From mobile apps for monitoring medications to virtual appointments with specialists, telehealth services are creating new levels of convenience for providers and patients. But as companies digitize more pieces of the health care puzzle, this will mean navigating complicated state regulations, evolving payer relationships, and issues around data and patient privacy.
Brooke Bumpers and Craig Smith, counsel and partner in Hogan Lovells’ Health practice group, say the widespread use of telehealth is likely to expand – and that every health care company should consider how these technologies may soon change the way they do business.
“Demand is one of the biggest things driving telehealth,” says Bumpers. “Most adults are now very comfortable getting services through the use of technology and are increasingly demanding the convenience of getting health care services that way.”
But meeting the demand for over-the-air health care services has providers contending with a complicated patchwork of state-level licensure requirements and regulations, with some states passing numerous laws to encourage telehealth services, while others haven’t addressed it, or may even have laws on the books that restrict its use. “Companies have to make sure that they’ve met licensure requirements on a state-by-state basis,” says Smith. “If a company isn’t compliant with a particular state’s licensure requirement, then any claims it submits for those services could be considered a false claim, which could create serious ramifications.”
Bumpers says that the reimbursement landscape is also evolving. While many private payers are encouraging the greater use of telehealth services, reimbursement for services through federal programs is still relatively limited. “Right now Medicare only pays for telehealth interactions in very specific cases. And in some states, Medicaid won't cover telemedicine or telehealth interactions at all,” she says. “But we have started to see some changes on the federal side to embrace telehealth, and I think we’ll continue to see private payers loosen their requirements as they become more confident in the integrity of the services.”
With more and more health care interactions taking place digitally, issues around patient privacy and data security are a primary concern for providers, regulators, and patients. “The more removed you get from that (face to face) visual interaction, the more you have to question as a provider whether the patient on the other side of the screen is who they say they are,’” continues Smith. “[Companies] need to ensure (that) HIPAA compliance is built directly into their IT platform, and that you have ways of monitoring that those rules are applied properly.”
While telehealth technologies (and the regulations governing them) are still in their infancy, Bumpers and Smith urge their clients to educate themselves now about the potential impact. Understanding and anticipating the pace of innovation will be a critical part of meeting changing patient expectations. “If your company isn’t already involved in telehealth, (it) will be in the future,” says Bumpers. “We encourage companies to look at the landscape, see what's already being provided, what customers and patients are asking for, and to be prepared. Because [telehealth] is increasingly becoming a part of health care services, no matter what specialty you have or where you're located.”
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