It turns out that state legislators and providers wrestle with defining telehealth- and telemedicine-related terminology in addition to writing the laws that govern the practices.
States alternate between using the term "telemedicine" or "telehealth," according to the Center for Connected Health Policy's State Telehealth Laws and Medicare Program Policies 2015 report.
In some states both terms are explicitly defined in law and/or policy and regulations. In some cases, "telehealth" is used to reflect a broader definition, while "telemedicine" is used mainly to define the delivery of clinical services. Additionally, some states put specific restrictions within the definition, such as excluding email, phone, and/or fax from the definition.
Here are 14 additional takeaways from the report.
• No two states are alike in how they define and regulate telehealth.
• While there are some similarities in language, noticeable differences exist.
• Although these differences are to be expected as each state defines its Medicaid policy parameters, it creates a confusing environment for telehealth participants, particularly when a healthcare system provides services in multiple states.
• Rhode Island and New Jersey are the only two states that lack legal definitions for both terms.
• Currently, 47 states and Washington, D.C.'s Medicaid programs reimburse for some form of telehealth in their public program. Iowa, Massachusetts and Rhode Island do not.
• Since July 2014, South Dakota is the only state to have removed reimbursement.
• Store-and-forward practices, which refer to the use of computer-based communication between provider and patient that do not take place in real time, are only defined in a handful of state Medicaid programs.
• Only 16 states have some form of reimbursement for remote patient monitoring in their programs.
• Email, phone and fax are rarely acceptable forms of care delivery unless they are in conjunction with another type of system.
• Twenty-nine states include some form of consent requirement in their policies.
• Eight state medical boards issue special licenses or certificates related to telehealth.
• Most states considering using an internet or online questionnaire as inadequate to establish a patient-provider relationship.
• Currently, 29 jurisdictions have laws that govern private payer telehealth reimbursement policies.
• In the 2015 legislative session, 42 states have introduced more than 200 telehealth-related pieces of legislation.
Read the full report here.
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