Legislative Testimony for LB400: Change requirements related to coverage of telehealth by insurers and medicaid

Good afternoon, members of the HHS Committee. My name is Nicole Fox, and I am the Director of Government Relations for the Platte Institute. The Platte Institute supports LB400.

Telehealth played an instrumental role in the provision of a variety of health care related services during the COVID-19 pandemic. It allowed patients to gain and maintain access to care in a safe, convenient environment.

During the pandemic, all 50 states temporarily expanded access to telehealth services by a variety of approaches.[i]

They made it easier to use telehealth to treat people either confined in their homes or with no alternative but to travel long distances to the nearest provider.

Permanent reforms to telehealth could help and encourage patients—particularly vulnerable patients or those in rural areas—to seek care in a timelier manner and comply with follow-up medical needs. Reform broadens the availability of health care providers, not only in terms of numbers of providers, but also in terms of the variety of health care disciplines that can be accessed.

Nebraska is one of several states looking to take permanent action, and we applaud this, as Nebraska’s temporary measures are set to expire 30 days after the COVID-19 state of emergency is lifted.

LB400 is the result of a 2020 interim study which examined the role of telehealth services during the COVID-19 pandemic. While many of the identified regulatory barriers to accessing telehealth in Nebraska were federal in nature, there were a few state-level regulatory barriers that stood out.

Patients should be able to receive medical services from the location of their choosing if the services provided are able to meet the standard of care. Patients should not be restricted to accessing care in only medical facilities such as a hospital, urgent care center, or physician’s office. Instead, patients should be able to use telehealth services from their home or place of work if they chose to do so.

In fact, many of the telehealth proponents who testified at the interim hearing noted that eliminating geographic restrictions was a top component of improving access.[ii] Travel times were significantly reduced for those in rural areas. Workers did not have to take significant blocks of time off work. Children benefitted from being in their home environment. LB400 prohibits the exclusion of telehealth services based on originating location.

Telehealth can be delivered in many ways. Delivery options should be up to the doctor and patient. Limiting delivery to only certain technologies can make telehealth unusable for some patients which ultimately restricts access. LB400 amends the definition of telehealth to include audio-only services for the delivery of behavioral health services.

A regulatory barrier that can block the utilization of telehealth is one that can make it hard to either start or maintain a patient-provider relationship. When medical needs are urgent, or significant travel is needed, the requirement for written consent to be obtained before a telehealth visit can occur can lead to delays in initial evaluation and treatment, and even follow-up care. LB400 allows verbal consent in lieu of written consent for an initial visit, provided that a signature for consent to treat is obtained within ten days of the initial telehealth consultation. This signature may be obtained electronically.

All the proposed reforms in LB400 not only reduce barriers to telehealth access, but they also increase choices available to patients. If Nebraska makes the temporary reforms prompted by the pandemic permanent, it could help telehealth—a tool long-promised to expand access and lower costs—finally reach its full potential.

The Platte Institute thanks Sen. Arch for his efforts to reduce barriers to telehealth access for Nebraskans. We ask the committee to advance LB400 to General File.

[i] https://www.himss.org/news/telehealth-transformation-how-us-states-are-leveraging-virtual-care-response-covid-19

[ii] http://news.legislature.ne.gov/hea/2020/12/07/lr-350-interim-study-hearing-december-8-130-p-m/