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Florida’s House Proposes Adding a Significant Financial “Carrot” to Encourage Reimbursement of Telehealth Use by Health Care Providers and Expand Health Access and Options to Its Residents

The Florida Bar Health Law Updates March 2019

Florida may be joining the race toward improving health care access for its residents via telehealth. Members of Florida’s House Health Quality Subcommittee approved the telehealth-friendly bill (HB 23), which if passed, would create a substantial tax-incentive for health plans and HMOs to cover and reimburse providers for telehealth services.  According to the Fall 2018 Reimbursement Policies report by the Center for Connected Health Policy, Florida lags behind 39 states and the District of Columbia when it comes to private payer telehealth parity laws, with Kansas, Iowa, and Utah joining the ranks when their private payer parity laws went into effect at the beginning of this year.

If passed, HB 23 would:

  • Encourage coverage and reimbursement for telehealth services. Effective January 1, 2020, “any health insurer and health maintenance organization [(HMO)] that cover services provided by telehealth” would receive a tax credit, which would rollover up to five years if not fully used in any single year. The insurers and HMOs would be allowed a tax credit equal to 0.001 percent of total insurance premiums received on accident and health insurance policies or plans delivered or issued in Florida in the previous calendar year that provide medical, major medical, or similar comprehensive coverage.
  • Define “Telehealth”. Telehealth would mean “the use of synchronous or asynchronous telecommunications technology by a telehealth provider to provide health care services, including, but not limited to, patient assessment, diagnosis, consultation, treatment, and monitoring; transfer of medical data, patient and professional health-related education; public health services; and health administration.” It would exclude “audio-only telephone calls, e-mail messages, or facsimile transmissions.”
  • Incorporate an expansive list of healthcare providers covered under the tax incentive. Florida would explicitly recognize the following types of licensed or certified healthcare providers to provide their services via telehealth platforms:
    • Behavior analysts;
    • Medical transportation services (under Part III of Chapter 401 of the Florida statutes);
    • Acupuncturists;
    • Physicians;
    • Osteopathic physicians;
    • Chiropractors;
    • Podiatrists;
    • Optometrists;
    • Nurses and Nursing Assistants;
    • Pharmacists;
    • Dentists, Dental Hygienists, and Dental Laboratories;
    • Midwives;
    • Speech-Language Pathologists and Audiologists;
    • Occupational Therapists;
    • Radiologists;
    • Respiratory Therapists;
    • Dieticians and Nutritionists;
    • Athletic Trainers;
    • Orthotists, Pedorthists, and Prosthetists;
    • Electrologists;
    • Massage Therapists;
    • Medical Physicists;
    • Opticians and Hearing aid specialists;
    • Physical Therapists;
    • Psychologists; and
    • Clinical Social Workers, Marriage and Family Therapists, Mental Health Counselors, and Psychotherapists.
  • Allow out-of-state healthcare providers to provide services without a Florida license. Out-of-state providers would be able to register with the applicable board to provide telehealth services to Florida residents.  This would allow out-of-state healthcare providers, with valid licenses and/or certifications, and in good standing in their own respective states, to provide telehealth services to Florida residents without having to first obtain a Florida license and/or certification, which is currently required. Presumably, out-of-state health providers would also be covered in the tax incentive, should insurers and HMOs cover and reimburse telehealth services performed by those providers.

Although the bill provides incentives to promote telehealth access, the bill does not require that insurers and HMOs reimburse for telehealth services. Although several progressive, value-based insurers in Florida have openly advocated for telehealth expansion or included certain telehealth services in their offerings, this is a nascent trend.  Many telehealth providers and proponents of telehealth have discovered that without statutory mandates, most insurers are hesitant about covering and reimbursing telehealth services.  If the House bill passes into law, it will be interesting to see whether the tax incentive carrots will be as effective as mandates in promoting telehealth use across providers and plan enrollees.

Reprinted by permission of The Florida Bar Health Law Updates, co-edited by attorney Elizabeth Scarola of Epstein Becker Green.