Sen. Arthenia Joyner, D-Tampa, has introduced SB 478, a bill that would authorize virtual medical visits in the state. Efforts by Joyner to pass similar measures have failed over the years, but Joyner is optimistic that 2015 will be different. She told Government Technology in an email that controversial items have been left out of this year’s legislation.
One sticking point has been compensation. Sam Miller, spokesman for the Florida Insurance Council, told the South Florida Sun-Sentinel that insurers don’t want the state to require them to pay doctors the same rates for telemedicine visits as they do for face-to-face exams.
Consequently, Joyner removed language last month from SB 478 that would have required Medicaid to pay equal rates of reimbursement. When asked by Government Technology if reimbursement differences might dissuade providers from offering telemedicine visits, Joyner replied that payment for services remains a negotiation between the individual providers and the insurance payers.
“In some cases, the insurance payer may also be providing more than monetary reimbursement initially,” Joyner said. “They may also be providing the equipment necessary to conduct the telemedicine visits, so some insurers and providers might argue the payment parity would preclude these unique payment arrangements.”
The practice of meeting with doctors over the Internet for minor ailments has gained popularity in the last decade, particularly as broadband connectivity has expanded. Prisons are experimenting with virtual medical appointments for inmates and virtual medical kiosks have been installed in municipal buildings to help local government employees better manage their sick hours.
But even though many experts say better technology and an influx of care-seekers stemming from the Affordable Care Act’s insurance mandate will help telemedicine flourish, it still faces a number of challenges.
Cross-state licensure is one of the bigger hurdles. In a 2012 interview with Government Technology, Greg Billings, executive director of the Center for Telehealth and e-Health Law, said only 12 states had licensing procedures that let physicians give direct care to patients in other states through telehealth.
In addition, just 12 states deemed electronic exams to met the standard of a face-to-face medical appointment, allowing physicians to prescribe medications. Doctors practicing telemedicine and prescribing to patients in the other 38 states could be in violation of state law, he said.
When contacted to update those numbers, Billings told Government Technology that his group no longer tracks the information because of the rapid rate in change among states.
“Medical boards are acting and state legislatures (e.g. Florida) are in full-swing on telemedicine,” Billings wrote. “Changes are being made by the moment. And more importantly, often you need to have talked to the medical board to determine the true position [in a state].”
SB 478 currently is in the Appropriations Subcommittee on Health and Human Services. Joyner says the measure has a “wide range of support” to move forward, including endorsements from the Florida Medical Association, the Orlando-based Florida Hospital group, and the Florida Chamber of Commerce.
“Telemedicine maximizes the use of new resources and medical technology,” Joyner said. “It has the ability to connect Floridians to quality medical care they may otherwise [not] be able to reach because [a doctor] is too far away, they don’t have transportation, or they are unable to leave home.”
