After A Year Of Doctor Visits On Video, Mixed Results For Telemedicine In Texas Legislature

Lawmakers expand telemedicine for very low income patients, but hold off on changing rules for state-regulated private plans.

By Bret JaspersJune 3, 2021 10:00 am, , , ,

From KERA:

As people physically stayed away from her office last year, Dr. Salma Saiger met with many patients through video chat.

“They would show me their pets and their grandchildren,” said Saiger, a primary care physician in Mesquite. “And it [helped] create a good, deeper relationship.”

Telemedicine opened up during the COVID-19 pandemic, both nationally and locally. The Texas insurance department temporarily required state-regulated health plans to cover virtual visits at the same rate as in-person visits, although that expired at the end of 2020.

Also during the pandemic, the state temporarily expanded telehealth services that were covered under Medicaid and CHIP. Medicaid insures very low income Texans, and CHIP covers children from low income families.

Now, those emergency rules could become permanent if Gov. Greg Abbott signs a recently-passed bill into law, as expected.

This expansion is only for Medicaid, CHIP or other state-provided coverage. That’s a setback for health care providers who were hoping telehealth visits would be reimbursed at the same rate as in-person visits under private health plans, known as “payment parity.”

At least three bills in the Texas House and one bill in the Texas Senate would have required “payment parity.” All failed.

Supporters will likely have to wait until 2023 to try again since the state Legislature meets only once every two years.

“I think telemedicine is still trying to prove itself in terms of cost efficiency or cost effectiveness,” said Tom Banning, CEO of the Texas Academy of Family Physicians. “Certainly, it has improved the accessibility of care.”

Banning said lawmakers had “legitimate” concerns that expanding access would drive up costs, and there isn’t a lot of long-term research on whether paying for telemedicine lowers the cost of care.

Even the bill that did pass, HB 4, was measured in its approach. It said the head of the Texas Health and Human Services Commission will design policies and procedures for Medicaid telehealth services in accordance with federal law.
Still, Banning called the passing of HB 4 “an important step” in physicians’ ability to use telemedicine to care for patients.

Saiger wants to continue having the option to build the intimacy with patients video visits provide.

“I hope telehealth is here to stay,” Saiger said.

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