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Is Your State Red or Blue? (Telehealth wise, of course.)

telemedicine-mapThere’s been a lot of talk lately about Red states and Blue states and maps  – mostly of the electoral sort. We’ll leave it to the media and your friends on Facebook to comment on that map. But we’d like to introduce another one. We’ve created an up-to-date map that shows you instantly which states have adopted, and which are considering, telemedicine parity laws.

If your state is blue (+ Hawaii), you have some type of telehealth parity law in place. Yellow states are considering such legislation. Those in red have nothing pending yet. (Alaska has a unique partial parity law.)

State Telemedicine Parity Laws

Although it might seem otherwise, there’s one thing about which many politicians across the country agree and that’s telemedicine. State legislators from California to Main recognize that telemedicine has the potential to reduce healthcare costs, use our precious healthcare professionals more efficiently, and make life just a little bit easier for patients. That’s why 28 states have laws that require private insurance companies to reimburse healthcare providers for encounters conducted through telemedicine. As of this writing, 13 more are considering doing the same. Although the laws vary from state to state, they generally require that private payers ignore the patient’s location when evaluating a claim. This makes it possible for patients to enjoy a video visit from their home, office, or anywhere else they choose.

The Rules

Again, each law is different, but every state with a telehealth parity law includes real-time video visits as an acceptable form of telemedicine. A few also cover the store-and-forward approach, but most do not. In terms of provider eligibility, in most cases any provider that can bill for an in-office visit is eligible to be reimbursed for a video visit.  Some states require that a prior in-person relationship be established before telemedicine reimbursement can be expected, but others do not. State medical boards also have different rules related to prescribing medications during a video visit. Most allow it for medications that are not controlled substances.

Some states require that payers reimburse the same amount for telemedicine encounters as they do for in-office visits, while others leave reimbursement amount decisions up to the payer. Fortunately, telemedicine is good for insurers as well as state healthcare systems and patients, so many are happy to reimburse at the same rate as they do for in-person encounters even if the state does not force them to do so.

Of course, there are a few exceptions. Some states have out clauses for certain types of insurance plans like worker’s compensation plans and small group plans.

State parity laws apply to private payers. Medicare and state Medicaid reimbursement is another animal entirely.

Even if your state is still in the red (on this map, not the one you’ll see on CNN), your patients may still be eligible for telemedicine. Many of the country’s largest insurers offer reimbursement even in states without a telehealth law.

Pundits and politicians are talking a lot about jobs lately.  If you are a healthcare provider, the proliferation of these telemedicine-friendly laws and policies just might make yours a little bit easier and more lucrative.