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Gaining Clarity: The Evolution of Telehealth in 2023

In the ever-changing landscape of healthcare, the year 2023 provided a clearer picture of telehealth’s trajectory. As we delve into the key developments and insights, it’s evident that while progress is underway, challenges persist in solidifying permanent changes amidst evolving state and federal laws.

Telehealth Stability Amidst Legislative Flux: Despite the ongoing extension of temporary measures responding to the COVID-19 public health emergency, 2023 marked significant progress in understanding how telehealth will be utilized, paid for, and regulated. The implementation of coverage and payment parity laws has been pivotal, offering stability and enabling physicians to comfortably integrate telehealth into their patient care practices.

The Role of Coverage Parity: Coverage and payment parity laws, particularly those mandating equitable reimbursement for telehealth services, have played a crucial role in fostering physician confidence. Jacqueline Marks Smith, a senior manager at Manatt Health, emphasized the impact of these laws in facilitating physicians’ investments in new technologies, ensuring the full implementation of telehealth in their practices.

Kimberly Horvath, a senior attorney with the AMA Advocacy Resource Center, highlighted the importance of coverage parity, emphasizing its role in overcoming barriers to patient access. The AMA’s steadfast support for coverage parity aligns with the commitment to fair and equitable payment for telehealth services, essential for breaking down financial barriers in both private and state-regulated plans.

State Telehealth Policy Trends: In collaboration with Manatt, the AMA published a report outlining state telehealth policy trends in 2023. This comprehensive resource delves into the intricacies of evolving state-level policies, reflecting the dynamic nature of telehealth regulations across the country.

Anticipating a Busy 2024: Looking ahead, 2024 is poised to be a busy year for telehealth. At the federal level, the Centers for Medicare & Medicaid Services will continue waiving geographic and originating site restrictions for telehealth through December 31, 2024. Additionally, the AMA supports the CONNECT for Health Act of 2023, a bipartisan proposal seeking to expand Medicare coverage of telehealth services while making pandemic-related flexibilities permanent.

Focus on Coverage Parity: Coverage parity remains a focal point in the telehealth landscape, with more than 40 states having enacted telehealth coverage parity laws by January. Payment parity, a critical aspect of this landscape, was implemented in 21 states. Legislative activity is buzzing, with 15 states introducing various payment parity bills in 2023. Nevada, for instance, passed a law ensuring payment parity for specific regions and healthcare facilities, emphasizing the need for targeted approaches.

Audio-Only Telehealth Gains Recognition: An interesting development in 2023 was the increased recognition of audio-only telehealth visits. Five states, including Florida and Utah, took steps to acknowledge and reimburse audio-only services. This recognition is crucial, especially for patients with limited internet access, those in rural areas, and seniors without audiovisual capability.

As we navigate the evolving landscape of telehealth, the AMA remains at the forefront, advocating for policies that ensure fair reimbursement, coverage parity, and the continued integration of innovative technologies. The journey continues, and the role of telehealth in shaping the future of healthcare remains central to the AMA’s mission.


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