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As coverage expands under the implementation of the federal health care reform, the role of telemedicine—allowing health care providers to connect to patients and other providers across the country at any time of day via the Internet—is increasingly essential to ensure that access to care is adequate, particularly in rural and underserved areas.  Patient consultations that utilize telemedicine avoid many of the delays experienced in traditional health care delivery and can help to prevent unneeded emergency rooms visits. 

On April 5, Virginia Governor Bob McConnell (R) signed SB 675, which unanimously passed both chambers of the state General Assembly.  The measure requires all health insurers to cover health care services provided via telemedicine (defined as the “use of interactive audio, video or other electronic media for the purpose of diagnosis, consultation or treatment”) – excluding audio-only telephone, e-mail or fax transmission.  Virginia is the 12th state to adopt such a mandate. 

Some insurers utilize telemedicine services without a state mandate.  The Blue Cross Blue Shield plan of Hawaii, for instance, recently announced that it will become the first health plan to deploy Online Care Team Edition, an online care system to allow live, on-demand specialist care consultations in primary care provider exam rooms.  The new product moves beyond previous telehealth services—that connect patients at home to doctors via the Internet—by putting primary care physicians at the center of coordinating care.  Through this online medical home, a PCP needing to refer a patient can go online from a regular office computer, find an in-network specialist, and launch a live consultation with the physician.  American Well, the creator of the online system, says this will not only reduce the delay, inconvenience and cost associated with the traditional referral process, but also enhance physician collaboration.

Because physicians often are not reimbursed for time spent on the telephone with insurance companies or responding to patients’ emails, payment for telemedicine services can help to financially stabilize providers, particularly those in small private practices.  For a listing of telemedicine reimbursement mandates by state and additional telemedicine resources, refer to my Telemedicine Reimbursement PDF.



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