Reimbursement Lacking for Telehealth Despite Physician Shortage

December 8, 2014 in News

Many telemedicine services, such as video visits with physicians, remain uncovered by insurance plans despite physician shortages throughout the U.S., USA Today reports.

Background on Physician Shortage

According to USA Today, 43 rural hospitals have closed since early 2010, making it harder for patients to receive necessary treatments. Further, many rural counties lack primary care providers, which observers say could be improved by remotely connecting patients with doctors and other health care providers, such as physician assistants or nurse practitioners.

However, some states have expressed concern that physicians who see patients via videoconferencing systems will not follow up with patients appropriately. Nearly 30 states do not allow reimbursement for video visits with physicians, according to USA Today.

AMA Looks To Push Telemedicine in 2015

The American Medical Association estimates that more than 25 states will attempt to develop or update telemedicine laws in 2015.

In June, AMA adopted a list of principles dealing with state licensing and reimbursement that it hopes state legislators will introduce next year (O’Donnell, USA Today, 12/7).

The list groups telehealth technologies into three general categories:

  • Real-time, interactive health care services through an online portal;
  • Remote monitoring via devices; and
  • Store-and-forward practices, such as through electronic health records, email and other communications technology.

The guidelines suggest that before providing a telehealth service, a physician should:

  • Have a “face-to-face” patient visit, which could include real-time audio and video technology; and
  • Inform the patient of cost-sharing responsibilities and limitations in prescribed medications (iHealthBeat, 6/12).

In November, AMA adopted a policy supporting the Federation of State Medical Board’s interstate compact for physician licensure.

The compact aims to boost patient safety and facilitate the licensing of doctors across state borders, including those who provide telehealth services. Specifically, the compact:

  • Creates a faster licensing process for physicians who practice telehealth or who are interested in practicing medicine across multiple states;
  • Provides an alternative way for physicians to obtain a state license; and
  • Reaffirms that the patient’s location sets the applicable oversight and patient protections (iHealthBeat, 11/11).
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