NY Telehealth Bill Expands Coverage, Supports License Reciprocity, eConsults

New York Governor Andrew Cuomo is aiming to put his state at the front of the line in telehealth access and coverage with a wide-ranging legislative proposal that, among other things, eliminates geographical restrictions on Medicare coverage, supports license reciprocity and launches a telehealth training program.

"While New York State has been on the cutting edge of promoting telehealth for its residents, the adoption of telehealth by both patients and providers has been slow," the governor said in a press release issued ahead of Monday’s State of the State Address. "COVID-19 has changed not only the way we live, but the way healthcare providers support their patients, especially in regard to mental health. New Yorkers have adapted throughout 2020, but it is time to push telehealth to the next level in New York State and fully integrate it into our existing healthcare system. These proposals will better allocate our healthcare and technological resources for the 21st century."

Cuomo’s bill includes a number of regulatory and statutory changes aimed at permanently extending many of the emergency measures enacted over the past year to address the coronavirus pandemic. It also includes new proposals designed to push new connected health services for issues like substance abuse, behavioral health and specialist consults.

Along with Massachusetts, where Governor Charlie Baker signed wide-ranging telehealth legislation less than two weeks ago, New York is part of a wave of states taking the lead on realigning access and coverage. California is also reportedly considering new telehealth guidelines.

These states have been hard hit by COVID-19, and have seen firsthand how connected health can be used to target gaps in care. Some telehealth advocates are hoping they set the example that Congress and the federal government could follow in future policy decisions.

Specifically, Cuomo’s bill would:

• Require commercial health insurers to cover telehealth and extend Medicare coverage to audio-only phones, subject to federal approval;
• Require payers to reimburse for telehealth services “at rates that incentivize use when medically appropriate;”
• Require telehealth services “offered as part of a mandatory telehealth program” to integrate with the state’s health information network;
• Eliminate geographical restrictions in Medicaid coverage;
• Create “interstate licensing reciprocity” with states throughout the Northeast for specialist services, including behavioral health;
• Expand telehealth services for mental health and substance abuse treatment, including eliminating the in-person exam requirement prior to using telehealth, expanding the list of providers able to use telehealth, developing guidelines for “predominantly virtual outpatient substance abuse disorder treatment” and extending telemental health services into nursing homes;
• Encourage insurers to cover e-consults and support the expansion of telehealth platforms that facilitate specialty consults;
• Require insurers to provide telehealth platforms that allow members to access care providers in an emergency for triage and referrals to appropriate care;
• Create an open-access continuing professional education telehealth training program, developed by the Reimagine New York Commission with help from the Northeast Telehealth Resource Center, Stony Brook Medicine, Weill Cornell Medicine, Cityblock Health and others; and
• Launch a telehealth facilitator program, developed by the Reimagine New York Commission, Mount Sinai Health Partners and AIRnyc, to help underserved populations develop a comfort level with telemedicine and mHealth technology.

Cuomo’s call for interstate licensing reciprocity addresses one of the primary barriers to telehealth expansion, and one that many organizations and health systems want addressed by the federal government. Providers who want to treat patients in other states are constrained and often turned off by the complex process of getting licenses to practice in each state.

The COVID-19 crisis prompted several states to relax those rules and recognize providers from other states with valid licenses, but those rules end with the emergency. Long-term proposals range from interstate licensure compacts to license portability to having one license that’s good throughout the country.

Among those offering praise for Cuomo’s proposals was the American Telemedicine Association.

“The ATA applauds Governor Cuomo for recognizing the unique role that telehealth can play in bringing healthcare into the 21st century and in expanding access to care, at a lower cost, to underserved communities,” ATA CEO Ann Mond Johnson said in a press release. “In response to the public health emergency, telehealth shored up a troubled healthcare system, when our nation needed it most. It is now vital for states, such as New York, to act as soon as possible this year to ensure telehealth remains available to all, wherever and whenever it is needed. The ATA is hopeful that the New York state legislature will work with Governor Cuomo to pass this needed telehealth modernization legislation.”