4 questions with Latoya Thomas, director of the ATA State Policy Resource Center

Telemedicine policies are rapidly changing year to year. Since 2016, seven states have improved their coverage and reimbursement of telemedicine services, while three have furthered their restrictions, according to an American Telemedicine Association report.

ATA, a Washington, D.C.-based nonprofit, educates healthcare providers and governmental bodies about remote care services, and works with Congress and lawmakers to inform legislation and eliminate barriers. The association advocates for telemedicine policies at the federal and local levels, says Latoya Thomas, director of the ATA State Policy Resource Center.

"We have to have our fingers on both the federal and state pulses, just because of the complex nature of our healthcare landscape," she explains. "We're focused on all areas."

Ms. Thomas spoke with Becker's Hospital Review about a few of the association's key programs and what legislative priorities it hopes to influence in the near future.

Editor's note: Responses have been lightly edited for length and clarity.

Question: What are your core responsibilities as director of the ATA State Policy Resource Center?

Latoya Thomas: My job is to serve as a clearinghouse of information for what's happening at the state level. There's a lot of information with regards to what a provider can and cannot do from a clinical perspective in the respective state they're licensed or certified when they use telehealth. Folks want to know whether or not they can practice across state lines or practice with other healthcare professionals. I also advise industry stakeholders, along with lawmakers who are trying to get their feet wet and learn a little more about telemedicine and how it might affect their constituents.

Q: What telemedicine policies has ATA been prioritizing this year?

LT: We believe if a state has decided it will license or certify a healthcare professional, then that healthcare professional should be able to use any tool at their disposal to practice at the top of their scope. We don't believe telehealth should be regulated any differently than in-person practice.

We are really committed to addressing artificial government barriers, like mileage or geographic requirements. Medicare currently stipulates you must be in a particular geographic location for a service to be covered when using telehealth. Or, licensing boards and state entities often make arbitrary proposals requiring a provider and patient to establish a relationship through in-person means, without medical necessity. We see those requirements as arbitrary, and we are committed to working with states and the federal government to come up with proposals to eliminate them.

We've also been encouraging states to adopt telehealth parity laws to promote a more value-based healthcare delivery model. Those laws hold payers accountable for covering and reimbursing services they've already agreed to, and making sure they don't discriminate when a beneficiary is having that service delivered by telehealth. If the payer's already agreed to cover and pay for that service under their original terms and conditions, then they should be accountable for doing so when that service is delivered remotely.

Q: One of the programs ATA hosts is the Telehealth Capitol Connection, a regular series that educates Congress, federal agencies and national organizations about different facets of telehealth. How did this program take shape?

LT: We kicked this series off last year. Congressional staffers and industry stakeholders told us they wanted more information about telehealth. There are currently a lot of questions about healthcare, where it's going, how it's going to be financed and what folks can do to alleviate costs, while still enhancing care and providing choice. Many people wanted more information about how telehealth could be integrated into those discussions, which were happening at the federal level. We've highlighted a variety of topics so far, looking at subjects like remote patient monitoring, value-based payments, broadband infrastructure and behavioral healthcare.

Q: ATA recently published new practice guidelines on telestroke care and telemental health. What's the intended impact of these guidelines?

LT: The guideline documents, which are proposed and vetted by our membership, are extremely helpful for the provider industry. Any time you see a new tool or intervention that's still evolving, you want to establish some kind of baseline understanding of what integrating this new tool into your practice means. You need to understand how to comply with state requirements, clinical practice requirements and federal requirements — if they exist.

The guidelines also serve as a good resource for specialty societies, which may not have a physician statement on telehealth or may not have developed telehealth guidelines yet. They can serve as a springboard for further discussion and future guidelines as more research comes out. The guidelines also show legislative officials and regulators that we've done our homework. We're not just introducing this concept of providing remote healthcare. We can substantiate our proposals with research documents that have been vetted.

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