The California Department of Health Care Services (“DHCS”) recently revised its Medi-Cal telehealth policy to allow providers increased flexibility in their use of telehealth as a modality for delivering medically necessary services to their patients. The policy is retroactively effective as of July 1, 2019, and fee-for-service providers must submit claims for services provided via telehealth according to the new policy. Updates to the telehealth policy include the following:
Continue Reading California Expands Medicaid Telehealth Policy

In its recently updated Work Plan, the Office of the Inspector General (“OIG”) at the Department of Health & Human Services (HHS) announced that it will conduct an audit focusing on how selected state Medicaid agencies and Medicaid managed care organizations (“MCOs”) leverage telehealth to provide behavioral healthcare.
Continue Reading OIG to Audit Provision of Behavioral Health Services Through Tele-Health Under Medicaid Managed Care

On Friday, April 5, 2019, the Centers for Medicare and Medicaid Services (“CMS”) announced that it had finalized policies allowing Medicare Advantage plans (“MA Plans”) to include additional telehealth benefits in their basic benefit packages starting in 2020.  The final rule implementing the changes (the “Final Rule”) will be published in the Federal Register on April 16, 2019. An advance copy of the Final Rule is available here.
Continue Reading CMS Expands Telehealth Benefits under Medicare Advantage

In a September 14, 2018 Proclamation, President Donald Trump announced that the week of September 16 through September 22, 2018 would be Prescription Opioid and Heroin Epidemic Awareness Week (“Awareness Week”). As described in the Proclamation, the goal of Awareness Week is to “raise awareness about the prescription opioid and heroin epidemic and to consider concrete follow up activities.”
Continue Reading Congress Passes “SUPPORT for Patients and Communities Act” — A Rare Example of Bi-Partisanship

The Texas Medical Board’s (the “Board”) adoption of new telehealth licensing regulations may finally put to bed long-running challenges to the state’s historically rigid position with respect to healthcare services delivered remotely via telemedicine.  As we previously reported, the Board had been embroiled in a legal dispute with Teladoc, a large, nationwide telehealth company, involving antitrust challenges and an injunction against the Board’s enforcement of its in-person examination requirement, discussed below.  The ongoing battle prompted action by the Texas legislature to enact statutory changes (Senate Bill 1107 passed last May) to eliminate the requirement that Texas physicians must conduct an in-person visit prior to issuing a prescription.  These new regulations were issued in response to the statutory change.
Continue Reading Texas Telemedicine Saga Finally Over? The Texas Medical Board Substantially Revises Telemedicine Regulations

In our July 10, 2017 post regarding telemedicine prescribing, we wrote about the seven exceptions to the Haight Act’s requirement that a provider and patient have an-person visit before a prescriber/practitioner can prescribe a controlled substance for his/her patient. As we concluded in the post, the current exceptions are so narrowly focused that they are of limited utility to telemedicine providers and practitioners.
Continue Reading More Telemedicine Food for Thought: Exception Five to the Haight Act’s In-Person Examination Requirement

On October 18, 2008, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008 (the “Haight Act”) came into law as the federal government’s first attempt to address the public health risks associated with online pharmacies – such risks including the dispensing of drugs (including addictive drugs to be used recreationally) without a valid prescription, and the dispensing of adulterated drugs, counterfeit drugs, and/or expired drugs, all of which could result in significant harm to individuals who may have been looking for an easy way to obtain prescribed medications at a lower price.
Continue Reading Giving Telemedicine More Room to Breathe: Recent and Pending State and Federal Actions in the World of Online Prescribing

The use of telemedicine has expanded access to care to patients in rural areas and provided a convenient alternative to battling congested physician offices and emergency department waiting rooms. In repeated studies the delivery of medicine through electronic means has reduced the cost of care, improved efficiencies, and provided a realistic solution to increasing shortages of physicians. Despite promising studies, however, multiple barriers continue to present obstacles to widespread adoption and implementation of telemedicine.  One of the greatest barriers to adoption continues to be variances and inconsistencies in state laws governing the practice of medicine.
Continue Reading Recent Relaxation of State-level Challenges to the Expansion of Telemedicine but Barriers Remain

One of the largest hurdles to the growth of telemedicine – streamlined physician licensure in multiple states – soon may be addressed.  The Federation of State Medical Boards (FSMB) will vote on adopting the federation’s Interstate Medical Licensure Compact at its annual meeting in April.  The FSMB is a national non-profit organization representing all medical boards within the United States.  The telemedicine policy is a newly proposed licensing option under which qualified physicians seeking to practice in multiple states would be eligible for expedited licensure in all states participating in the Compact.
Continue Reading Interstate Medical Licensing Compact Could Pave a Smoother Path for Telemedicine Providers