PA-ACP Praises State Senate for Passing Telemedicine Bill
The state Senate October 27 passed Sen. Elder Vogel’s telemedicine bill by a 46-4 vote. As passed by the Senate, SB 705 defines telemedicine, to include physical health, behavioral health and substance abuse related services, it outlines who can provide health care services through telemedicine, requires health insurers to provide reimbursement for telemedicine services if they pay for the same services in person, but does not establish equity in payments via government fiat, instead establishing that payments be established between the provider and the individual insurer.
Larry Jones, MD, FACP, Eastern PA Governor and President of PA-ACP Services, Inc. praised the Senate, and said that the use of telemedicine during the COVID-19 pandemic has clearly demonstrated its value in enhancing access to top quality care, from inner cities to the most rural regions of the Commonwealth.
He said, “PA-ACP will continue to advocate and lobby for use of telemedicine with both new and established patients, and with insurers for parity in reimbursements to practitioners for those services. CMS and the state’s oversight agencies for Medicaid and the CHIP program already recognize this. PA-ACP knows that telehealth care is critical to maintaining and protecting our patients’ health on an ongoing basis.”
PA-ACP has also supported payment equity for telehealth services, and a definition that includes video visits, telephone visits and remote patient monitoring and counseling. The benefits are clear: elimination of long waits for appointments, accommodation for those who have to travel significant distances to see specialists, saving lives when seconds matter, increased choice of providers, addressing physician and specialist shortages, and increased access to health care, home and community-based services, and counseling/treatment for substance use disorders.
In other words, improved access to quality health care. But the General Assembly has been clear that they will not dictate terms for payment of services, seeing those as contractual issues between insurers and providers.
Right now, between the extended telehealth orders and CMS dictates, many telemedicine visits are reimbursed at 100% parity with office visits. However, the Blues and commercial insurers each have their own policies for these visits ranging from 100% parity to as low as 20% (!)
As for the future of SB 705, the bill was again referred to the House Insurance Committee this session. That committee was the one that amended the legislation last session to prohibit REMS list medication prescriptions. (This was a conscious effort to ban abortion pills without specifically stating abortion pills.) Seventeen states already prevent the remote prescription of abortion medications.
The House’s official statement last year was that the restriction re the REMS list, “only applies to medications the FDA says have serious safety concerns. As we expand efforts to improve access to high quality healthcare, it is in the best interest of all Pennsylvanians that we match our policies with federal regulations designed to keep us safe.”
A 2017 American College of Obstetricians and Gynecologists study, partially funded by proabortion rights sources, found no difference in patient safety between a medical abortion and a clinical procedure.)
The state Senate yesterday passed Sen. Elder Vogel’s telemedicine bill by a 46-4 vote. This is the FOURTH time the Senate has passed a bill to regulate telemedicine, having done so in 2018, 2019, and 2020 previously.
We started working on the bill, helping draft language and testifying in 2015 on then SB 1342. Similarly, we supported SB 780 in 2017-18, which passed 49-1 but the House amended the bill to preclude abortion counseling, and the Senate didn’t concur.
In 2019, and 2020, the House amended SB 857, which had passed by a 47-1 vote, with the amendment prohibiting prescription of all medications on the federal REMS list by a 111-77 vote. On concurrence, the Senate passed the amended bill 27-21, but the Governor vetoed the legislation because of its prohibition on prescription of mifepristone, citing interference in women’s health care and decision making between physicians and patients.
Yesterday, only Sens. Brooks, Dush, Hutchinson and Mastriano voted no on SB 705 , (presumably because it doesn’t have a prohibition on abortion counseling or abortion pills…) SB 705 again is the original bill passed by the Senate with some technical changes, mandating insurers reimburse physicians and other health care providers for telehealth visits.
PA-ACP, through ERG Partners, has worked with Sen. Vogel, legislators, medical organizations, hospitals and health care systems for the last six years to secure passage of this telehealth legislation, advocating and lobbying for use of telemedicine with both new and established patients, and for parity in reimbursements to practitioners for those services, a program accepted by CMS, and the state’s oversight agencies for Medicaid and the CHIP program.