Senate bill would require insurers to cover telehealth

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A health care bill passed by the Senate last week would make telehealth a lasting fixture in the state's health care system.

Under the bill, which passed by a 38-0 vote on Thursday, health insurance providers, including MassHealth, would be required to cover video, phone and other virtual appointments as they would in-person visits for two years. The bill also creates a system to end "surprise" medical bills for out-of-network services, expands the health care workforce and calls for an analysis of Massachusetts' health care system and the impacts of COVID-19.

Demands placed on the health care system during the pandemic necessitated increased telehealth use, and the overwhelming conclusion has been that "telehealth works," said state Sen. Cindy Friedman, D-Arlington, in a speech Thursday on the Senate floor. Friedman sponsored the bill, "An act to put patients first," which she said "builds upon vital lessons learned during the COVID-19 public health crisis."

Insurance providers' lack of telehealth coverage had been a key obstacle to telehealth prior to the pandemic, said state Sen. Adam Hinds, D-Pittsfield. Social distancing concerns had led Gov. Charlie Baker to mandate insurers to cover telehealth beginning March 16.

"What's been the barrier up until then was that you wouldn't have the same reimbursement from health insurers," Hinds said. "They weren't covering the use of telehealth, and now this bill does require across the whole range of telemedicine."

Reimbursement for telehealth will be important for hospitals and providers that have lost revenue due to the pandemic, said Michael Leary, director of communications for Berkshire Health Systems.

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"This bill contains the provision of payer equity, meaning a telehealth visit would be reimbursable at the same rate as an in-person visit," Leary wrote in an email. "One of the barriers to fully implementing telehealth services prior to COVID-19 was the lack of payer equity, and with this being established it makes it easier for the patient to be 'seen' and to receive the care they need when they need it."

Some small business and health insurance leaders, however, have opposed the two-year requirement for paying telehealth at an in-person rate, asking instead for a "transition period ... to negotiate appropriate reimbursement," State House News Service reports.

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The ease and timeliness of telehealth appointments have led to "a great deal of positive feedback" from patients, Leary said. BHS has used telehealth extensively and continues to offer it even though in-person services are now available. While BHS encourages in-person visits in cases where direct interaction is more important, it is "absolutely continuing telehealth as an important component of patient care, where appropriate, moving forward."

Telemedicine has allowed patients at the Brien Center to bypass waiting rooms and long commutes, said Dr. Jennifer Michaels, medical director of the facility, which provides mental health and substance abuse services.

"Some of the people we serve have challenges traveling to the Brien Center historically," said Michaels, who said some insurers did not reimburse the Brien Center for audio appointments prior to the pandemic. "Telemedicine provides a way to reach more people and a way to reach them in a way patients sometimes prefer."

The bill also removes barriers for providers to practice, and it creates a new license for dental therapists, who already practice in 12 states.

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It also calls for the Health Policy Commission and the Division of Insurance to set a standard rate for out-of-network care to be instituted in 2021, seeking to protect patients from receiving "surprise" bills when they inadvertently receive care not covered by their insurance.

Finally, it tasks the commission and Center for Health Information and Analysis with analyzing the state of Massachusetts' health care system, including COVID-19's impact on accessibility, care and finances. The analysis will also address disparities due to race, class, geography or other factors.

Hinds said that while health care reform has faced "a bumpy path" in the state, he hopes the House will collaborate with the Senate to turn the bill into law.

"It really feels like we need to work with our House counterparts to make sure there's progress," he said.

Danny Jin, a Report for America corps member, is The Eagle's Statehouse news reporter. He can be reached at, @djinreports and 413-496-6221.


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