After roughly a decade of sometimes political wrangling, a new law mandates that payers reimburse providers for covered services offered via telehealth.
Long-standing barriers to telehealth adoption in Pennsylvania are coming to an end with the passage of a new law that includes coverage parity.
Governor Josh Shapiro last week signed into law SB 739, ending a decade-old battle to ease barriers that have kept hospitals and health systems in the Keystone State from embracing virtual care. The new law requires health insurers and managed care plans to reimburse providers for any covered services that are offered through telehealth, as well as setting accessibility standards for state Medicaid and Children’s Health Insurance Program (CHIP) coverage.
“Every Pennsylvanian deserves to have access to quality, affordable healthcare when and where they need it – and it shouldn’t be up to an insurance company to pick and choose what they cover,” Shapiro said in a press release. “More and more Pennsylvanians are relying on telemedicine to see their doctors, and this bill requires insurers to cover services delivered via telemedicine the same way they cover traditional in-person services. My administration will continue to work across party lines to expand access to healthcare for all Pennsylvanians, including those in our rural communities.”
The signing ends more than 10 years of efforts by telehealth advocates to get a parity law on the books. More than 40 states now mandate coverage parity, which requires payers to reimburse providers for telehealth services if they offer those same services in person. Some also require payers to reimburse at the same rate as in-person care, which is called payment parity.
The bill was sponsored by State Senator Elder Vogel, Jr., a Republican from rural Rochester who has long argued that the state needs to reduce telehealth barriers to improve access to care in rural and remote regions where brick-and-mortar providers are scarce and in-person visits are challenging. Some 33 Pennsylvania hospitals have shut down in the past 20 years, with 15 occurring in just the last five years, according to the state.
Vogel first sponsored the bill in 2016, but it never got out of committee. At least two versions introduced since then were shot down by Democratic lawmakers after Republican lawmakers added amendments to ban the use of telemedicine in abortion care. In 2020, then-Governor Tom Wolf, a Democrat, vetoed the bill after it was passed along party lines.
Among those supporting the new law is the Hospital and Healthsystem Association of Pennsylvania (HAP), a membership organization comprising more than 230 hospitals and health systems in the state.
“Today’s passage of Senate Bill 739 is a long-sought win for Pennsylvania patients and health care providers,” HAP president and CEO Nicole Stallings said in a press release. “Telehealth helps meet patients where they are, increasing access to routine and preventative care to improve health outcomes. It also extends the reach of providers at a time when the commonwealth’s growing need for care is outpacing the professionals available to deliver it.”
Eric Wicklund is the associate content manager and senior editor for Innovation at HealthLeaders.
KEY TAKEAWAYS
More than 40 states now support telehealth parity, which requires payers to reimburse providers for telehealth services if those services are offered in person.
Pennsylvania now has a law on the books mandating coverage parity and setting standards for Medicaid and CHIP coverage.
Advocates say the new law will encourage providers in the state to use telehealth, thereby reducing barriers to access that particularly plague rural regions.