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Supporting the Practice of Telemedicine in Delaware: The Role of Coverage Mandates and Licensure Regulations

Executive Summary

As of July 1, 2012, the Delaware Medical Assistance Program reimburses for telemedicine-delivered services provided to Delaware Medicaid clients in order to improve access to behavioral health services, general health care services, and medical subspecialties not widely available in the state (Delaware.gov, 2012). Now that the Division of Medicaid & Medical Assistance (DMMA) will reimburse health care providers for telemedicine services, what additional legislative steps can be taken to assure the potential telemedicine offers for increasing health care access and reducing costs are realized?

A high percentage of Delawareans live in areas designated either as health professional shortage areas or medically underserved areas and telemedicine will relieve the need for primary and specialty care. Through a literature review, the top two policy options were identified as mandating coverage by insurance carriers and revising licensure regulations where they preclude the use of telemedicine. Models from an industry association and the State of Vermont are considered, as is the continuum of state to national control of licensure.

Delaware’s General Assembly can best support the practice of telemedicine in the state by mandating that private insurance carriers cover services through teleconferencing. Licensure regulations should be based on the uniform application promoted by the Federation of State Medical Board (FSMB) in light of the three-year grant to facilitate medical licensure portability that was awarded to the organization last year by the Health Resources and Services Administration (HRSA) to “continue initiatives currently underway to streamline the state medical licensure process and reduce statutory and regulatory barriers to telemedicine” (FSMB, 2012). This move would be in keeping with Delaware’s approach as an early adopter of federally supported health information technology (HIT).

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Author: Rachel Linstead Goldsmith, MPA ‘13, University of Delaware, School of Public Policy and Administration

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