Telehealth Reform
Approximately 20% of Americans live in rural areas, but only 10% of providers practice in these regions. Through telehealth, technology can be used to better connect patients with the services and specialists they need. By modernizing Missouri’s telehealth regulations, two bills moving through the legislature seek to expand the use of telehealth and broaden patient access to care.
Senate Bill 621, sponsored by Gary Romine (R-Farmington), is on the Senate calendar for a final vote before moving to the House. HB 1923, sponsored by Rep. Jay Barnes (R-Jefferson City), was passed by the House Health and Mental Health Policy Committee, and the Select Committee on Social Services is likely to hear the bill on February 25.
Both of these bills will authorize providers to perform services via telehealth as long as the services are within their scope of practice and they can meet the same standard of care as provided face to face. SB 621 and HB 1923 also change the requirements for synchronous telehealth in the Medicaid program by adding schools, Child Advocacy Centers, and patients’ homes to the list of approved originating sites. These locations are currently not allowed under Mo HealthNet’s telehealth rules. Licensed professional counselors and providers in rural health clinics would become eligible providers for telehealth services within the Medicaid program. This will open up opportunities for rural health clinics to use other RHCs as consulting providers for telehealth services.
Fiscal Year 2017 Budget
The fiscal year 2017 budget bills have been amended by the Appropriations Committees and sent to the full House Budget Committee for further review. Substitute bills with the Budget Chair’s modifications will be released soon, and the Budget Committee will vote on the bills as early as next week.
This year’s budget is likely to include a small rate increase for Medicaid providers, which was funded in the FY 2016 budget with tax amnesty funds. There will be very little money available, however, for new or expanded programs. About $50 million of the state’s general revenue is likely to be set aside by the House to be used to match local funding for transportation projects.
Last year, Missouri lost $50 million of tobacco settlement funding because a court found that the state had not adequately enforced the Master Settlement Agreement. This resulted in the Governor withholding $50 million from the budget, mostly from health and social services programs.
Attorney General Chris Koster recently announced that he reached a deal in which Missouri would receive the $50 million, as well as future tobacco settlement funds, in exchange for the state passing allocable share. Allocable share is designed to even the playing field between small and large tobacco companies. It is unclear whether or not this issue will gain traction in the legislature. Bringing these funds back into the state budget, however, could increase opportunities to expand healthcare initiatives.
