The American Medical Association (AMA) House of Delegates, meeting in Chicago this June 2016, has adopted two resolutions aimed at telemedicine encounters between physicians and their patients:
Resolution 233 directs the AMA to advocate for telemedicine parity laws that require private insurers to cover telemedicine-provided services at reimbursement rates comparable to that of in-person services. The AMA will also be developing model legislation to achieve parity at the state level and working with the Federation of State Medical Boards to draft model state legislation defining telemedicine for inclusion in state level medical practice laws and regulations.
Another concern expressed in the resolution was when coverage for payment is limited to physician services provided by select third-party vendors.
A key feature of the discussion was the requirement that the physician be licensed in the state where the patient is located. Resolution 233 was introduced by the Alabama delegation and supported by the Pennsylvania delegation.
Resolution 234, introduced by the Virginia and Washington delegations, directs the AMA to develop model legislation and/or regulations that relate to services provided by telemedicine services and vendors:
- Require coordination of care with the patient's medical home or treating physician
- Require that the record of medical care provided by telemedicine be provided to the patient's treating physician (with the consent of the patient)
- Require the third party vendor to abide by laws addressing the privacy and security of the patient's medical information
- Require that a valid patient-physician relationship be established
- Require that the physician be licensed in the state where the patient receives the care
- Require that the standards and scope of telemedicine services be consistent with those of in-person services
Telemedicine in Pennsylvania
There are still many questions and issues remaining related to the provision of telemedicine services. The Pennsylvania Medical Society (PAMED) is focused on addressing some of these barriers to the advancement of telemedicine and is advocating for a set of safeguards and standards to support the appropriate coverage of and payment for telemedicine services in our state.
The proposal – which PAMED helped draft with the Hospital and Health System Association of Pennsylvania – will define what telemedicine is, offer guidelines outlining who can provide telemedicine services, and provide clarity around insurance company reimbursement for these services. Conversations held recently among all the stakeholders have been fruitful, and we expect a compromise bill to be introduced in both chambers.
PAMED will share any updates with members via the Daily Dose email newsletter.