Washington State Lawmakers Mull Audio-Only Telehealth Guidelines

A bill now before the state’s Senate would set strict rules for the use and coverage of audio-only telehealth services, such as the telephone.

Washington state lawmakers are working on legislation that would set specific guidelines for use and coverage of audio-only telehealth platforms, such as the phone.

HB 1196, sponsored by State Rep. Marcus Riccelli, would mandate coverage for audio-only telehealth beyond the coronavirus pandemic as long as the service met certain requirements. The bill was passed almost unanimously by the House this week and is now before the state Senate.

Federal and state lawmakers have been grappling with establishing permanent rules for audio-only telehealth, which is now allowed in most states under emergency measures in place for the COVID-19 public health emergency.

Proponents note that audio-visual telehealth isn’t always available in areas where broadband access is limited or unreliable, and many people don’t have the resources or access to telemedicine technology. Opponents say the phone isn’t a safe or secure method for conducting healthcare.

“The emergence of telehealth throughout this pandemic has made healthcare more accessible,” Riccelli said in a press release provided to State of Reform. “This bill ensures that those gains in accessibility are also equitable. Audio-only telehealth allows those without a computer or broadband access to just as easily gain access to a doctor and rapidly get medical advice.”

Some states have made audio-only telehealth coverage permanent under certain conditions, such as for mental health services, while others are waiting for Congress or the Centers for Medicare & Medicaid Services to set the federal ground rules for permanent coverage. Some lawmakers in New Hampshire have filed a bill seeking to end coverage for the modality.

Under Riccelli’s bill, care providers could be reimbursed for audio-only telehealth services as long as they’ve established a valid relationship with the patient through an in-person exam within the past year. It would also establish payment parity for the service, though larger healthcare groups (11 or more providers) would have the leeway to negotiate reimbursement.

In addition, the bill requires providers to obtain a patient’s consent ahead of time, and it prevents providers from charging facilities fees for appointments.

The bill is also specific in defining audio-only telehealth as “the delivery of health care services through the use of audio-only technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment.” It does not include e-mail or fax communications, nor does it allow providers to bill separately for services that have always been done by phone, such as the sharing of lab results.

“This bill will help our rural and underserved areas where audio-only might be the most reliable option for telehealth,” Riccelli said in his press release. “It will also provide our healthcare providers with certainty around reimbursement for their services.”

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