Texas' decision to tighten its grip on telemedicine access isn't going over well with the American Telemedicine Association.
The Washington, D.C.-based organization recently updated its state-by-state report cards to give Texas a 'C' in physician practice standards and licensure – the lowest grade that any state has received.
Texas joins Alabama as the only two states to score a 'C' on the report card, which was originally issued last September. In all, 22 states scored an 'A,' with Massachusetts moving up to the top grade, while West Virginia, Idaho and the District of Columbia dropped from 'A' to 'B.'
"Healthcare providers have seen a considerable amount of state policy activity to improve coverage and reimbursement of telemedicine-provided services by various payers. However, despite improvements to address the payment challenges, healthcare providers are encountering conflicting and sometimes confusing policies from their own colleagues," the 83-page report's overview says.
"Some states are creating new laws that impact access to care via telemedicine, while others are amending existing policies with greater implications," the summary continues. "More notably, a few state medical boards are adopting practice standards with higher specifications for telemedicine than in-person care. Specifically, these boards have considered legal guidelines requiring an initial examination be conducted in-person and a physician-patient relationship be established in-person. Boards have also considered other telemedicine barriers including requirements for a telepresenter, in-person follow up exam, and patient informed consent. These decisions leave telemedicine providers no choice but to navigate the medical practice laws in their state or risk punitive action by their board."
[See also: ATA accreditation levels the field for telemedicine providers]
ATA CEO Jonathan Linkous said the organization received a lot of feedback – and spurred a lot of activity in state capitals across the country – when the first report cards were issued last year.
“After ATA issued the State Telemedicine Gaps Reports last September, many state regulating bodies responded by looking at how their laws and regulations impact healthcare delivery in their state,” Linkous said in a press release. “As a result of state actions across the nation, ATA re-evaluated the indicators for each state and issued new reports. As before, we anticipate that these reports will serve as an incentive to increase the utilization of telemedicine to improve the accessibility, affordability and quality of healthcare.”
Along with a report card on physician practice standards and licensure, the ATA also has one that rates each state on coverage and reimbursement, based on 13 indicators.
The District of Columbia and five states – Maine, New Hampshire, New Mexico, Tennessee and Virginia – maintained their 'A' grades, "suggesting a supportive policy landscape that encourages telemedicine adoption," while Maryland and Mississippi dropped to 'B' because of new laws that curb Medicaid reimbursement for telemedicine.
Connecticut and Rhode Island scored an 'F' on that report card, "suggesting many barriers and little opportunity for telemedicine advancement," according to the 103-page report's executive summary.
See also:
Teladoc sues Texas board over telemedicine rules
ATA execs: Telemedicine progress won't be easy in DC
