By Melissa Patrick
Kentucky Health News
FRANKFORT, Ky. -- A Senate tele-health bill aimed at increasing access to care and saving the state money is awaiting a vote in the House, amid an objection from the state's largest health insurer and opposition to an amendment that would keep tele-health form being used in abortions.
Senate Bill 112, sponsored by Republican Sen. Ralph Alvarado, passed the Senate without dissent and has been placed in the regular orders of the day in the House. It includes a Senate amendment to prohibit tele-health from being used for abortions.
Alvarado, a Winchester physician, told the House committee that telemedicine has been proven to save money through such measures as "video conference follow-ups and remote patient monitoring that decrease hospitalizations and increase the quality of care."
He added that it allows physicians the ability to remotely monitor chronic diseases more efficiently, increases access to specialty care, increases access to mental-health care, decreases use of emergency rooms, and increases provider access to those with transportation issues.
Alvarado 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 tele-health program had saved the state $2.5 million.
The bill 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.
Committee Chair Addia Wuchner realized after the panel approved the bill without dissent that there were lobbying interests that wanted to speak against the bill, and she gave them a chance to speak.
Lawrence Ford of Anthem Blue Cross and Blue Shield, said that the insurance firm supports tele-health and its expansion, but has concerns about the bill's requirement that providers be paid the same amount for a tele-health visit as an in-patient visit, unless a lesser rate had been negotiated. He said a tele-health visit through Anthem now costs $49, while an average in-person visit cost $83.
He added that while there was no fiscal note attached to the bill, "There was a statement that was prepared by the Department of Insurance that stated that this legislation could increase health care costs for insurance plans by as much as $7.7 million."
"We have issues and oppose any efforts by the General Assembly to venture into rate-setting services between two parties," Ford said. Later, Rep. Jim Gooch, R-Providence, filed a floor amendment to remove the equal-payment provision.
Tamarra Wieder of Planned Parenthood Advocates of Indiana and Kentucky told the panel that while the organization supports tele-health, it opposes the restrictions that the amended bill placed on abortions, which she referred to as a "constitutionally protected medical service."
"Telehealth delivery of medication abortion has been demonstrated to be just as safe and effective as in-person protocols and to improve patient safety by enabling abortion earlier in the pregnancy when it is the safest," Wieder said.
Kate Miller of the American Civil Liberties Union - Kentucky said the amended bill would decrease rural Kentucky women's access to legal abortions, since the only abortion provider in Kentucky is in Louisville.
After the opponents spoke, Wuchner asked if any committee members wanted to change their vote. None did.
Kentucky Health News
FRANKFORT, Ky. -- A Senate tele-health bill aimed at increasing access to care and saving the state money is awaiting a vote in the House, amid an objection from the state's largest health insurer and opposition to an amendment that would keep tele-health form being used in abortions.
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| Sen. Ralph Alvarado |
Alvarado, a Winchester physician, told the House committee that telemedicine has been proven to save money through such measures as "video conference follow-ups and remote patient monitoring that decrease hospitalizations and increase the quality of care."
He added that it allows physicians the ability to remotely monitor chronic diseases more efficiently, increases access to specialty care, increases access to mental-health care, decreases use of emergency rooms, and increases provider access to those with transportation issues.
Alvarado 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 tele-health program had saved the state $2.5 million.
The bill 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.
Committee Chair Addia Wuchner realized after the panel approved the bill without dissent that there were lobbying interests that wanted to speak against the bill, and she gave them a chance to speak.
Lawrence Ford of Anthem Blue Cross and Blue Shield, said that the insurance firm supports tele-health and its expansion, but has concerns about the bill's requirement that providers be paid the same amount for a tele-health visit as an in-patient visit, unless a lesser rate had been negotiated. He said a tele-health visit through Anthem now costs $49, while an average in-person visit cost $83.
He added that while there was no fiscal note attached to the bill, "There was a statement that was prepared by the Department of Insurance that stated that this legislation could increase health care costs for insurance plans by as much as $7.7 million."
"We have issues and oppose any efforts by the General Assembly to venture into rate-setting services between two parties," Ford said. Later, Rep. Jim Gooch, R-Providence, filed a floor amendment to remove the equal-payment provision.
Tamarra Wieder of Planned Parenthood Advocates of Indiana and Kentucky told the panel that while the organization supports tele-health, it opposes the restrictions that the amended bill placed on abortions, which she referred to as a "constitutionally protected medical service."
"Telehealth delivery of medication abortion has been demonstrated to be just as safe and effective as in-person protocols and to improve patient safety by enabling abortion earlier in the pregnancy when it is the safest," Wieder said.
Kate Miller of the American Civil Liberties Union - Kentucky said the amended bill would decrease rural Kentucky women's access to legal abortions, since the only abortion provider in Kentucky is in Louisville.
After the opponents spoke, Wuchner asked if any committee members wanted to change their vote. None did.
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