Commission and the Maryland Institute for Emergency Medical Services) was established to further pursue these issues.
Telemedicine Task Force
Three advisory groups were established to develop recommendations: the Finance and Business Model Advisory Group, the Technology Solutions and Standards Advisory Group, and the Clinical Advisory Group. The Finance and Business Model Advisory Group recommended that state-regulated payers should be required to reimburse for telemedicine services to the same extent as face-to-face health care services. The Technology Solutions and Standards Advisory Group wanted a network built on existing standards and integrated into the statewide health information exchange. All 46 Maryland hospitals are reporting regularly into the health information exchange (e.g., discharge data, lab data, radiology data), and so the group wanted telehealth integrated into this network. Additionally, the group recommended certain minimum requirements related to connectivity. The Clinical Advisory Group focused on changes in licensure, credentialing, and privileging of providers to facilitate the adoption of telehealth.
As a result of the recommendations of the Finance and Business Model Advisory Group, legislation was introduced in 2012 in both the Maryland House and Senate. The bill required state-regulated private payers and Medicaid to cover services delivered through telehealth as they would if delivered in person. Furthermore, private payers would not be permitted to require preauthorization for telehealth services, nor could they limit these services to just rural areas. The Maryland Department of Health and Mental Hygiene (DHMH) supported the bill with amendments. One amendment allowed Medicaid to conduct a review. Unlike other states, the Maryland Medicaid program sits within the DHMH, as opposed to the Department of Social Services. So while the DHMH supported the bill, they wanted to fully understand the implications to the entire system. DHMH stated that if services were deemed to be cost neutral, it would cover services in FY2013, but if they were not neutral, they would seek coverage in FY2014 through budget initiatives in the 2013 legislative session. Another amendment allowed private payers to require preauthorization for telehealth services. The bill was passed and signed into law with both of these amendments.