NH Permanently Extends Telehealth Coverage, Including Payment Parity

New Hampshire has enacted a new law that greatly expands how care providers in the Granite State can use telehealth.

HB 1623, signed on July 21 by Governor Chris Sununu, amends the state’s definition of telemedicine to include new modalities, including audio-only phones, and requires Medicaid and private payers to reimburse for telehealth services on the same basis that it reimburses for in-person care.

It also ends restrictions on originating and distant sites for telehealth services, and expands the list of care providers able to use telehealth to encompass physicians, physician assistants, advanced practice nurses, midwives, psychologists, allied health professionals, dentists, mental health practitioners, community mental health providers employed by community mental health programs, alcohol and other drug use professionals, dietitians and professionals certified by the national behavior analyst certification board.

The law makes permanent several telehealth freedoms passed by emergency measures to deal with the coronavirus pandemic, including reimbursement parity and the ability for providers and patients to collaborate on care through a telephone. Several states have passed or are considering similar bills, and Congress and the federal government are under pressure to act as well.

“Expanding telemedicine has been critical during this time of crisis and proven to be a helpful and important tool for providers and patients to have for the long term,” Sununu said last month, after the bill had cleared both the House and Senate. “Expanding these services permanently will help streamline our health care system by breaking down burdensome regulations.”

The bill drew strong support from care providers across the state, many of whom have expanded their use of telehealth and mHealth during the COVID-19 crisis.

“Why wouldn’t we embrace this solution – this three-month experiment – that has been working and has provided access to people regardless of their ability to leave their home?” Cynthia Whitaker, chief of services at Greater Nashua Mental Health, told the state’s NPR news outlet last month as the state Senate prepared to pass the bill.

New Hampshire’s new law also eliminates the requirement for an in-person exam prior to a virtual visit for providers treating patients living with substance abuse disorder (SUD) in several locations, and also enables them to use telehealth to prescribe Class II-IV non-opioid controlled drugs.

The law applies to care providers employed by or contracted with the Department of Veterans Affairs; treating patients in state hospitals, clinics, correctional facilities and community mental health centers; and those treating patients in so-called “doorway” substance abuse programs.

The legislation is an effort to expand treatment options for healthcare providers working with patients with substance abuse issues, especially those in rural areas with limited or no access to care. Studies have shown a marked increase in substance abuse over the past few years, with those numbers spiking even higher during the coronavirus pandemic.

It also addresses the federal government’s long-pending plan to create a special registration for care providers who want to prescribe scheduled drugs via telemedicine for SUD treatment.

Under the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, certain healthcare providers were allowed to prescribe controlled substances for treatment as long as they’d first had an in-person examination with the patient. That law offered several instances in which the in-person requirement could be waived.

On March 16, the US Drug Enforcement Agency (DEA) waived that requirement by invoking the public health emergency exception. That waiver is still in place, but will expire when the COVID-19 emergency is ended.