Why Discrepancies and Inconsistencies With Parity Laws Present a Challenge for Telemedicine

There are many potential benefits[1] for patients who have access to remote medical care, also known as telemedicine. While this technology can make medical care management easier, especially in areas of the country with limited access to immediate medical assistance, there are some issues with payment policies that are preventing telemedicine from being more accessible.

What Are Parity Laws?

“Equivalent treatment of analogous services” is how parity is defined. What it means in terms of parity laws[2] for medical care provided remotely is reimbursement from private insurers for telemedicine services that are the equivalent of “in-person care” that a patient with the same issues would receive. The Affordable Care Act (ACA) allows for nationwide access to telehealth services. However, it’s still largely up to the states to decide whether or not such services will be covered by Medicaid and private insurers.

What Incentives Are Available on the Federal Level?

Grants and reimbursement incentives are available to states via the ACA to encourage the adaption of telemedicine technology. The federal government does play a role in shaping how telemedicine services are made available through Medicare programs. Except in Alaska and Hawaii, remote monitoring isn’t covered by Medicare, meaning only costs for the electronics needed for real-time communication are covered. However, Medicare does cover telemedicine substitutes for in-person visits. This includes psychiatric treatment. The current structure, in general, limits services provided for and reimbursed by Medicare, although there are efforts being made to change this.

What About Reimbursement on the State Level?

States decide how (or if) reimbursement is provided through Medicaid or by private insurers. Thirty-one states and the District of Columbia have telemedicine parity laws today.[3] Twenty-four states plus D.C. have no restrictions on the type of technology that can be used for healthcare access. Twenty states still have no parity laws specific to telemedicine, or they have some artificial barriers that present obstacles for providers. Five states have laws in place that prohibit the use of cellphone or video phone technology for telehealth purposes. Most states do not have restrictions on Medicaid reimbursements when telemedicine is used in rural areas.

Approximately 75 percent of healthcare costs are related to the management of chronic conditions.[4] There’s research suggesting that better access to healthcare may reduce hospital stays and healthcare expenses for individuals with conditions such as diabetes and heart disease. Telemedicine in schools has also proven to be effective in some locations. As efforts are being made to establish more consistency with parity laws, there are also steps being taken in some states to clarify telehealth emergency laws and standards[5] and other issues that may affect the availability of remote healthcare.

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References

[1] http://www.americantelemed.org/main/about/about-telemedicine/telemedicine-benefits
[2] http://www.healthaffairs.org/do/10.1377/hpb20160815.244795/full/
[3] http://searchhealthit.techtarget.com/blog/Health-IT-Pulse/Telemedicine-parity-laws-are-on-the-rise-but-restrictions-impede-use
[4] http://www.chronicdisease.org/?page=whyweneedph2imphc
[5] https://www.healthcarelawtoday.com/2017/09/12/joint-commission-introduces-new-accreditation-standards-for-telehealth-services/