Health care

Telehealth Coverage Debate Still Unfolding in Mass. Legislature

E-consults, patient monitoring and interpreter services would be covered under the proposals, which also call for the creation of two task forces looking at barriers to telehealth across state lines

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Massachusetts doctors and health care associations embraced legislation Tuesday that could make telehealth a more permanent option for patients who are in too much pain to visit a provider's office in person or cannot coordinate travel logistics.

Bills filed by Rep. Marjorie Decker and Sen. Adam Gomez (H 986/S 655) would require insurance reimbursement parity for all telehealth services, going beyond a 2020 law that ensured parity for virtual behavioral health visits and nixing the sunset on the payment parity mandate.

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E-consults, patient monitoring and interpreter services would be covered under the proposals, which also call for the creation of two task forces looking at barriers to telehealth across state lines. Patients with limited technology and digital literacy skills should also expect help from their insurers, including through digital health education, as they navigate the telehealth landscape.

Dr. Alexa Kimball, president and CEO of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center, said telehealth is about providing continuity of care -- not convenience. At a hybrid public hearing of the Joint Committee on Financial Services, Kimball testified that she expected to examine some of her patients with "severe debilitating diseases" virtually later Tuesday, potentially because they needed to adjust their medication but couldn't take time off from work. Still, the visit will be largely the same for Kimball, as she sits in an exam room and relies on her staff, although she may need to ask more questions to make up for the missing physical components.

"We learned quickly in the pandemic that telehealth hadn't been embraced not because of the technology but because of the reimbursement," Kimball said.

Dr. Hugh Taylor, vice president of the Massachusetts Medical Society, called telehealth an "essential part" of his primary care practice. He uses the virtual option when patients have tested positive for COVID-19 and cannot be seen in person, as well as for individuals with mobility issues or who cannot arrange transportation for a traditional visit.

"But we're worried it might not be sustainable because of the uncertainty about paying for the services," Taylor testified. "With this uncertainty, it makes it hard for practices to make plans for how to continue using telemedicine ... It makes no sense to pay less for telemedicine than for in-person care -- the patients receive the same high-quality care."

The telehealth and digital equity bill is a priority piece of legislation for the Massachusetts Health and Hospital Association, with Director of Virtual Care and Clinical Affairs Adam Delmolino saying in a statement Monday it provides "Massachusetts with a long-term infrastructure to sustain and grow virtual care for the millions of patients within its borders."

Copyright State House News Service
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