09 February 2021
Authors: Nathaniel M. Lacktman Jacqueline N. Acosta Sarah J. Iacomini Sunny J. Levine
For years, Foley has monitored legal policy in the telemedicine and digital health industry, following how advances in technology have coupled with improved state regulations to supercharge the growth of telehealth and virtual care services in the United States. We now share the results of our 2021 50-State Survey of Telehealth Commercial Payer Statutes, which confirm significant legal advancements supporting the industry. The report provides a detailed landscape of the state telehealth commercial insurance coverage and payment laws, and is useful to healthcare providers (both traditional and emerging), lawmakers, entrepreneurs, telemedicine companies, and other industry stakeholders as a guide of telehealth insurance laws and regulations across all 50-states and the District of Columbia (D.C.).
Our first national telemedicine and digital health report was published seven years ago, with this report being our firm’s fourth publicly-available survey on telemedicine. Our prior reports found one of the most significant barriers to adoption was limited or unclear reimbursement for telehealth and digital health services. Enter the COVID-19 pandemic, which compelled state and federal policymakers to remove restrictions and expand reimbursement for telehealth and virtual care at a rate previously unseen. The new changes followed the previously established pathway of coverage, but the pace at which they were made was stunning. Medicare introduced nearly 100 telehealth service codes covered on a temporary basis until the Public Health Emergency expires, including payment for telephone-only consults. States and commercial health plans followed suit. Although some of the reimbursement expansions are temporary and slated to end when the Public Health Emergency expires, many have already become permanently codified into state law.
Foley’s 50-state survey of telehealth commercial insurance laws examines each individual state and D.C.. We provide the actual language of all the statutes and regulations and have created a multistate table and various heat maps to better illustrate the landscape and give policymakers and industry advocates a macro perspective. Our summaries and analyses reveal trends and patterns, and highlight subtle but important differences between state law language.
Coverage Provisions
While it is true that clarity of coverage and limitations on reimbursement remain frustrations for telehealth growth, the legal landscape has materially improved. Currently, 43 states and D.C. maintain some sort of state telehealth commercial payer law; a sea change compared to a decade ago.
Reimbursement Provisions
In 2021, we anticipate more efforts among states to update their prior telehealth coverage laws to keep pace with the industry’s growth or make permanent those expansions temporarily adopted during COVID-19.
We extend our sincere gratitude to the telehealth advocacy groups, professional associations, academic medical centers, lawmakers, visionary start-ups, bold entrepreneurs, and all the individuals who have helped—and continue to help—make telemedicine and digital health what it is today.
To read the full survey, download the 2021 report.
Want to Learn More?
Visit foley.com/telemedicine for a complete list of events where members of the Foley Telemedicine and Digital Health Industry Team will be speaking.
For more information on telemedicine, telehealth, virtual care, remote patient monitoring, digital health, and other health innovations, including the team, publications, and representative experience, visit Foley’s Telemedicine & Digital Health Industry Team.
