The California Medical Association (CMA) has recently received inquiries from doctors' offices asking if there will soon be changes in the parity of payments for telehealth. This article will explore the regulations surrounding telemedicine in California and how they have evolved over the years. The state of California has joined the growing list of states and government entities that have adopted asynchronous telehealth or storage and forwarding, particularly on online or telephone portals that allow consumers to answer questions and submit data, and providers to review that data at their discretion. For instance, in Texas, coinsurance, co-pays and deductibles for telemedicine “cannot exceed those for the same service provided in person.”In order to provide telehealth technologies to patients in California, licensees must be licensed in the state, although they do not need to reside there.
Studies conducted by Seton Hall University have revealed that telemedicine coverage requires an increase in private insurance enrollment, as well as routine checkups; in urban areas, they have observed a decrease in hospital care. To facilitate access to telehealth and telemedicine, both state governments and the federal government have implemented several policy changes. These include granting exemptions to insurers and regulators regarding telemedicine regulations, as well as requiring private insurance plans to cover telemedicine if they cover the same services when provided in person. Alternatively, a single incentive from insurers for providers to invest in infrastructure would shift care to telemedicine without distorting long-term incentives. Any California patient who has given informed consent is eligible to receive this type of care. The CMA Economic Services Center has published updated profiles of each of California's top payers. For example, in Arkansas and California, reimbursement for healthcare services provided through telemedicine must be made “on the same basis as in-person services.” In particular, the use of telemedicine increases among people insured by the plans covered by the mandates and, as providers invest in the skills and infrastructure needed to provide care through telemedicine, the use of telemedicine increases among people insured by plans not covered by the mandates. This confirmation is likely to encourage providers to increase telemedicine visits and to invest in the necessary infrastructure, such as technology, staff, different clinical schedules and patient assistance to obtain and use telemedicine technology.
To sum up, it is evident that California has a parity law for telemedicine services that requires reimbursement for healthcare services provided through telemedicine on the same basis as those provided in person.
