California Orders Payers to Expand Coronavirus Telehealth Coverage

California state officials are putting pressure on payers to expand telehealth coverage during the Coronavirus pandemic.

The directive issued on Monday by the California Department of Insurance is the latest in a string of state actions aimed at boosting access to connected health during the emergency. Some insurers have resisted amending their telehealth coverage, forcing state officials to mandate payment parity and coverage for new sites and modalities, such as phone calls.

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Amon the states still struggling with telehealth coverage is Florida. Last week, the Florida Medical Association sent a letter to the State Insurance Commissioner asking him to mandate payment parity to offset “the uneven response of the health insurance companies doing business in the state.”

California’s action aims to even the playing field for telehealth coverage.

“Being able to interact with your health care provider electronically will protect vulnerable people from unnecessary in-person visits with their health providers and get them help faster,” Insurance Commissioner Ricardo Lara said in a March 30 press release. “Increasing access to telehealth helps consumers comply with social distancing guidelines, protects the health of vital health care providers, and guarantees access to care for our most vulnerable during these extraordinary times.”

The notice calls on payers to:

• Allow providers to use not just audio-visual telemedicine platforms, but other platforms including synchronous video and phone calls;
• Set reimbursement rates “that mirror payment rates for an equivalent office visit;”
• Expand telehealth access to mental health treatment, substance abuse services, family therapy and behavioral health services, including autism care; and
• “Eliminate barriers to providing medically and clinically appropriate care using appropriate telehealth delivery models.”

State officials are also asking payers to encourage members to use telehealth instead of visiting healthcare facilities, which are overtaxed in dealing with the virus.

Several payers, including Humana, BCBS, Cigna and Aetna, have expanded telehealth coverage for their members and member health plans, including eliminating co-pays.

All of the changes as a result of the pandemic are temporary, and will be rolled back once the emergency is contained.