Telemedicine has the potential to improve access to care and ease the physician shortage. However, physician licensing and other regulations, a lack of reimbursement parity laws and other obstacles have hindered telemedicine's expansion across the country, though not evenly.
State laws affecting telemedicine delivery vary greatly state-to-state, meaning some state environments are more conducive to telemedicine expansion than others. The American Telemedicine Association has analyzed these laws and regulations and issued each state grades for coverage, reimbursement policies and physician licensure requirements to "showcase the states that are doing an excellent job when it comes to telemedicine, and to serve as a wake-up call to those who are failing to extend quality and affordable care to the residents of their state," said ATA CEO Jonathan Linkous.
In terms of telemedicine-friendly insurance coverage and reimbursement policies, Maryland, Maine, Mississippi, New Hampshire, New Mexico, Tennessee and Virginia all received top marks. All these states have laws requiring private insurers to reimburse telemedicine services at the same rate as in-person services, scored highly for Medicaid telemedicine coverage and feature few provider or location requirements for reimbursement.
By contrast, Connecticut, Iowa and Rhode Island received failing grades for coverage and reimbursement policies. These states have no Medicaid coverage for telemedicine and no parity laws in place.
In terms of physician standards and licensure requirements, the ATA gave A's to 23 states: including Colorado, Connecticut, District of Columbia, Delaware, Idaho, Illinois, Indiana, Kansas, Maine, Maryland, Minnesota, Montana, New Hampshire, New Jersey, New Mexico, New York, Ohio, Oregon, South Carolina, Tennessee, Utah, West Virginia and Wisconsin, as well as Washington, D.C. These states all allow for a telemedicine visit to take the place of an initial in-person encounter, do not require a healthcare provider to be with the patient during a telemedicine encounter and ease the out-of-state licensing process by at least offering a more streamlined process for physicians already licensed in another state.
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