Maryland Legislators Ready to Debate Expanding Telehealth Definition

Maryland lawmakers are gearing up for a battle over telehealth.

In response to a rule passed last July by the Maryland Board of Physicians that limits first-time telehealth use with new patients to real-time audio-visual platforms, legislators in both the Senate and House have proposed bills expanding the definition of telehealth to include asynchronous (store-and-forward) services.

Both SB 402, which faces a hearing today, and HB 448, which faces a hearing next week, aim to give care providers more leeway to use telemedicine technology that fits their workflows. Supporters of the Board of Physicians rule, meanwhile, argue that a care provider can’t establish a good doctor-patient relationship via connected health unless it’s through a real-time audio-visual platform.

The debate has played out in several states – most notably Texas, which saw a protracted battle between the Texas Medical Board and Teladoc, a telehealth company at that time focused on phone-based services.

Among those supporting the two new bills is the ERISA Industry Committee (ERIC), a Washington-based non-profit advocating for large companies who want to include telehealth services in their employee health plans. The organization has long lobbied for state telehealth laws that are technology-neutral.

“Large, multistate employers need consistent telehealth policies around the country so that their employees and families can enjoy the same company benefits regardless of the state in which they live or work,” James P. Gelfand, ERIC’s Senior Vice President of Health Policy, wrote in separate letters to the House and Senate committees holding hearings on the bills. “It is imperative that employers’ funds to pay benefits are used to maximize value for patients, and not diverted to administrative and compliance burdens stemming from a myriad of disparate and potentially conflicting state rules and regulations.”

Telehealth advocates have long argued that care providers should be able to select the telemedicine technology that works best for them in creating a doctor-patient relationship with first-time or new patients. Opponents say that first point of contact should be through a platform that offers both audio and visual connections, to as closely resemble an in-person visit as possible.

Among those opposed to that restriction are providers and companies that use asynchronous platforms, where both patient and provider long online at their convenience to enter and share information, as well as those using phone- and message-based services.