New Hampshire Seeks to End Telehealth Parity and Audio-Only Phone Coverage
On January 13, 2021, New Hampshire lawmakers, Jess Edwards, Jason Osborne and John Hunt, introduced House Bill 602, which seeks to roll back certain provisions of the July 21, 2020 telehealth bill (“House Bill 1623”) signed into law by Governor Chris Sununu, during the height of the COVID-19 public health emergency (the “Pandemic”). House Bill 1623, amended the state’s definition of telemedicine to include new modalities, including audio-only phones, and requires Medicaid and private payers to reimburse for telehealth services on the same basis that it reimburses for in-person care. In sharp contrast, the newly proposed House Bill 602 would revise the state’s telehealth rules to eliminate payment parity and coverage for audio-only services.
While the other states have moved to make temporary health care exceptions undertaken during the Pandemic more permanent, as discussed in our earlier entries in the “State” of Telehealth series (see “State” of Telehealth Series: Arizona, New Jersey, and New York), New Hampshire’s bill rolls back these exceptions by striking language from state law that compels private payers and Medicaid to reimburse providers “on the same basis as the insurer provides coverage and reimbursement for health care services provided in person.” It also excludes audio-only phone calls and faxes from the list of acceptable telehealth and telemedicine modalities.
Payment Parity for Telehealth.
At the height of the Pandemic, the concept of parity for telehealth services was introduced to give reluctant service providers a reason to try telehealth and to encourage widespread adoption, which in turn would create more access to health care services for those unable to travel. However, since its adoption, it has been an issue of contention within the payer industry. Those opposed to the concept believe that the payers should be able to negotiate with providers, and that telehealth services should be valued differently than in-person care. Others in favor of parity say that it should be kept on par with in-person care in order to create more access to healthcare services.
Audio Only Phone Calls
Audio only services are a recent trend in the expansion of telehealth services that have risen during the Pandemic. In our December 31, 2020, Blog Post “The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?”, we discussed the proposal of the Permanency for Audio-Only Telehealth Act, which seeks to make permanent regulatory changes to Medicare regulations, allowing for the adoption of audio-only telehealth services as an alternative to video and in-person treatment. In New Hampshire, however, the proposed House Bill 602 would operate in contrast to current trends by striking coverage for telehealth services delivered via audio-only phone from House Bill 1623. Telehealth advocates argue that audio-only calls should be included in coverage because “not everyone has access to reliable broadband connectivity or the resources to use or buy audio-visual telemedicine services”. Opponents of the audio-only service argue that a phone call is an inadequate platform for establishing doctor-patient relationships or for providing proper healthcare services.
Those opposed to New Hampshire’s House Bill 602, like Scot Wilson, LCMHC, a licensed clinical mental health provider at Seacoast Mental Health Center in Portsmouth, argue that “it would do nothing more than reduce the already sparse amount of services in New Hampshire.”
With the vaccine rollout underway, many states are currently reevaluating the telehealth exceptions made during the Pandemic. We will continue to monitor New Hampshire’s proposed amendments to its telehealth exceptions, along with other states in our “State” of telehealth series.
This article is not an unequivocal statement of the law, but instead represents our best interpretation of where things currently stand. This article does not address the potential impacts of the numerous other local, state and federal orders that have been issued in response to the COVID-19 pandemic, but which are not referenced in this article.