Tuesday, February 27, 2018

Senate passes bill to create reimbursement model for telehealth services after adding anti-abortion amendment

By Melissa Patrick
Kentucky Health News

A telehealth bill aimed at increasing access to care and saving the state money passed the Senate without opposition Feb. 26 after its sponsor ticked off a long list of benefits and accepted an amendment to outlaw its use for abortions.

Sen. Ralph Alvarado
“Telemedicine is gradually changing the way health care is delivered by using various forms of telecommunications to remotely access clinical services,” said Republican Sen. Ralph Alvarado, a Winchester physician. He said those include the ability to monitor chronic diseases more efficiently, increased access to specialty care, increased access to mental-health care, decreased use of emergency rooms, and increased provider access to those with transportation issues.

Alvarado added, “Telemedicine has been proven to save money where implemented," with such measurs as "video conference follow-ups and remote patient montoring." He cited a study in the journal Health Affairs which he said found savings of 7.7 percent to 13.3 percent per patient, per quarter, for chronically ill Medicare recipients. In addition, he said the state-employee telehealth program had saved the state $2.5 million.

Senate Bill 112, which went to the House on a 36-0 vote, would require the Cabinet for Health and Family Services to develop telemedicine policies, including a reimbursement model, with similar expectations for the public insurance market. It also requires health-care providers to be licensed in Kentucky in order to receive reimbursements, though they would be able to live anywhere in the world.

Sen. Tom Buford, R-Nicholasville, voted for the bill but voiced concerns that it would not provide a mechanism for providers and insurers to negotiate reimbursement rates, and insurance companies would be required to pay full price for telehealth treatment.

Sen. Wil Schroder, R-Wilder, introduced a floor amendment to prohibit telehealth from being used in the performance of what he called a "webcam abortion," which is an abortion that results from taking a prescribed abortion medication in early pregnancy. He said 19 states have outlawed them. The actual language of the amendment says telehealth can't be used for abortions and a physician performing one must be in the same room as the patient.

The amendment was adopted 32-3, with three Louisville Democrats, Perry Clark, Denise Harper Angel and Morgan McGarvey, voting against it. (Democrats Ray Jones of Pikeville, Gerald Neal of Louisville and Reggie Thomas of Lexington did not vote.) McGarvey said he voted for the amended bill "because I feel that telehealth is important to expanding the practice and scope of care Kentucky. I do feel it should be available for all legal procedures."

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