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California Bill Would Level the Playing Field for Telehealth

The California Assembly passed a telehealth bill requiring health-care plans to equally reimburse providers for services having the same effect remotely as in person. Gov. Gavin Newsom has until Oct. 13 to make it law.

by / October 4, 2019

A bill sitting on California Gov. Gavin Newsom’s desk would expand telehealth access to all state residents by requiring health plans to reimburse providers for appointments that would have the same impact whether in person or via video conferencing, for example.

Assembly Bill 744 updates telehealth definitions and contracting law to ensure people have access to health care regardless of where they live in the state, according to the fact sheet. The bill received overwhelming support in the California Assembly, where it passed with 79 votes for and none against the legislation Sept. 13.

Assemblymember Cecilia Aguiar-Curry, D-Winters, authored the legislation as part of her continued goal to improve the availability of public services for her rural constituents.

“What [AB 744] does is it strengthens and clarifies the existing telehealth statutes,” Aguiar-Curry told Government Technology. “Now it makes it so that health plans and insurers in the state will follow the same things. The reimbursement of telehealth services is already covered under Medi-Cal, so this is basically saying, ‘Health plans, you now have to do the same thing.’”

The bill broadens existing statute for Medi-Cal, California’s Medicaid health-care program overseen by the Department of Health Care Services (DHCS), to reimburse providers for more telehealth services. DHCS spokeswoman Katharine Weir-Ebster said that if the bill is signed into law then Medi-Cal could cover all appropriate health-care services provided by store and forward, where information about a patient is gathered and then sent securely through email, messaging service, or cloud-based service to doctors for diagnoses.

“[Section 6] of AB 744 is largely consistent with DHCS’ recently updated policy on telehealth, which gives Medi-Cal providers more flexibility and discretion in determining if a Medi-Cal-covered benefit and/or service is appropriate to be rendered via a telehealth modality, including services rendered via store and forward, such as e-consults,” Weir-Ebster wrote in an email. DHCS updated its telehealth policies in August.

While the bill did not have opposition when it went to floor last month, health-care plans were concerned that the legislation would limit rate negotiations with providers, Aguiar-Curry said. She said the bill has been amended to clarify that it does not set rates unless the exact same in-person service is being conducted remotely.

Aguiar-Curry said she’s been working with her colleagues in the Assembly and Senate on unique solutions to improve broadband access, telehealth and aging in place since her election in 2016.

“The No. 1 thing I had to do is educate my urban colleagues that what works in [Los Angeles] does not necessarily work in a rural area and what you have in [Los Angeles] doesn’t mean we necessarily have it in our rural areas,” she said. "For the past three years, whether it’s health care, agriculture, energy or water, having those discussions and sharing with my colleagues that we are different, we are all in one state and we need to work together.”

She said her efforts to pass the bill were indirectly helped by the platform Newsom ran on, which included the expansion of health care access in the state. The aftermath of recent disasters, such as wildfires, brought telehealth and other public services to the forefront of the Legislature, she said.

“The thing that’s most important to me with any bill that I have in my office is that what’s the problem, how do we fix it and how is it implemented?” Aguiar-Curry said. “I go back every single year to my initial bills and I see is it being implemented, is it doing what we wanted it to do, and I will continue to do that with this telehealth bill. There could be some unintended consequences that we might have missed, but everybody agrees that this is the way to go forward.”

A spokesperson with the governor’s office said all bills are evaluated based upon their merits and a decision will be made before the Oct. 13 deadline. If signed into law, California residents would start to see its impact after Jan. 1, 2021 when health-care plans and providers issue, amend or renew contracts.

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Patrick Groves Staff Writer

Patrick Groves was a staff writer for Government Technology from 2019 to 2020.

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