Washington State Seeks to Make Audio-Only Telehealth Permanent

On February 5, 2021, Washington State Rep. Marcus Riccelli introduced House Bill 1196 ("HB-1196") which seeks to set specific guidelines for use and coverage of audio-only telehealth platforms, such as the phone. HB-1196 would mandate coverage for audio-only telehealth beyond the public health emergency (the "Pandemic") as long as the service met certain requirements. The bill was passed almost unanimously by the House on February 24, 2021 and is now before the state Senate.

HB-1196 comes as many state and federal lawmakers grapple with establishing permanent rules for audio-only telehealth, which is now allowed in most states under emergency measures put in place as a result of the Pandemic. As discussed in our December 31, 2020, Blog Post, " The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?", the Centers for Medicare and Medicaid Services has put forth amendments which would expand Medicare coverage for telehealth services to include the use of audio-only services. Legislation, like HB-1196, seek to create greater accessibility to healthcare services through telemedicine.

Proponents of HB-1196 note that audio-visual telehealth isn't always available in areas where broadband access is limited or unreliable, and many people don't have the resources or access to telemedicine technology. In a press release on February 24, 2021, Riccelli noted that while the Pandemic has served as a gateway for greater access to healthcare services, the purpose of HB-1196 is to "ensure that those gains in accessibility are also equitable." Audio-only telehealth services ensures that those without a computer or broadband access to are able to gain access to a doctor and rapidly get medical advice. Opponents have criticized the bill, arguing that the phone isn't a safe or secure method for conducting healthcare.

Under the bill's definition of audio-only telehealth, email and fax communications would be excluded from reimbursement. Additionally, providers would not be allowed to bill separately for services that have always been done by phone, such as the sharing of lab results. Moreover, HB-1196 requires that providers obtain a patient's consent ahead of time, and prevents providers from charging facilities fees for appointments.

In addition, HB-1196 would allow healthcare providers to be reimbursed for audio-only telehealth services as long as they've established a valid relationship with the patient through an in-person exam within the past year. The bill would also establish payment parity for the service, though larger healthcare groups (11 or more providers) would have the leeway to negotiate reimbursement.

Washington joins a number of states seeking to make permanent changes to their telemedicine regulations. We will continue to monitor the expansion of telehealth services in the state of Texas, and other states across the nation in accordance with our "State" of Telehealth series.

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