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E c e p t a t e i p s a n t a u t u t e x c e r n a t e x p e d i s s i t r e s a u d a e o m m o t e m f u g i t a e t e t u r r e s c u m e n o n c u s . B a k e r & D a n i e l s L L P u s e r U n k n o w n !` M AWN 6400 >^ > > ! A / / 0 0 0 0 / 0 0 0 0 8 <0 , h0 0 }M 0 `1 : 1 1 $4 $4 $4 8M +P h R hM 0 p3 p3 @ $4 0 0 1 1 V p3 1 3 R 1 :M . !P
$4 hK X p3 4 " L ( hM L P 0 $4 $4 $4 $4 hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM hM V i r t u a l V i s i t s G a i n i n g G r o u n d
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T e l e h e a l t h s e r v i c e s a r e i n - d e m a n d a n d , q u i t e l i t e r a l l y , o n - d e m a n d . P a t i e n t s a r e i n c r e a s i n g l y s e e k i n g o u t h e a l t h s e r v i c e s v i a r e a l - t i m e s y n c h r o n o u s a u d i o - v i d e o e n c o u n t e r s w i t h h e a l t h c a r e p r o v i d e r s ( k n o w n a s t e l e h e a l t h o r t e l e m e d i c i n e ) . T h e a v a i l a b i l i t y o f o n - d e m a n d v i r t u a l d o c t o r v i s i t s v i a t e l e h e a l t h r e v e r s e s t h e l o n g s t a n d i n g p a r a d i g m o f p l a c i n g t h e b u r d e n o n p a t i e n t s t o s e e k c a r e w h e r e i t s p h y s i c a l l y a v a i l a b l e . T e l e h e a l t h i s a l s o i n - d e m a n d a s e v i d e n c e d b y r e c e n t p r i v a t e p a y e r , f e d e r a l a n d s t a t e a c t i v i t y a i m e d a t i n c r e a s i n g a c c e s s t o a n d u s e o f t e l e h e a l t h s e r v i c e s .
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T e l e h e a l t h s e r v i c e s a n d t h e r u l e s g o v e r n i n g t h e r e i m b u r s e m e n t o f s u c h s e r v i c e s h a v e b e e n a h o t t o p i c o n C a p i t o l H i l l i n r e c e n t w e e k s .
2 1 s t C e n t u r y C u r e s . F e d e r a l p o l i c i e s t o e n c o u r a g e t e l e m e d i c i n e s e r v i c e s h a v e b e e n i n c l u d e d i n a l e g i s l a t i v e e f f o r t , e n t i t l e d t h e 2 1 s t C e n t u r y C u r e s i n i t i a t i v e , c u r r e n t l y u n d e r w a y i n t h e U . S . H o u s e E n e r g y a n d C o m m e r c e C o m m i t t e e . O v e r t h e c o u r s e o f l a s t y e a r , t h e C o m m i t t e e h e l d s e v e r a l h e a r i n g s , r o u n d t a b l e d i s c u s s i o n s a n d i s s u e d w h i t e p a p e r s o n a v a r i e t y o f i s s u e s c o n c e r n i n g t h e m o d e r n i z a t i o n o f t h e d i s c o v e r y , d e v e l o p m e n t a n d d e l i v e r y o f m e d i c i n e . T h o s e a c t i v i t i e s i n c l u d e d a h e a r i n g s p e c i f i c a l l y o n H Y P E R L I N K " h t t p : / / e n e r g y c o m m e r c e . h o u s e . g o v / e v e n t / 2 1 s t - c e n t u r y - c u r e s - r o u n d t a b l e - d i g i t a l - h e a l t h - c a r e " d i g i t a l h e a l t h c a r e l a s t s u m m e r t h a t e x a m i n e d t h e u s e s o f t e l e m e d i c i n e a n d w h a t s n e e d e d t o m o r e w i d e l y f a c i l i t a t e t e l e m e d i c i n e s e r v i c e s i n t h e f u t u r e .
I n J a n u a r y 2 0 1 5 , t h e E n e r g y & C o m m e r c e C o m m i t t e e i s s u e d a n H Y P E R L I N K " h t t p : / / e n e r g y c o m m e r c e . h o u s e . g o v / p r e s s - r e l e a s e / 2 1 s t - c e n t u r y - c u r e s - l e g i s l a t i v e - p h a s e - n o w - u n d e r w a y - c o n t i n u e d - f e e d b a c k - s o u g h t - c u r e s 2 0 1 5 - b e g i n s - i n - e a r n e s t " i n i t i a l l e g i s l a t i v e d r a f t o f t h e 2 1 s t C e n t u r y C u r e s b i l l t h a t c o n t a i n s a p r o v i s i o n t h a t w o u l d c r e a t e a l i s t o f t e l e m e d i c i n e s e r v i c e s t h a t w o u l d b e c o v e r e d b y M e d i c a r e a n d r e q u i r e d b u d g e t n e u t r a l i t y f o r a l l o f t h o s e n e w l y c o v e r e d s e r v i c e s . H o w e v e r , t h a t i n i t i a l d r a f t w a s r e c e n t l y H Y P E R L I N K " h t t p : / / e n e r g y c o m m e r c e . h o u s e . g o v / s i t e s / r e p u b l i c a n s . e n e r g y c o m m e r c e . h o u s e . g o v / f i l e s / 1 1 4 / 2 0 1 5 0 4 2 9 D i s c u s s i o n D r a f t . p d f " r e v i s e d , a n d t h e t e l e m e d i c i n e p r o v i s i o n w a s r e m o v e d a n d r e p l a c e d b y p l a c e h o l d e r l a n g u a g e s t a t i n g t h a t f u r t h e r w o r k i s n e e d e d t o i n c l u d e a p r o v i s i o n o n t e l e m e d i c i n e s e r v i c e s . W h i l e t h e r e m o v a l o f t h a t l a n g u a g e i s a s e t b a c k f o r c r a f t i n g p o l i c i e s t h a t w o u l d e n c o u r a g e t h e u s e o f t e l e m e d i c i n e , t h e f a c t t h a t t h e p r o v i s i o n s t i l l h a s a p o t e n t i a l p l a c e i n t h e b i l l i s e n c o u r a g i n g , a s c o m p a r e d t o o t h e r p r o v i s i o n s t h a t w e r e s i m p l y c u t o u t . D u r i n g t h e c o m i n g w e e k s , t h e E n e r g y a n d C o m m e r c e C o m m i t t e e w i l l a t t e m p t t o f i n a l i z e l a n g u a g e o n t e l e m e d i c i n e b e f o r e t h e b i l l m o v e s o u t o f t h e C o m m i t t e e t o b e c o n s i d e r e d b y t h e f u l l H o u s e o f R e p r e s e n t a t i v e s .
M o r e H o u s e A c t i o n . S e p a r a t e l e g i s l a t i v e e f f o r t s o u t s i d e t h e 2 1 s t C e n t u r y C u r e s e f f o r t a r e a l s o u n d e r w a y . R e p . G r e g g H a r p e r ( R - M S ) i n t r o d u c e d a H Y P E R L I N K " h t t p s : / / w w w . c o n g r e s s . g o v / b i l l / 1 1 4 t h - c o n g r e s s / h o u s e - b i l l / 2 0 6 6 " b i l l t h a t p r o m o t e s a n d e x p a n d s t h e a p p l i c a t i o n o f t e l e h e a l t h u n d e r M e d i c a r e a n d o t h e r F e d e r a l h e a l t h c a r e p r o g r a m s . R e p . H a r p e r s t e l e h e a l t h l e g i s l a t i o n b u i l d s o f f a p r e v i o u s b i l l , t h e T e l e h e a l t h E n h a n c e m e n t A c t o f 2 0 1 3 , w h i c h s o u g h t t o a d j u s t M e d i c a r e h o m e h e a l t h p a y m e n t s t o a c c o u n t f o r r e m o t e p a t i e n t m o n i t o r i n g a n d t o e x p a n d c o v e r a g e t o a l l c r i t i c a l a c c e s s a n d s o l e c o m m u n i t y h o s p i t a l s . A d d i t i o n a l l y , R e p . D o r i s M a t s u i ( D - C A ) i n t r o d u c e d H Y P E R L I N K " h t t p s : / / w w w . c o n g r e s s . g o v / b i l l / 1 1 4 t h - c o n g r e s s / h o u s e - b i l l / 6 9 1 ? q = % 7 B % 2 2 s e a r c h % 2 2 % 3 A % 5 B % 2 2 H . R . 6 9 1 % 2 2 % 5 D % 7 D " l e g i s l a t i o n e a r l i e r t h i s y e a r t h a t c a l l s f o r s t a t e s t o a u t h o r i z e h e a l t h c a r e p r o f e s s i o n a l s t o d e l i v e r h e a l t h c a r e t o i n d i v i d u a l s t h r o u g h t e l e m e d i c i n e .
S e n a t e H e a r i n g a n d L e g i s l a t i o n . O n A p r i l 2 8 , 2 0 1 5 , t h e U . S . S e n a t e C o m m i t t e e o n C o m m e r c e , S c i e n c e a n d T r a n s p o r t a t i o n ' s S u b c o m m i t t e e o n C o m m u n i c a t i o n s , T e c h n o l o g y , I n n o v a t i o n a n d t h e I n t e r n e t h e l d H Y P E R L I N K " h t t p : / / w w w . c o m m e r c e . s e n a t e . g o v / p u b l i c / i n d e x . c f m ? p = H e a r i n g s & a m p ; C o n t e n t R e c o r d _ i d = 0 c 4 7 b 8 8 f - 4 1 b 1 - 4 6 1 b - 9 6 b 6 - 1 4 b 6 a 8 2 f 5 6 3 2 & a m p ; C o n t e n t T y p e _ i d = 1 4 f 9 9 5 b 9 - d f a 5 - 4 0 7 a - 9 d 3 5 - 5 6 c c 7 1 5 2 a 7 e d & a m p ; G r o u p _ i d = b 0 6 c 3 9 a f - e 0 3 3 - 4 c b a - 9 2 2 1 - d e 6 6 8 c a 1 9 7 8 a " a h e a r i n g t o e x a m i n e h o w t h e u s e o f t e l e h e a l t h h a s h e l p e d l o w e r c o s t s a n d i m p r o v e p a t i e n t o u t c o m e s . T h e h e a r i n g , e n t i t l e d A d v a n c i n g T e l e h e a l t h t h r o u g h C o n n e c t i v i t y , e x p l o r e d a w i d e v a r i e t y o f i s s u e s , i n c l u d i n g p r o v i d e r l i c e n s u r e i s s u e s , t h e r o l e o f t h e F e d e r a l C o m m u n i c a t i o n s C o m m i s s i o n t o e n a b l e a n d p r o m o t e t e l e h e a l t h s e r v i c e s , a n d p r o v i d e r r e i m b u r s e m e n t l i m i t a t i o n s . S u b c o m m i t t e e m e m b e r s g e n e r a l l y s e e m e d t o f a v o r i n c r e a s i n g u s e o f t e l e h e a l t h , w i t h m a n y o f t h e l a w m a k e r s c a l l i n g o n M e d i c a r e t o r e i m b u r s e f o r s u c h s e r v i c e s .
D u r i n g t h e h e a r i n g , S u b c o m m i t t e e C h a i r m a n R o g e r W i c k e r ( R - M S ) H Y P E R L I N K " h t t p : / / w w w . w i c k e r . s e n a t e . g o v / p u b l i c / i n d e x . c f m / p r e s s - r e l e a s e s ? I D = c 6 e f 3 d f c - 2 b f 7 - 4 d c a - 9 5 5 5 - 5 a 0 4 2 a e 6 f 2 b 4 " a n n o u n c e d p l a n s t o r e i n t r o d u c e , w i t h S e n a t o r T h a d C o c h r a n ( R - M S ) , a b i l l t h a t w o u l d e x t e n d M e d i c a r e c o v e r a g e f o r t e l e h e a l t h s e r v i c e s p r o v i d e d i n u n d e r s e r v e d a r e a s . T h e T e l e h e a l t h A d v a n c e m e n t A c t a i m s t o b r i n g p a r i t y i n p a y m e n t a n d h e l p i m p r o v e M e d i c a r e r e i m b u r s e m e n t . T h e b i l l w a s i n t r o d u c e d b u t n o t v o t e d o n d u r i n g t h e 1 1 3 t h C o n g r e s s .
A l l t h i s i n j u s t t w o w e e k s t i m e ! T h e s e r e c e n t a c t i o n s e v i d e n c e t h a t f e d e r a l l a w m a k e r s a r e b e c o m i n g m o r e p r o a c t i v e i n t h e i r p u r s u i t o f t e l e h e a l t h p o l i c e s t h a t w i l l b o t h s h a p e t h e m a n n e r i n w h i c h s e r v i c e s a r e d e l i v e r e d a n d h o w t h o s e s e r v i c e s w i l l b e p a i d f o r .
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O n A p r i l 1 0 , 2 0 1 5 , t h e H Y P E R L I N K " h t t p : / / w w w . t m b . s t a t e . t x . u s / d l / D A D 8 9 6 4 5 - F 8 1 F - C F 5 1 - 6 F F 8 - D 0 E 2 0 8 9 1 6 2 5 A " T e x a s M e d i c a l B o a r d v o t e d t o c h a n g e t h e p r a c t i c e o f t e l e h e a l t h i n t h a t S t a t e . T h e B o a r d c l a r i f i e d t h a t a p h y s i c i a n - p a t i e n t r e l a t i o n s h i p c a n b e e s t a b l i s h e d t h r o u g h a f a c e - t o - f a c e v i s i t h e l d e i t h e r i n p e r s o n o r v i a t e l e m e d i c i n e . C i t i n g p a t i e n t s a f e t y , t h e B o a r d e x p l a i n e d t h a t E s s e n t i a l l y t h e o n l y s c e n a r i o p r o h i b i t e d i n T e x a s i s o n e i n w h i c h a p h y s i c i a n t r e a t s a n u n k n o w n p a t i e n t u s i n g t e l e m e d i c i n e , w i t h o u t a n y o b j e c t i v e d i a g n o s t i c d a t a , a n d n o a b i l i t y t o f o l l o w u p w i t h t h e p a t i e n t . M a n y e x p e c t t h e T e x a s M e d i c a l B o a r d s v o t e t o b e H Y P E R L I N K " h t t p : / / w w w . g o v t e c h . c o m / h e a l t h / T e x a s - M e d i c a l - B o a r d - F a c e s - L a w s u i t - O v e r - T e l e m e d i c i n e - R e s t r i c t i o n s . h t m l " c h a l l e n g e d i n c o u r t .
O n A p r i l 1 7 , 2 0 1 5 , W a s h i n g t o n S t a t e s G o v e r n o r s i g n e d a b i l l e x p a n d i n g c o v e r a g e f o r t e l e m e d i c i n e s e r v i c e s p a i d f o r b y c e r t a i n h e a l t h p l a n s i n t h e S t a t e o f W a s h i n g t o n , b e c o m i n g t h e 2 4 t h s t a t e t o a d o p t a f u l l o r p a r t i a l t e l e m e d i c i n e p a r i t y l a w . G e n e r a l l y , p a r i t y l a w s r e q u i r e h e a l t h c a r e p a y e r s t o c o v e r s e r v i c e s f u r n i s h e d e l e c t r o n i c a l l y t o t h e s a m e e x t e n t s u c h s e r v i c e s w o u l d b e c o v e r e d i f f u r n i s h e d i n a f a c e - t o - f a c e v i s i t . A l t h o u g h t h e n e w l a w r e q u i r e s p a r i t y i n c o v e r a g e , i t d o e s n o t r e q u i r e p a r i t y i n r e i m b u r s e m e n t . T h e n e w W a s h i n g t o n S t a t e p a r i t y l a w r e c e i v e d s t r o n g s u p p o r t i n b o t h W a s h i n g t o n l e g i s l a t i v e h o u s e s .
O n A p r i l 2 5 , 2 0 1 5 , a p a n e l o f e x p e r t s e x p l o r e d T r e n d s a n d D e v e l o p m e n t s i n T e l e m e d i c i n e a s p a r t o f t h e H Y P E R L I N K " h t t p s : / / w w w . f s m b . o r g / M e d i a / D e f a u l t / P D F / F S M B / A n n u a l % 2 0 M e e t i n g / 2 0 1 5 a m _ a g e n d a . p d f " F e d e r a t i o n o f S t a t e M e d i c a l B o a r d s A n n u a l M e e t i n g i n F o r t W o r t h , T e x a s . S p e a k e r s d i s c u s s e d h o w p r o v i d e r s a n d p a t i e n t s a r e u s i n g e m e r g i n g t e c h n o l o g i e s t o i m p r o v e h e a l t h o u t c o m e s , o n l i n e p r e s c r i b i n g a n d m e d i c a t i o n d i s p e n s i n g i s s u e s , a n d t h e F e d e r a t i o n s H Y P E R L I N K " h t t p : / / w w w . f s m b . o r g / M e d i a / D e f a u l t / P D F / F S M B / A d v o c a c y / F S M B _ T e l e m e d i c i n e _ P o l i c y . p d f " M o d e l G u i d e l i n e s f o r t h e A p p r o p r i a t e U s e o f T e l e m e d i c i n e T e c h n o l o g i e s i n t h e P r a c t i c e o f M e d i c i n e .
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I n t h e l a s t w e e k o f A p r i l 2 0 1 5 , U n i t e d H e a l t h c a r e , t h e l a r g e s t h e a l t h i n s u r e r i n t h e U . S . , a n n o u n c e d a s i g n i f i c a n t n e w c o v e r a g e d e c i s i o n t o i n c l u d e v i r t u a l v i s i t s t h r o u g h t h e p o p u l a r I n t e r n e t - b a s e d p l a t f o r m s D o c t o r o n D e m a n d , A m e r i c a n W e l l s A m W e l l a n d O p t u m s N o w C l i n i c . T h e s e c o m p a n i e s a l l o w f o r a p h y s i c i a n c o n s u l t a t i o n i n r e a l - t i m e , a s w e l l a s w r i t i n g a p r e s c r i p t i o n f o r c o m m o n c o n d i t i o n s l i k e t h e f l u , p i n k e y e , U T I s , s i n u s i n f e c t i o n s a n d b r o n c h i t i s . T h i s n e w c o v e r a g e d e c i s i o n i s c u r r e n t l y a v a i l a b l e t o U n i t e d H e a l t h c a r e s s e l f - f u n d e d e m p l o y e r s . U n i t e d H e a l t h c a r e a n n o u n c e d p l a n s t o e x p a n d t e l e h e a l t h c o v e r a g e t o e m p l o y e r - s p o n s o r e d a n d i n d i v i d u a l p l a n p a r t i c i p a n t s i n 2 0 1 6 .
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