My CMS News and Ideas on Telemedicine in Florida

March 27, 2014

Telemedicine Issues in the Florida Legislature

Filed under: Uncategorized — cbondsullivan @ 3:09 pm

Both the Florida House and Senate committees have voted to move their respective telemedicine bills on for further consideration this Legislative session. From the support they have garnered, it looks as though the State of Florida will see a change in the law that will require reimbursement for telemedicine services.

The initial bills introduced into the Legislature equated a telemedicine visit with a face-to-face visit with a physician for purposes of reimbursement.  The focus of the bills was on defining telemedicine and establishing who could use – and be reimbursed for – the service. In subsequent debates, this focus changed, in part because of expected agendas of different players but also because the differences between a telecommunicated office visit and an in person encounter started to become clearer.

As everyone who has implemented an electronic health record system into a physician’s practice, technology is disruptive and a change agent. It is not neutral. The use of telecommunications-based technology can dramatically increase the geographical accessibility and reach of both physician and patient, which changes the face-to-face relationship between doctor and patient. Telemedicine allows for detailed visualization when used with advanced video capabilities and increased medical information if complemented with a health information exchange feed.

It is quite interesting to watch how certain issues have come up for discussion in both the House and Senate. These have addressed:
1) Eligibility for telemedicine services
2) Health plan reimbursement equivalency
3) Prescribing over telemedicine
4) Out-of-state physicians offering telemedicine services
5) Malpractice insurance for telemedicine

There is a lot to write about. More to come.

March 15, 2014

The Florida Legislature Mulls Telemedicine in the 2014 Legislative Session

Filed under: Uncategorized — cbondsullivan @ 5:36 pm

The idea of telemedicine as a viable extension of health care treatment is starting to be noticed among Florida’s politicians. Both the Florida House and Senate have submitted bills to promote the use of telemedicine services by mandating that health care insurers treat a telemedicine visit as equivalent to a face-to-face office visit and reimburse a doctor accordingly. Of course there are any number of points of debate, which will presented in the days to come. But right off the top are: Who gets to provide telemedicine services? Doctors only or other clinical professionals like ARNP? Are the insurance payments equivalent or will each health care provider contract for telemedicine reimbursement separately? Can controlled substances be prescribed over a telemedicine visit? These and other questions will surely be addressed in the weeks to come.

The House has introduced a bill: HB 751. The Senate has introduced SB 1646. These bills have major differences in length, depth and number of issues addressed. To give an example of the differences, here is the way both bills define Telemedicine Services:

House Bill 751

(a) “Telemedicine” means the use of synchronous or asynchronous telecommunications technology by a telemedicine provider to provide health care services. The term does not include audio-only telephone calls, e-mail messages, or facsimile transmissions.

Senate Bill 1646

(11) “Telemedicine” means the practice of medicine through the use of advanced communications technology by a telemedicine provider at a distant site in compliance with federal and state privacy and confidentiality requirements and encryption standards. Services provided through telemedicine may include patient assessment, diagnosis, consultation, treatment, prescription of medicine, transfer of medical data, or other medical-related services. The term does not include audio-only calls, e-mail messages, or facsimile transmissions. Telemedicine includes telehealth and telemonitoring.

If telemedicine reimbursement is to become law this session, these two bills will have to be integrated and then pass the vote of both chambers. If one or the other bill passes – or a combination of the two – the resulting statute will be a game changer for health care in Florida.

More to come.

Telemedicine Matters

Filed under: Uncategorized — cbondsullivan @ 3:55 pm

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