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From Health Law Daily, September 10, 2014

Telemedicine report cards issued, three states flunked the test

By Bryant Storm, JD

The American Telemedicine Association (ATA) released two reports that highlight gaps in coverage, reimbursement, physician practice standards, and licensure. The reports represent a novel approach to analyzing new content by identifying and comparing state policies. The reports included report cards where states are rated with grades ranging from A to F. The reports are designed to present the information in a simple and easy to use format. Jonathan Linkous, CEO of ATA, said in an ATA press release that the hope for the reports is “to showcase the states that are doing an excellent job when it comes to telemedicine, and to serve as a wake-up call to those who are failing to extend quality and affordable care to the residents of their state.”

Coverage and reimbursement. The first report of the two focuses on how states succeed in their approaches to coverage and reimbursement for telemedicine. The report seeks to understand the success of states by analyzing state achievements with 13 indicators. The indicators include comparisons between telemedicine and in-person care, Medicaid’s use of telemedicine in the state, eligible telemedicine technologies available in the state, geographical restrictions, eligible providers, restrictions on telemedicine physician services, eligibility of mental and behavioral health services, and the eligibility of home health services.

For each indicator, states were assigned a grade of A through F as well as a composite grade for overall performance. Maryland, Maine, Mississippi, New Hampshire, New Mexico, Tennessee, and Virginia all received the highest composite scores, while Connecticut, Iowa, and Rhode Island received the lowest.

Physician standards and licensure. The second report details the differences between professional licensure portability and practice standards for telemedicine among states. It highlights the fact that differing state standards for physicians is one of the biggest challenges that telemedicine faces.The report analyzed state standards and policies that inhibit the use of telemedicine and assigned states a grade that is representative of the success of its current policies when compared to other states. State policies were analyzed against four indicators: physician-patient encounters, requirements to have a health care provider present during telemedicine encounters, informed consent requirements, and licensure.

As was the case with the first report, the standards and licensure report assigned individual grades for each indicator and a composite grade for each state. Twenty-three states and the District of Columbia were awarded the highest composite grade, indicating a landscape that is supportive of telemedicine. Twenty-seven states fell into the middle category which suggests those states have room to improve. One state, Alabama, received the lowest composite score.

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