New Law Requires Insurance Coverage for Telehealth and Telemedicine Services

A recently enacted New York state law requires that commercial nsurers cover reimbursement for telehealth and telemedicine services as they would otherwise cover those services for in-person visits. The law seeks to help eliminate barriers to obtaining necessary health care, especially in the state’s rural and underserved communities.

Under the new state law, the terms “telehealth” and “telemedicine” are differentiated for reimbursement purposes. “Telehealth” generally refers to the technology used to enable the remote clinical services. It is defined as, “delivering health-care services by means of information and communications technologies.” These technologies, including telephones, remote patient monitoring devices or other electronic means, provide access to health assessment, diagnosis, consultation, treatment, education, and case management of a patient’s health care remotely. Telehealth includes non-real time communication of health data. For example, telehealth technology is often used for treatment of chronic conditions from a distance, such as cardiac monitoring.

The term “telemedicine” generally refers to the remote delivery of clinical health-care services by means of real time two-way electronic audio-visual communications. Such communications include the application of a secure video conferencing or store and forward technology to facilitate the assessment, diagnosis, consultation, treatment, education, care management, and self-management of a patient’s health care. Thus, telemedicine is similar to a typical physician office visit in that the patient and physician interact as if in the same examination room — although they could be hundreds of miles apart. For example, a physician in an office could discuss a patient’s laboratory-test results with the patient, who is in her home, via videoconference.

New York is the 22nd state to enact a telehealth parity law. Millions of dollars have already been invested in equipment across the state by health-care providers to allow for telehealth services. The new law will ensure that patients who are not able to travel to specialists or who have chronic conditions requiring frequent monitoring, to receive reliable remote care that is reimbursable under their health plans.                

Maureen Dunn McGlynn is a partner in the business department of Mackenzie Hughes LLP, a law firm based in Syracuse. She focuses on health-care law as she advises, counsels, and litigates for hospitals, physicians, physician-practice groups, dentists, diagnostic and treatment centers, and other health-care providers. This article is drawn from a March 3 post on the Mackenzie Hughes Plain Talk blog. Contact McGlynn at mmcglynn@mackenziehughes.com