Bill Commits Massachusetts To Telehealth

State House News Service

BOSTON - New House tele-health legislation aims to incorporate lessons from the COVID-19 pandemic into the state's health care system, according to Majority Leader Ron Mariano, who said he expects representatives to vote on the bill this week.

The bill is a Health Care Financing Committee redraft of legislation the Senate passed in late June, which sought to expand access to telehealth and protect patients from surprise costs arising from seeing out-of-network providers. Mariano said the new bill's development stemmed from conversations during an earlier meeting of the Special Committee on Commonwealth Resilience and Recovery that he leads.

"It has two basic goals: To apply the lessons we've learned from this pandemic to make longer-term changes to our health care system and also to provide the system with some flexibility during this pandemic," the Quincy Democrat said.

Mariano said that the bill makes a commitment to tele-health, beginning with primary care, behavioral health and chronic disease management. He said the bill does not try to tackle some of the issues surrounding privacy in telemedicine.

"There are some ancillary issues around privacy and data information protection that we don't solve for here, and we need to address and be aware of," Mariano said.

The bill includes language allowing insurers to include a deductible, copayment or co-insurance requirement for telehealth so long as the charges do not exceed those for in-person services. For behavioral health services, the bill says insurers are to ensure that the rate of payment for in-network providers of audio-only or video telehealth is "no less than the rate of payment for the same behavioral health service delivered via in-person methods."

A March order from Gov. Charlie Baker required insurance coverage for all medically necessary telehealth services and to reimburse providers at the same rate as in-person care during the COVID-19 emergency. Mariano said the bill would make pay parity for behavioral health services permanent, while otherwise expanding telehealth pay parity for a year.

The bill, Mariano said, looks to extend other emergency orders related to the COVID-19 pandemic, touching on topics including testing and treatment for the corona-virus, out-of-network rates and temporary licenses for certain health care workers. It also would direct "enhanced" Medicaid payments to independent community hospitals that have "operated for years on razor-thin margins," he said.

Sen. Cindy Friedman, who co-chairs the Health Care Financing Committee and was a main architect of the Senate's telehealth bill, said she was "pretty surprised" by the emergence of the House bill from committee Monday and "glad to see it."

"I'm glad that the House has decided to take up health care," she told the News Service. "I mean, we only have 11 days left of the session, so I was starting to say, 'Hmm, is this going to happen?'" Joint House-Senate rules set July 31 as the last day for formal lawmaking sessions, leaving a tight clock for the House to pass a bill and the two branches to reconcile the differences between their approaches to send a final bill to Baker.

"I'm very comfortable with the Senate's position on tele-health, scope of practice and out-of-network," said Friedman, an Arlington Democrat. "We have done an incredible amount of work and investigation, and I think our pieces are on very solid ground, so, I hope when I delve into the pieces that the House has presented that we're going to see similarities."

In 2018, legislative negotiators could not reach agreement on competing House and Senate health care bills, leaving the two branches to start their efforts over again this session.

The Senate this session approached health care legislation with a series of different bills, passing one in November that targeted drug pricing and another, in February, addressing barriers to behavioral health care.

Mental health and pharmaceutical prices are important issues, Friedman said, adding that she will be "disappointed" if those aren't addressed this session.

"We'll see, and I don't turn away from anybody or any effort to fix the health care system in any of its pieces," she said.

Mariano did not say anything about how the House might approach other health care bills passed by the Senate. He said he expected the House to take up the tele-health bill before the end of the week.