Bills now before Washington state lawmakers call for payment
parity for telehealth, a training curriculum for using telemedicine,
credentialing guidelines and a Project ECHO program addressing students with
mental health issues.
January 31, 2019 - Washington
state lawmakers will be taking up no less than four telemedicine bills this
legislative session, thanks to one state senator who sees telehealth as a
priority in the Pacific Northwest.
“It’s a challenge
for people who live in areas to get adequate health and mental health care
where there isn’t easy access to care providers, particularly specialists,”
Republican State Sen. Randi Becker said in a recent
press release. “This includes many of my constituents because
there isn’t a hospital in my district. The last thing you want to do when you
are sick or suffering from mental illness is travel hours to see someone
qualified to treat you. Telemedicine closes that distance and allows the health
care system to do a better job making patients well.”
Three bills were
reviewed this week by the Senate Health and Long Term Care Committee. They are:
SB 5385,
which targets payment parity. The bill seeks to have payers reimbursed for
telemedicine and asynchronous (store-and-forward) telehealth services at the
same rate as in-person care. It would also eliminate a requirement that any
asynchronous telehealth services be accompanied by “an associated office visit
between the covered person and the referring health care provider.
SB 5386,
which focuses on training standards for healthcare providers using
telemedicine. The bill seeks to establish a telemedicine training program by
2022 that includes education on how to use the technology and all applicable
state and federal laws, liability, informed consent and any other necessary
guidelines. All providers would have to complete this program every four years.
SB 5387,
which applies to telemedicine credentialing. The bill, if passed, would enable
healthcare providers using telemedicine to extend the physician’s privileges to
the health system in which the patient is located, provided both locations
agree to the service.
“Demand is very
high for telemedicine and has the potential to save $6 billion a year in health
care costs for insurance companies,” Becker said in the press release. “In
fact, 93 percent of patients who have used telemedicine say it lowered their
health care costs. We should be doing everything we can to expand services and
improve access.”
A fourth bill
introduced but not yet assigned a hearing date calls for using telemedicine to
treat middle- and high-school-aged youths with mental health issues.
SB 5389
would, if passed, direct the University of Washington to use a virtual platform
to train school staff on how to identify students at risk of suicide, substance
abuse or violence. UW would use the
Project ECHO program, creating a hub-and-spoke telemedicine
platform so that participants could log on for regularly scheduled interactive
training sessions hosted by experts at the university.
The bill also calls
for the creation, through Project ECHO, of a regularly updated directory of
psychiatrists who use telemedicine and are able to work with at-rick students.
It then mandates that schools in the state create a telemedicine station so
that at-risk students can conduct at least two telehealth sessions with a
psychiatrist from that directory.
Also, the bill
mandates that all school nurses, school social workers, school psychologists
and school counselors complete a training program of at least three hours on
identifying at-risk students that includes guidance on using telemedicine. That
program would also be incorporated into the certification process for teachers.
Becker has long
been an advocate for telehealth. Bills sponsored by her were passed into law in
2015 and 2016 that, respectively, established payment requirements and
originating site definitions for telemedicine and added the patient’s home as
an originating site.
Two bills
introduced by Becker last year, one calling for payment parity
and the other allowing the consumer to choose where to receive telehealth
services, failed to make it out of the Legislature. A later bill co-sponsored
by her did become law; it directed the state’s Collaborative for the
Advancement of Telemedicine to review payment practices and make
recommendations for improved parity across providers – a precursor to this
year’s payment parity bill.
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