InSight Applauds Changes to Delaware Telemedicine Guidelines Supporting Further Access to Behavioral Health

July 6, 2015 | Delaware recently amended its legislation to mandate parity for private insurers’ coverage of telemedicine services and to further clarify the scope of practice for several kinds of healthcare providers. The legislation was put forward and promoted by a team of leaders and regulators from several notable Delaware organizations.

With recent regulatory changes, Delaware will now require private insurers to reimburse for telemedicine services at the same rates for which they cover in-person services. They also have expanded the scope of practice provisions of telemedicine service delivery for a range of health care providers licensed in Delaware.

The changes were put forth as two amendments to House Bill 69, the “Delaware Code of Relating to Telemedicine Services,” and were sponsored by House Rep. Bryon Short and Sen. Bethany Hall-Long in the Senate. The amendments were the result of collaboration from several key players in healthcare best practices and legislation including the Delaware Medical Society, the Division of Substance Abuse and Mental Health, the Delaware House of Representatives and the Delaware Telehealth Coalition.

House Bill 69 was introduced this past March and passed by the House in early April and by the Senate in early May, both by unanimous votes. The amendment changes will go into effect January 1, 2016.

The bill synopsis cites multiple factors as motivating reasons to support and promote greater use of telemedicine and placed particular emphasis on expanded access to behavioral health services. “Geography, weather, availability of specialists, transportation, and other factors can create barriers to accessing appropriate health care, including behavioral health care, and one way to provide, ensure, or enhance access to care given these barriers is through the appropriate use of technology to allow health care consumers access to qualified health care providers.”

“The gist of the legislation really is about parity, where an office visit or a visit through your health-care professional provided through an approved electronic means is treated the same in terms of reimbursement from the insurance company,” Rep. Bryon Short, primary sponsor for the bill, said.

The other change to the telemedicine code expanded practice standards for physicians who practice telehealth as well as physician’s assistants, mental health counselors, marriage and family therapists, psychologists and several other types of health care providers as well. The amendment makes technical corrections referring to health services corporations and code references, adds the Advanced Practice Registered Nurse profession and includes definitions of several key terms for understanding telemedicine regulations.

“While the mandate for private-pay reimbursement is terrific, what stands out most about this bill is that it seeks to explicitly remove ambiguity or doubt that telemedicine is a valid form of practice for multiple professions,” Dan Khebzou, a member of the Delaware Telehealth Coalition and account executive with InSight Telepsychiatry said.

While many states have updated their language about telemedicine in the last few years, Delaware’s changes are unique in that they provide clear guidelines for appropriate use. “This bill is particularly forward thinking in that it clarifies telemedicine use for so many professions,” says Khebzou.

Delaware has been a particularly telemedicine-friendly state since House Bill 69’s first passing in 2004, but received an “F” in a 2014 study of telemedicine use under private insurance coverage by the American Telemedicine Association. The changes to this legislation demonstrates a willingness to take recommendations for improvement seriously and positions the state as a leader in the widespread adoption of a telemedicine.

Along with House Rep. Bryon Short and leadership from the Delaware Telehealth Coalition including, Andrew Wilson of the Delaware State Medical Board, Carol Morris of the Delaware Department of Health and Social Services and several other members of Delaware’s leadership organizations worked together to ensure that the language added in the amendments was sufficient and appropriate for meeting the goals of both the parties involved in writing the legislation and those of organizations and regulatory bodies who would be affected by it.

Contributions from the Delaware Medical Society ensured that the amendments stayed in line with regulations from organizations like the Division of Professional Regulation and the Delaware Department of Health and Social Services.

“The Delaware Medical Society’s support of this bill puts them ahead of the curve when compared to their peer medical societies in other states who have yet to acknowledge the inevitability of telemedicine as a rapidly-growing trend in healthcare,” said Geoffrey Boyce, Executive Director of InSight.

Delaware already has several telemedicine programs that will benefit from the changes in House Bill 69.
InSight Telepsychiatry has partnered with healthcare organizations throughout the state that have recognized an acute need for telemedicine, and particularly telepsychiatry services. The programs range from hospital emergency departments to substance use treatment facilities for children and adolescents to federally qualified health centers.

As part of a Governor’s Initiative to get more psychiatric care into underserved regions, a pilot program with several community health centers utilizes psychiatrists from InSight Telepsychiatry for psychiatric consultation.

The updated legislation will make it easier for Delaware to make decisions about incorporating other new developments in healthcare access more readily. In writing the amendments, special consideration was given to leaving room for further expansion of telemedicine use down the line while being mindful of the original scope of the bill.

“With mandated private insurance reimbursement and updated language covering the scope of practice for many health care providers, it will be easier for consumers and the providers who treat them to embrace telemedicine as a practical solution to issues of proximity and availability for appropriate healthcare services,” says Boyce.