States Require Reimbursement For Telemedicine

Five states—California, Louisiana, Texas, Oklahoma, and Kentucky—have passed legislation mandating private insurance coverage of medical services provided by telemedicine, according to the American Telemedicine Association.

The Louisiana law (SB 773, approved in 1995) states that a health care provider participating at the originating terminus of a telemedicine transmission shall be reimbursed at a rate of not less than 75 percent of the amount of reimbursement for an office visit. The bill prohibits provisions in health and accident policies that discriminate against payments for telemedicine.

In California, the law (SB 1665, approved in 1996) prohibits insurers from requiring face-to-face contact between a clinician and patient for services appropriately provided through telemedicine, subject to the terms of the contract.

The Oklahoma law (SB 48, 1997) provides that health care plans cannot deny coverage for services provided through audio, video, or data communications. This would allow compensation for patient consultations and diagnoses and the transfer of medical information through telecommunication technology. The law excludes telephone and fax communications from the term “telemedicine.”

Kentucky prohibits Medicaid and private insurers from excluding coverage for services provided through telemedicine. Likewise, Texas prohibits private plans from excluding coverage for telemedicine services; those services may be subject to deductible and copayment requirements not to exceed those for face-to-face services.

More information is posted online at www.amdtelemedicine.com/private_payer/state_legislation.cfm.