
This article highlights important recent changes in legislation and regulations impacting healthcare professionals, telehealth and digital health companies, pharmacists, and technology providers engaged in delivering virtual care.
Key Recent Developments
- Increased emphasis on telehealth within behavioral and mental health services.
- Growing initiatives to ensure parity in coverage and payment for these services.
In-Depth Examination
Recent Legislative Changes and Proposals
In Illinois, a new piece of legislation, known as HB 4475, is gaining traction with the backing of co-sponsors.
If passed, this bill would require all accident and health insurance policies, including managed care plans issued, amended, or renewed after January 1, 2025, to cover both outpatient and inpatient mental health and substance use services provided out-of-network as if they were in-network.
This means individuals would have the freedom to select their preferred provider, facility, or treatment method—including telehealth—for necessary care.
The bill has already navigated the initial stages of approval in both the house chamber and the relevant committees.
Recent Changes Finalized in Legislation
Meanwhile, in Washington, the Department of Health is assessing new standards aimed at certifying voluntary peer specialist and trainee credentials, following the enactment of SB 5555 (chapter 469, Laws of 2023).
These upcoming regulations will require certified peer specialists delivering telehealth services to undergo specific telehealth training as outlined in WAC 246-929-340.
In Missouri, emergency rule updates to the state’s Consolidated Health Care Plan, which covers employees and retirees from various state agencies and participating public entities, have been implemented.
These updates encompass a variety of issues, including virtual visit coverage, guidelines for payments outside of the network, and contributions to health savings accounts.
Notably, the new regulations ensure that consultations conducted through the vendor’s telehealth platform will be fully covered after participants meet their deductible, unless IRS rules permit otherwise.
Importance of These Legislative Changes
There is a notable surge in telehealth adoption for behavioral health services.
Legislative actions, such as the proposed bill in Illinois aimed at achieving coverage parity, reflect a clear response to the growing need for accessible mental health and substance use treatment.
In Washington, efforts to strengthen certification processes for telehealth providers show a commitment to enhancing service delivery.
This expansion is especially significant for individuals in remote or underserved areas, as it offers greater flexibility and convenience, which can lead to improved engagement and better health outcomes.
States continue to scrutinize insurance coverage and compensation rates for telehealth services, which feeds into broader discussions about both coverage parity—how telehealth services compare to in-person ones—and payment parity—the obligation to reimburse telehealth services at rates similar to those for face-to-face visits.
This balancing act seeks to maximize the advantages of access and convenience while managing costs and maintaining quality care.
Missouri’s recent emergency amendments affirm broad coverage for virtual consultations after meeting deductibles, while the Illinois proposal aims to empower patients to choose freely between in-person and telehealth options for essential behavioral health services.
Telehealth marks a significant shift in healthcare delivery, but the regulatory landscape remains intricate and continually evolving.
Source: Natlawreview