Tracking Telehealth Policies to Advocate for Greater Access to Care

PHI’s Center for Connected Health Policy (CCHP) serves as the federally designated National Telehealth Policy Resource Center, providing an essential function by tracking state and federal regulations around telemedicine in order to promote better systems of care and improved health outcomes, and provide more equitable access to quality, affordable health care. 

In 2021, legislative tracking by CCHP identified more telehealth-related bills than any year before: 201 bills were passed in 47 state legislatures, nearly double the number adopted in 2020. As telehealth becomes increasingly prevalent, it is expected that states and the federal government will continue to develop more new policies in 2022.

Among the bills tracked in 2021 by CCHP were several dealing with Medicaid reimbursement, private payer reimbursement, cross-state licensing, online prescribing and professional regulatory requirements, pilot studies, broadband and COVID-19. See CCHP’s 2021 roundup of state approved legislation, which includes a detailed listing of all bills by topic area and state. A brief summary is below.

COVID-19

CCHP tracked 18 bills that passed in 2021 that were directly related to the COVID-19 pandemic and included an explicit mention of telehealth. Most state telehealth COVID-19 bills either extended or ended the flexibilities made by previous legislation.

Medicaid Reimbursement

CCHP tracked 36 pieces of legislation that passed dealing with Medicaid reimbursement for telehealth. A few states explicitly made reference to their COVID flexibilities in these laws, and chose to extend or make those permanent. Arkansas, for example, extended Medicaid reimbursement for certain behavioral and mental health services until after the end of the COVID-19 pandemic.

Private Payer Reimbursement

CCHP tracked 42 private payer laws enacted in 2021, with more bills requiring reimbursement for telehealth modalities beyond live video than ever before.

Cross-State Licensing

CCHP tracked 43 cross-state licensing bills that were enacted, with most involving a state joining a new interstate compact and a few states going further on their own. For example, an Arizona bill allows an out-of-state provider to offer telehealth in the state if the provider registers with the state’s applicable regulatory board and fulfills reporting and other requirements.

Online Prescribing & Professional Regulatory Requirements

CCHP tracked 80 bills enacted to deal with professional regulation around telehealth, including many of which address online prescribing requirements. Common professions where telehealth was explicitly allowed included dentistry, physical therapy and veterinary medicine, while some bills went a step beyond by allowing for the use of telehealth simply by establishing professional practice standards. 

Pilot Studies/Demonstration Projects

CCHP tracked 12 bills that passed that included a study, pilot or demonstration project,  most frequently related to audio-only reimbursement or payment parity. These studies often explicitly intend to inform the direction of future policy decisions.

Broadband

In 2021, CCHP tracked 15 broadband bills that were enacted, compared with just 3 in 202. This large increase was likely due to the disparities in access to broadband that the pandemic made evident. Much of the enacted legislation centers around funding for broadband projects in low and/or underserved areas with limited access to broadband.  

See the CCHP Policy Finder for updates on new state and federal telehealth policies and proposals.