Telehealth Coverage Continues to be Voluntary for Health Insurers.

The passage of the Telehealth bill does not actually require health plans to cover services delivered via telehealth.  With an effective date of January 1, 2020, the bill creates a new Section 627.42396, F.S., which reads, “A contract between a health insurer issuing major medical comprehensive coverage through an individual or group policy and a telehealth provider, as defined in s. 456.47, must be voluntary between the insurer and the provider and must establish mutually acceptable payment rates or payment methodologies for services provided through telehealth.” Subsection (45) also was added to Section 641.31, F.S., which mirrors this language for health maintenance organizations.

The language only clarifies that contracts signed by insurers with telehealth providers be “voluntary” with mutually acceptable rates or payment methodologies and requires the telehealth provider to initial any contract provision that would cause telehealth reimbursement to be different than reimbursement for the same services provided in person. Unfortunately health plan reimbursement continues to be a stumbling block for telehealth providers and patients as Florida remains among the minority of states without telehealth insurance coverage. What does this mean for Medicaid? We are working with the Agency to encourage that current coverage stays “as is.”