Tuesday, May 8, 2018

New telehealth law will require insurers in Ky. to pay for virtual visits in the home, starting in July 2019

Kentuckians will soon be able to see their health-care provider in the privacy of their own home, thanks to a new law passed during the 2018 legislative session, Lisa Gillespie reports for WFPL.

Currently, telehealth visits are limited to doctors and high-level practitioners, and patients must be in a clinical setting for the visit. But Gillespie reports that  the new law, which goes into effect July 2019, will allow Medicaid and commercial insurance to pay for telehealth visits in the home. It will also require insurers to pay mid-level providers, like psychologists, family therapists and physicians assistants, for telehealth visits.

"Telemedicine is similar to a face-to-face health-care visit but instead, patients interact with health providers remotely, usually via computer screen," Gillespie notes.

Mary Horsley of Eastern Kentucky told Gillespie about how her mother-in-law, also named Mary, had benefited from telehealth after being diagnosed with Alzheimer's disease.

Horsley said that instead of having to make the drive to Lexington to see an Alzheimer specialist every three months, they were able to go to their local rural health clinic -- which her mother-in-law was familiar with -- and participate in a telehealth visit. They did this for seven years until Mary died, Gillespie reports.

“I’m hoping this legislation will open up the opportunity to see these specialists from their homes,” Horsley said. “For people with Alzheimer’s, it is difficult for them to go places that are unfamiliar to them but a lot of times they’re familiar in their home.”

Rob Sprang, director of Kentucky TeleCare at the University of Kentucky, told Gillespie that he new law will increase access to mental-health care in the state. He pointed out that while psychiatrists and psychiatric nurse practitioners have been able to practice telehealth, psychologists and licensed social workers have not been.

That's important because Kentucky has a shortage of mental-health providers. Gillespie notes that in 2013, Kentucky needed 1,638 more providers to keep up with demand, according to a state report. The report also found that the greatest shortages were in rural counties and that there were more clinical social workers and psychologists than any other mental health professionals in the state.

“[Rural] medical clinics are more likely to bring on some mental-health specialists, and in most cases they can’t justify a psychiatrist. But it does make good sense for them to hire a family therapist and they can leverage that person using telehealth to reach anywhere in the state,” Sprang said. “We need every clinician we can find to meet the problems of underserved patients in our state.”

Gillespie notes that while this new law will increase access to telehealth, not everyone in the state has internet access at home. She writes, "Though 85 percent of Kentuckians have access to high-speed Internet, there are still 524,000 people who don’t, and 187,000 people don’t have any internet providers where they live."

Sprang told Gillespie that advocates will push next year for additional telemedicine techonologies, including a requirement for insurance companies to pay for remote patient monitoring, like for daily weigh-ins or blood-pressure readings.

“Many cardiologists will tell you, ‘If I knew every morning what that patient weighed, I could predict when they trend poorly,’” Sprang said. “Because if they eat too much salt, or forget to take their diuretic, they will begin to gather fluid around their heart and lungs and before you know it, they can’t breathe.”

Legislation passed a few years ago required the state Medicaid program create a remote-monitoring pilot project, but lack of funding stalled it, Gillespie reports. Sprang said advocates will also ask lawmakers for money for that project.

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