by Audrey Kinsella
A new, clearer definition of "anywhere care" that can finally include the patient's home is about to become law in Vermont. A bill known as Senate Bill 50 was passed on June 7 and will take effect on the first of October.1 Until this law, Vermont Healthcare at Home providers have been required by Medicare to arrange for provision of remote telemedicine services at specific alternate care sites in order to qualify to send a claim and be paid. Eligible sites included physician's offices or a "healthcare facility," such as a distant clinic.
Now, according to the new Vermont legislation, not only can providers deliver telehealth services at home, but "all insurance plans in Vermont must provide coverage for health care services delivered through telemedicine to a patient at an 'originating site' to the same extent that the plan would cover the services if they were provided through an in-person consultation."
Most significantly, the law's definition of "originating site" for telemedicine encounters includes hospitals, healthcare facilities, a physician's office, OR a patient's home or workplace or other non-medical environment such as a university-based health center.
Finally! Home telemedicine is in
In an email exchange, Vermont governor Phil Scott, who spearheaded the passage of S.50, addressed a number of my questions about his goals for use of telehealth by Vermont residents.
AK: How do you think better access to healthcare achieved through telemedicine will improve healthcare provided to Vermonters?
PS: Any time we can affordably expand access to healthcare for Vermonters, I consider that important, and this law will work to achieve that by including access to mental health care and health care specialists.
AK: Are there any particular groups that you would like to see be better served through telemedicine? E.g., elders, people living with chronic diseases?
PS: One of my priorities as Governor is protecting the most vulnerable, and this legislation will benefit the vulnerable populations by making health care services more accessible throughout the state, and by making certain health care services more affordable by mitigating some of the costs associated with in-person visits. This could especially help those who have disabilities or illnesses that prevent them from driving long distances to access the care they need.
AK: Are there certain segments of Vermont that you would like to provide more services to, at least initially?
PS: The legislation could have an impact in rural, remote areas of the state, where access to care – particularly to specialists – is more of a challenge. We hope to address the issues stemming from accessibility and the shortage of specialists in rural areas, and telemedicine can play a role.
Remote access to healthcare specialists via telemedicine will soon be a reality for rural Vermonters, and it will be paid for. Senate Bill 50 will be a boon not only to isolated Vermonters but to the specialists as well. The law specifically notes the provision of parity payments to all telemedicine providers, including specialists.
This issue, parity, is dealt with at length on the American Telemedicine Association's web site. Additionally, a concise entry is available at: https://www.covingtondigitalhealth.com/2016/12/update-on-telemedicine-parity. Addressing parity, S.50 notes specifically that providers will be paid as billed. Moving in the direction of parity concerns among all telemedicine providers sets Vermont apart from most other states, so far.
1 An overview of the bill is provided at: http://www.jdsupra.com/legalnews/vermont-s-new-telemedicine-law-expands-70182.
Audrey Kinsella, MA, MS, is HCTR's telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at firstname.lastname@example.org or 828-348-5308.
©2017 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. email@example.com