote visits with nurses.

On the other hand, opponents argue that telehealth services are not equivalent to in-person services and should not receive reimbursements that rival those of face-to-face visits.

The Medicare Telehealth Parity Act, currently being considered by Congress, is intended to modernize the way Medicare reimburses telehealth services and to expand coverage for Medicare beneficiaries. The act would expand the number of qualifying geographic locations and expand coverage of telehealth services, although its likelihood of enactment is unclear.

Twitter: @JELagasse