It looked like a shoo-in. And then it didn’t. Overshadowed by Medicaid expansion, a pair of promising telemedicine bills perished in the closing days of the 2015 regular session.
State Sen. Aaron Bean (R-Fernandino Beach), chairman of the Senate Health Policy committee and a staunch supporter of telemedicine advancement, indicated the conservative approach – neither bill addressed parity for telemedicine reimbursement – would likely pass the 2015 session, making it easier to address monetary issues in subsequent sessions.
Telemedicine lobbyists agreed the proposed legislation in 2014 was too complex for bipartisan support and believed the more succinct drafts of SB 478, sponsored by Bean’s committee, and HB 545, sponsored by the House Health Quality Subcommittee, seemed poised for success. As the session wore on, it became evident the Senate version had the most potential, only after amendments were added to pacify the opposition.
A summary of the final version of SB 478 filed on April 16, defined telehealth, telehealth provider, prescription boundaries, practice standards and record-keeping, limiting telehealth to exclude “audio-only transmissions, email messages, facsimile transmissions and consultations.” HB 545’s final version summary was similar, but had a specific exclusion of teleheath products from the definition of “discount medical plan.”
“House Bill 545 wasn’t heard in its last committee of reference prior to cessation of House committee meetings, and no additional movement occurred after mid-March,” noted Tamara Demko, JD, MH, telehealth consultant for Florida TaxWatch. “Senate Bill 478, while making it to the full Senate Appropriations Committee – its last committee of reference – remained unheard and wasn’t revived in the tumultuous last week of the 2015 legislative session.”
To improve the odds of producing passable healthcare legislation, including a significant focus on telemedicine policy in 2016, Bean called last month for the creation of a Joint House and Senate Task Force on Health Care Policy Innovation.
“Our committee held a workshop (in early June) where we reviewed and discussed several pieces of legislation designed to expand access, increase competition and lower the cost of healthcare services in our state,” said Bean. “In one form or another, some of these policy ideas have previously earned support in the Senate, while others are new and haven’t yet been fully explored.”
Bean said legislators’ consensus view of which 2015 healthcare bills should move forward and when “is that a 20-day special session focused primarily on our constitutional responsibility to pass a balanced budget doesn’t lend itself to a thorough and proper vetting of foundational changes to our healthcare delivery system.”
“With the legislature scheduled to reconvene for committee meetings as early as September,” he continued, “I believe we have time to continue to work on these and other policy ideas in the interim. President Gardiner is open to the creation of a Joint Task Force on Health Care Policy Innovation. I believe this approach will provide the opportunity for the House and Senate to debate, discuss and take public testimony on comprehensive short and long term solutions to Florida's healthcare challenges.”
Despite the lack of passage of telemedicine legislation, Medicaid and some insurers are reimbursing Florida healthcare providers for telemedicine appointments via video-conferencing. The Department of Veterans Affairs benefits from frequent use of telehealth for specialties using secure video links.
“Beyond the great work of the VA, there are health care providers and health systems across Florida who are actively engaged in telehealth. Because of telehealth technology, Floridians are accessing care that has not been available to them in the past. One of the best and simplest ways for Florida to positively impact health outcomes is for policy makers to define and incentivize the proper use of telehealth by Florida’s providers,” said Rena Brewer, RN, MA, director of the Southeastern TeleHealth Resource Center (SETRC).
In the meantime, Florida – the nation’s third most populous state, where 1 in 4 Floridians is estimated to be 65 years and older by 2030 – lags behind the rest of the nation in telemedicine advancement. As of May, the American Telemedicine Association reported that 35 states scored higher than Florida concerning telehealth coverage and reimbursement.