The emergence of the coronavirus may be a tipping point for telemedicine. Before the pandemic, about 10 percent of Americans had used such services. The director of telehealth for the Mount Sinai Health System in COVID-19 hot spot New York City says that demand has increased tenfold.

Those at greatest risk from COVID-19 recently gained more access to online care. In March, the Centers for Medicare and Medicaid Services announced new guidelines for that expand coverage for telehealth services.

As health-care infrastructure is overloaded, online pre-screening gives concerned citizens a chance to talk to caregivers without adding to crowds and risks in waiting rooms. A number of bills have been introduced since the beginning of March to further the use of these telehealth services, some with applications beyond the current health crisis.

Service access: Maryland bill HB1663 aims to help citizens who are having difficulty accessing services, whether they are affected directly by COVID-19 or by the broader circumstances of the health emergency. It would authorize health-care professionals who are licensed out of the state to provide telehealth to Maryland residents.

New Jersey’s A3860 also allows out-of-state practitioners to provide and bill for services to its residents for the duration of the state’s public health emergency. If the out-of-state provider does not have a pre-existing relationship with a patient in New Jersey, services are limited to “screening for, diagnosing or treating COVID-19.” During the pandemic emergency, the director of the Division of Consumer Affairs is to waive legal or regulatory requirements “necessary to facilitate the provision of health care services using telemedicine and telehealth.” The bill was signed into law on March 16.

Georgia's HB1151 addresses the potential for telemedicine to enable low-income, medically underserved children and adults to have access to care. It adds language to the state’s insurance code requiring the insurance commissioner to include telehealth with other systems when considering whether a health carrier’s network coverage is sufficient in numbers and types of providers.

Telehealth coverage: North Carolina’s HB1037 requires both insurers and the State Health Plan to provide coverage for “telephonic healthcare” and “electronic patient visits.” This includes physical, occupational and speech therapy. Deductible charges may not be greater than if these services were provided in person, and providers will be reimbursed at the same rate as for in-person services. The bill prohibits requirements for pre-authorization of such services.

AB998, in Wisconsin, addresses a narrower aspect of online care, setting out guidelines that allow a dentist or dental hygienist to use telehealth in the practice of dentistry or dental hygiene. Teledentistry may have particular value for rural and disadvantaged children who have never had a dental exam.

Specialization: Kansas bill SB490 also addresses a specific telehealth specialty. It establishes guidelines for an “audiology and speech-language pathology interstate compact.” States that join the compact will allow patients in their state to be treated using telehealth by professionals from any member state.

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