Panel Examines Thorny Telehealth Legal Issues

| URAC Staff
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Rene Quashie of Cozen O’Connor and Adam Solander of Epstein, Becker and Green, will participate in a panel discussion at the Telemed Leadership Forum 2018: ROI of Telehealth, in Washington, DC March 27-29.

A blossoming telehealth market is grappling with evolving challenges when it comes to keeping pace with user comfort levels and legal and regulatory issues, experts tell The URAC Report. In many ways, the technology is outpacing regulations and broader acceptance, explains attorney Rene Quashie, member, Cozen O’Connor.

However, it’s not a time for a heavy dose of pessimism. “You’ve got a number of states that have passed covered parity laws that essentially require plans operating in a state to cover telemedicine” in many care practices, Quashie says. “I think there’s been a lot of positive legal and regulatory changes, but we’re left with a couple of big issues to deal with.”

Fortune 100 company health benefit administrators might end up setting the tone, says attorney Adam Solander, member, Epstein Becker and Green. Many of those big companies have focused their efforts on employee population health, he says.  They’ve gone at it several ways. In addition to population health and wellness, they’ve tried direct contracting and pushing chronic care management to providers handling the actual care. Telehealth is becoming increasingly popular as a tool in the toolbox to provide those and other services.

However, the diversity of approaches presents a myriad of legal challenges, Solander says. “Many telehealth companies started off as direct consumers, now they have to be compliant with regulatory regimes like the Employee Retirement Income Security Act (ERISA), and the Health Insurance Portability and Accountability Act (HIPAA), and others.”

As a panelist at URAC’s Telemed Leadership Forum March 27-29 in Washington, D.C., he’ll focus on ways a digital health company can manage “this minefield of regulations that applies in the larger employer world.”

For Quashie, buy-in among users remains an important issue. His big question: “Have folks out there accepted the clinical efficacy and quality of telemedicine services?” He’s encouraged by market moves in the right direction, but notes “there are still skeptics out there who believe telemedicine should be only used sparingly and in certain limited circumstances.” They haven’t been “completely sold” on the value of telemedicine, he says.

Quashie continues, “Regardless of what you do on the legal and regulatory side, if you don’t have buy-in by medical and clinical stakeholders themselves, the legal and regulatory progress is not going to mean much.”

On the positive side, market forces may be working in telemedicine’s favor, Quashie says. As Medicaid and other programs are “squeezed” financially, there will be a demand for finding less expensive ways of providing services, he adds. “I think [company healthcare plans and service provers] are going to be forced to look at alternative ways to deliver service” especially for patients in remote parts of the country, or those who are otherwise disinclined to visit a facility for treatment.

“Telehealth is definitely not going away,” echoes Solander. “It’s something employers will rely more and more on. Ultimately, the [providers] who are going to be successful are the ones that are able to make employers comfortable not only about their product, but what they’re doing about regulatory and legal compliance,” Solander says.

Quashie believes reimbursement will continue to play an important role in the evolution of telehealth in the marketplace. “As we transition from a fee-for-service world into a world in which providers are going to reimbursed based on quality metrics and values, there will people who don’t want to fully embrace telemedicine because they don’t think they are going to be reimbursed for using such services.”

Accreditation and education can help to raise awareness of telehealth’s parity when providing healthcare services, both agree.

Solander and Quashie will be joined by Christa Natoli, deputy executive director at the Center for Telehealth and eHealth Law.


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