Florida laws and regulations have stymied the development of telehealth, primarily by remaining silent on the issues of telehealth service payment and provider licensure. While Florida Medicaid does cover telehealth services, there is no private insurance mandate and uncertainty remains about exact licensure requirements. Thus, companies and providers are hesitant to invest in telehealth capacity.
During the 2016 Regular Session, the legislature and Governor Scott approved a bill to convene a Telehealth Advisory Council to study telehealth related issues and make recommendations to increase the use and accessibility of telehealth services in Florida. The bill specified that Council recommendations are due to the Governor, the President of the Senate, and the Speaker of the House on or before October 31, 2017. To this end, the Council published their first draft on September 21, and spent the following day’s Council meeting reviewing the language line-by-line, even forgoing breaks and having pizza delivered to maximize their time!
An overriding theme of Wednesday’s meeting was precision and clarity; the Council actively looked for language open for misinterpretation in an effort to close loopholes. And their recommendation on provider payment is crystal clear:
“For purposes of health insurance coverage and payment, payment rates for services provided via telehealth shall be equivalent to the rates for comparable services provided via in-person consultation or contact contained in the participation agreement between the insurer and the healthcare provider.”
Not surprisingly, two council members from the insurance industry voiced their opposition to total payment parity and there was talk of limiting payment parity for a few years to help establish telehealth services. After expiration, insurance companies would be allowed to negotiate lower rates to appreciate some of the savings associated with telehealth. However, the council has agreed to make their recommendation unanimous, allowing public record to reflect opposing viewpoints. To be sure, we can expect the insurance industry to adamantly support a sunset provision this next session.
Regarding licensure, the Council recommends that providers must be licensed in the State of Florida to treat Florida residents via telehealth but they encourage participation in state compact agreements. Still up in the air is the role in telehealth services to determine Medicaid managed care network adequacy and a few other issues.
Senator Bean, a long proponent of telehealth, introduced SB 280 ahead of the Council’s recommendations. He cites this bill as a starting point, and expects that, “We’re going to have a healthy debate” based on council recommendations and other influences. A companion bill has yet to be introduced in the House.
Florida TaxWatch has published several reports on telehealth and our recommendations have largely been adopted by the Council. We thank the Council for their diligent work on this important issue and we look forward to continuing to educate the public and our legislators on the cost saving merits of supporting telehealth policies in our state.