Ambitious New Bill Would Remove Most Remaining Telehealth Barriers in Arizona

I think we all know by now that the pandemic has led to a dramatic surge in the use of telehealth. In Arizona, that was partly thanks to several executive orders our governor signed in March and April of 2020 expanding telehealth coverage and flexibilities for the duration of the public health emergency. (Scroll to Executive Orders 2020-07, 2020-15, and 2020-29.)

Evidence of the efficacy of telehealth abounds, especially with such a massive increase in its use over the past year. (Just a few examples of successful telehealth uses: connecting EMS responders to emergency docs, keeping providers and patients safe during COVID, allowing rural hospitals to provide inpatient dialysis, and multiple other instances.)

In light of telehealth’s usefulness, safety, and convenience, last month the governor’s office came out in support of making Arizona’s pandemic telehealth expansions permanent. The governor’s telehealth priorities are reflected in HB 2454, “Telehealth; Health Care Providers; Requirements.” If passed, this bill could catapult Arizona back into a leadership position in terms of state telehealth regulation.

A quick recap: Arizona started out as a telehealth pioneer, with the legislature funding one of the nation’s first telepsychiatry networks, along with the Arizona Telemedicine Program, in 1996. But then we fell behind other states. It wasn’t until 2014 that Arizona law specified that the physician-patient relationship could be established via a live telehealth session. By 2015 we had a law in place requiring private payers to cover a very short list of healthcare services via telehealth, and only in rural areas. Since then, Arizona has expanded coverage to all parts of the state. And, as of January 1 of this year, after a series of laws adding a few new specialties at a time to our list of covered services (or, as I’ve heard it called, “body part by body part legislation”), our coverage finally includes any service that would be covered as an in-person service. So now we have coverage parity in place.

What would HB 2454 do to make this situation even better? Plenty! Here some of the most impactful provisions:

• It changes the word “telemedicine” in Arizona statutes to “telehealth,” a term more inclusive of non-physician providers and services.
• It requires payment parity for telehealth—payment at the same rate for the same service, regardless of whether that service is provided in person or via telehealth.
• It further expands the definition of telehealth to include audio-only telephone encounters to meet patient needs.
• It allows asynchronous telehealth (as opposed to live, two-way, interactive sessions only) as an exam modality for establishing a provider-patient relationship and prescribing or dispensing prescription drugs and devices.
• Arizona has several different definitions of telemedicine floating around in statute; this bill aligns them all.
• It adds to our current, very short, list of recognized telehealth providers so that any clinical provider would now be covered.
• It doesn’t specify telehealth technologies or uses but instead puts those judgements on the clinical providers, where they belong.
• It allows healthcare providers licensed in other states to provide telehealth services to people in Arizona.
• And it sets up an advisory committee on telehealth best practices.

For more detail, you can read the bill and track its progress, public input, and amendments here.

HB 2454 checks a lot of telehealth boxes and would keep telehealth accessible and affordable. With this bill, Arizona joins many other states that also are looking to make their pandemic telehealth flexibilities permanent.

The cross-state licensure provision, in particular, has been noted as model legislation by some national telehealth leaders, one of whom also brought up that Arizona is one of the very few states with a Universal Licensure law.

Is HB 2454 a panacea? No; there are still telehealth-related issues to be worked out. But it is a HUGE step forward for Arizona citizens and healthcare providers.

The Arizona Board of Regents voted to support HB 2454 during its January 28 meeting and U of A state relations is lobbying for the passage of the legislation.