Legislative Brief for Committee on Education and Health ​

Bill Name: HB 5406: Telemedicine Services1 ​ ​ Chief Patron: ​ Co-Chief Patrons: C.E. Cliff Hayes, Jr.; Shelly A. Simonds; ​ Wendy W. Gooditis

Other Patrons: G. "John" Avoli; Hala S. Ayala; Jeffrey M. Bourne; Betsy B. Carr; Lee J. Carter; Joshua ​ ​ G. Cole; Mark L. Cole; Carrie E. Coyner; Glenn R. Davis; Eileen Filler-Corn; Hyland F. "Buddy" Fowler, Jr.; Elizabeth R. Guzman; Dan I. Helmer; Charniele L. Herring; Patrick A. Hope; Clinton L. Jenkins; Mark L. Keam; Terry G. Kilgore; ; Dave A. LaRock; Mark H. Levine; Alfonso H. Lopez; Delores L. McQuinn; Martha M. Mugler; Kenneth R. Plum; Marcia S. "Cia" Price; Sam Rasoul; Chris S. Runion; Ibraheem S. Samirah; Don L. Scott; Mark D. Sickles; ; Roslyn C. Tyler; R. ; Vivian E. Watts; Michael J. Webert; Rodney T. Willett

Code sections impacted: amends and reenacts งง 3 2.1-325, 38.2-3418.16, and 38.2-4319 ​ ​ ​ ​ ​ ​

Legislation Overview: ​ ● Provides for payment of medical assistance for medically necessary health care services provided through telemedicine services, including audio only – extending through July 1, 2021. ● Applicable to where-ever patient is located: medical office, home of the patient, the patient's place of employment, or any public or private primary or secondary school or postsecondary institution of school. ● Requires insurance companies to provide coverage for telemedicine services. ● No requirement to use proprietary technology in order to be reimbursed. ● Allows prescription of controlled substances through telemedicine.

Findings:

1https://lis.virginia.gov/cgi-bin/legp604.exe?202+ful+HB5046E+hil Telemedicine was helpful for providing access to healthcare for patients in remote areas. In more urban areas, telehealth visits were found to be more convenient.2

A study from Massachusetts General Hospital3 demonstrated:

● Patients were highly satisfied by virtual visits and would recommend them to family and friends. ● Most patients and clinicians saw no loss of communication in virtual video visits compared with office visits ● Patients perceived considerable added convenience, saved travel time, and were willing to pay co-payments for virtual visits. ● Virtual visits are an important and useful option in clinical care.

Data from the CDC indicates4 telehealth can help maintain continuity and reduce delays in preventive, chronic and routine care. It may improve services for the medically and socially vulnerable. It can provide a safer option by maintaining social distancing and reducing the use of personal protective equipment (PPE).

Fiscal Impact:

● Budget neutral per DMAS. ● Extensions of telemedicine, including audio-only services through FY 2021 are already implemented in current budget, no additional costs anticipated. ● Small cost to state employee insurance plan, expected to be covered by state Health Insurance Fund – no changes needed to employer share of state health insurance premium.

Implications: ​

● Telehealth has clear benefits during the COVID pandemic in reducing staff exposure to ill persons, preserving PPE and reducing impacts of potential surges. ● Virtual care is demonstrated to be cost-effective, safe and accepted by patients and practitioners. ● The benefits of virtual care may extend beyond the pandemic. ● Extensions in universal broadband access will be necessary to reduce disparities based on race and income.

2 htps://myvitalz.com/wp-content/uploadhs/2016/07/Telehealth-Services-in-the-United-States.pdf ​ ​ 3 https://cdn.sanity.io/files/0vv8moc6/ajmc/9d9644f7a4ed38371020d1703ee74524f27ee17a.pdf ​ 4 https://www.cdc.gov/coronavirus/2019-ncov/hcp/telehealth.html ​