State Rep. Jay Barnes hopes to streamline delivery of telehealth services through MO Healthnet.
The Republican from Jefferson City presented HB 1617 to the state House's Health and Mental Health Policy Committee on Wednesday. The bill follows up on 2016 legislation - the Medicaid Modernization Act - that allows the Missouri Department of Social Services to reimburse health care providers that serve patients through telecommunications.
Over the past few years, as specialists became increasingly concentrated in urban areas, legislators sought ways to make their services more accessible to less populated areas.
Proposed Social Services rules to the use of telehealth state the only time use of the technology is appropriate is when "an in-person visit is not practical or feasible," Barnes said.
"I think that that is too narrow," he told the committee.
Committee Chairman Keith Frederick said he did not recall any intent on the committee's part to limit use of the technology to those circumstances when the first bill went through.
Another issue with the proposed rules is they would require the presence of a "tele-presenter" during a telehealth conference.
With telephone technology, that's not necessary, and it's disruptive to patients' privacy, Barnes said.
"When I go to a doctor, I want to talk to a doctor," he said. "Not a technology person."
Frederick said his recollection was the committee intended to prevent a third person from being involved in the visit between a physician and a patient. That third person's interaction may be "completely superfluous," Frederick said.
House Bill 1617 would prevent the department from restricting services provided through telehealth. It would require the Department of Social Services to reimburse providers that use telehealth to provide services to patients if providers can ensure patients get the same level of care as they would during an office visit or home visit by a health care professional.
The department would have to reimburse providers regardless of how near or far the patient is to the provider, as long as it is greater than the distance that could be walked by an average person in fewer than 20 minutes, according to the bill summary.
Another proposed rule Barnes is trying to overcome would prevent use of social media apps like Skype or FaceTime unless users show security is in place.
"Imagine if we had a rule that said a doctor cannot speak to a patient over an ordinary telephone," Barnes said, "because ordinary telephone lines can be intercepted."
Legislators want telehealth services and Medicaid to match the way services are provided in the private sector.
"It will save money," Barnes said, "and improve results."