Advancing California's Leadership in Telehealth Policy: A Telehealth Model Statute & Other Policy Recommendations
2011 | Download
In 1996, California passed one of the first telemedicine laws in the country, the Telemedicine Development Act of 1996 (TDA). At its passage, the TDA propelled California into a position of national leadership on telemedicine policy, giving credence to telemedicine as a legitimate means of providing health care services. The original intent of the TDA, as captured in its legislative language below, is as timely today as when it was first written 15 years ago.
“The use of telecommunications to deliver health services has the potential to reduce costs, improve quality, change the conditions of practice, and improve access to health care in rural and other medically underserved areas.”
The goals of the TDA—to reduce costs, improve quality, and increase access—are even more urgent today. California faces the 2012 fiscal year with a $25 billion deficit, the latest in a series of fiscally dire budget crises. California must also contend with medical inflation outstripping general inflation, shortages of health care providers, and an unequal distribution of specialists. Telehealth technologies can serve as tools to expand the delivery of high-quality, efficient medical care.
Created by PHI's Center for Connected Health Policy (CCHP), this report puts forth a Model Statute. CCHP convened a diverse group of 25 prominent health care professionals to serve on its Telehealth Model Statute Work Group. Over a year’s time, Work Group members studied and debated current California policies and available research, and helped hone recommendations for the Model Statute.
The Model Statute represents a platform for the ideal California telehealth policy environment, and sets aside constraining fiscal, economic, and political considerations. It should be acknowledged that there was not unanimous consensus among the Work Group members on all of the recommendations presented in this report. While this report reflects the Work Group’s deliberations, CCHP assumes full responsibility for its content. Work Group members participated as individuals; neither they nor their respective organizations were asked to endorse the policy proposals presented here.
The Model Statute is a revision to California’s visionary TDA, which focused on expanding coverage of interactive telemedicine services by private and public insurers. In 1996, policy makers feared patient resistance to telemedicine, on the one hand, and overuse of services on the other. These concerns led to TDA provisions, and subsequent regulations, that have become barriers to the use of telehealth. CCHP’s assessment of current telehealth practice, research findings, and other states’ policies, found high patient satisfaction with telehealth, and no indication of overuse. CCHP concluded that existing policy barriers to the spread of telehealth need to be eliminated.
The Model Statute proposes changes to existing law and key policy areas, where CCHP believes the state has the most leverage to promote telehealth use to the greatest benefit. The statutory changes include updates to the TDA, by broadening the type of technologies covered, encouraging more consistent payment policies, reducing administrative burdens on providers, and incorporating telehealth into state workforce laws. There are other policy recommendations that do not require changes in law, but would aid the state in the quest to expand adoption of telehealth technologies. CCHP encourages policy makers interested in sponsoring legislation to adopt all or portions of the recommendations contained in the Model Statute.