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Will The Florida Legislature Regulate Telehealth?

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Dr. Shayan Vyas at Nemours Children's Hospital in Orlando meets with Alyssa Grimes and 5-year-old Zach via a Skype-like application. Photo: Nemours Childrens Hospital

Florida doctors are already practicing telehealth without a regulatory system in place, but most insurance companies don’t cover the visits. Some telehealth supporters are drafting proposals that state lawmakers could consider during regular session in January, but so far, none have passed muster.

With just a few clicks of the mouse, Orlando mom Alyssa Grimes visits with a pediatrician from the comfort of her living room. She logs into a Skype-like application on her laptop, where she virtually meets her child’s doctor based across town at Nemours Children’s Hospital.
After the virtual visit, Grimes says five-year-old Zach was unfazed by the technology. He’s grown up with it. “Nowadays, that’s how a lot of children connect with friends and family, through like a FaceTime,” she said. “It was pretty similar to speaking to his grandma or grandma over FaceTime or Skype.”

This “telehealth” service isn’t covered by insurance. Patients must pay $49 per visit. And that’s where telehealth gets tricky. There’s no state law forbidding, restricting or regulating telehealth, so the biggest obstacle for patients and doctors is: who pays?
Nancy Wright is a pediatric endocrinologist in Tallahassee. Thirty-five percent of her patients are in Georgia, where she’s also licensed. “Right now,

I’m doing telemedicine out of my office in tall into Valdosta, a clinic there, a Children’s Medical Services clinic,” said Wright.
Wright said her field is so specialized that many patients drive up to a hundred miles to see her in person. The virtual space is a good option, but she says she needs to get paid like she does in Georgia.

“It is financially sound for the office to do this. We are paid for these visits by the children’s insurance companies,” Wright said. “In Georgia, there are only one or two insurance companies that refuse telemedicine. Everyone else is welcoming about this.”

The Telehealth Association of Florida has proposed several ideas requiring insurance to cover a visit via telehealth, said group president Christian Caballero. Its first proposal was turned down. It required insurance companies to cover a visit via telehealth if it was covered face-to-face. “Apparently, the insurance companies objected to it vehemently,” he said. “They didn’t want to be forced to provide this coverage.”

A second proposal offering insurance companies corporate tax credits al.so failed to get support. “That also has received some opposition from the insurance companies so they don’t want to go with that either,” said Caballero.

Cary Pigman is an emergency physician in Highlands and Hardee counties and a representative in the Florida House. He said he won’t accept a plan that regulates telehealth in any way. “You want to be careful when you get into proposing a bill to regulate something,” he said. “Very often you then stifle any further development.”

It may be better for the state to do nothing, he said. “If we do nothing, I think the business will continue to proliferate and unique products will be available.”

Alyssa Grimes, the mother in Orlando, says while she doesn’t mind paying cash virtual visits, it’d be nice if there were more telehealth options covered by insurance. But Pigman says he’s doubtful lawmakers will have much to offer in terms of answers this coming session.

WUSF is a partner with Health News Florida, a statewide collaborative reporting on health care.

Health reporting on WMFE is supported in part by AdventHealth.

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About Catherine Welch

Catherine Welch