Arizona's New Telehealth Law Supports Audio-Only Platforms, License Portability

Arizona Governor Doug Ducey has signed legislation that greatly expands telehealth coverage in the state, including allowing audio-only telehealth services in certain circumstances and permitting providers from other states to treat Arizona residents.

HB 2454, one of hundreds of bills introduced this year across the country to push connected health coverage and access past the coronavirus pandemic, essentially makes permanent emergency measures that were put in place in March 2020 to deal with COVID-19. State officials say the new law puts Arizona at or near the front in state-based telehealth policy.

“Ensuring Arizonans have access to safe and reliable medical services is a top priority,” Ducey said in a press release. “Telehealth expands access to medical services for low-income families and those living in rural areas, protects vulnerable populations, and allows snowbirds visiting our state to receive telemedicine from their home state. Patients and medical professionals know what’s best for their needs, and we’re working to make sure they have access to those services.”

Among other things, the new law establishes payment parity for many telehealth services, especially telemental health treatments, and it permits the use of virtual exams in worker’s comp cases as long as both sides agree to the service. It also prevents healthcare boards from requiring an in-person exam before a telehealth visit.

The new law also redefines telemedicine as telehealth, and continues to exclude faxes, e-mails, voice mails and instant messages.

Establishing coverage for audio-only telehealth services, such as a landline phone, is a relatively new concept, brought on in part by the pandemic. Telehealth advocates say coverage is important for those who lack broadband connectivity or the resources to use an audio-visual telemedicine platform, while opponents argue the phone isn’t a good enough platform for healthcare.

Arizona’s new law extends coverage for audio-only telehealth as long as it’s covered by Medicare or the state’s Medicaid program through this year; beginning in 2022, coverage will be determined by a state telehealth advisory committee, whose formation is part of the new law.

For now, coverage is allowed for audio-only services between a provider and patient who have an existing healthcare relationship, and where access to audio-visual services is “not reasonably available due to the (patient’s) functional status … lack of technology or telecommunications infrastructure limits, as determined by the healthcare provider.” For telemental health providers, there is no requirement for an existing healthcare relationship.

License portability is also a relatively new concept, addressing a long-time barrier to telehealth expansion. During the pandemic many states passed emergency measures recognizing medical licenses issued in other states, so that providers in other states could treat patients in that state, often through telehealth. The strategy bypasses the complex process of applying for a license in each state.

Arizona’s new law allows providers in good standing with their own state medical boards to treat Arizona residents, as long as several conditions are met. They include registering with the applicable state-based regulatory board and the controlled substances prescription monitoring program, paying a registration fee and agreeing not to have a physical office in Arizona.

The telehealth advisory committee will consist of 25 members, appointed by the governor, representing a wide range of healthcare services and specialties and several state departments. Its primary goal will be to develop standards and best practices for telehealth in the state.

The passage of telehealth legislation in Arizona and several other states puts pressure on Congress and the federal government to develop a national telehealth policy that extends past the COVID-19 public health emergency.