Nathaniel Lacktman, Foley's 50-State Survey of Telehealth Insurance Laws Highlighted for Guidance on Legal Landscape
Foley & Lardner LLP partner Nathaniel Lacktman, chair of the firm’s national Telemedicine & Digital Health Industry Team and member of the American Telemedicine Association Board of Directors, discussed telehealth reimbursement parity, exclusivity contracts, and remote patient monitoring in the Managed Healthcare Executive article, “Telehealth is a Go, and States Are Having Their Say So.”
Lacktman, citing Foley’s 50-State Survey of Telehealth Insurance Laws published earlier this year, said 33 states now have payment parity laws, compared with just 16 before the pandemic. Emphasizing the importance of parity laws to incentivize providers to employ telehealth, Lacktman added that most states do not require all telehealth services to be reimbursed at the full rate for in-person visits.
He explained that as telehealth has reached an inflection point, payers and providers can now better appreciate its costs and benefits. “And once we see that happen, then there’s every reason to have appropriately adjusted reimbursement rates,” he commented. “I just don’t think we should be premature with that and disincentivize something that we have collectively said is a good thing.”
Lacktman noted that without parity regulations, reimbursement rates can be arbitrarily set. “If you were to set an arbitrary payment rate for telehealth calculated at 50% of the identical service when delivered in person, who benefits from that?” he questioned. “I would posit that it’s primarily the shareholders of health insurance companies, as opposed to the individual members who pay the premiums or their employers or the providers delivering the services.”
Lacktman also assessed exclusivity contracts between health plans and telehealth providers, noting that during the industry’s nascency, some platforms entered contracts with health plans to become their exclusive telehealth service provider. “Because that has an anticompetitive nature, it could result in higher overall rates and lower quality of service,” he said, arguing that such restrictions are harmful to patients. “And this interrupts the continuity of care for the existing relationships between the primary care provider and the patient.”
On using asynchronous technologies like remote patient monitoring in telehealth, Lacktman noted that it remains too early to know exactly what roles these newer methods will play, but added that, “If we refuse to do payment until we can say, ‘Oh, this is clearly going to be great,’ we actually won’t get enough volume to know where it’s clearly great.”
Foley’s Telemedicine and Digital Health Industry Team helps organizations and entrepreneurs embrace emerging issues in virtual care, enabling them to provide innovative care for patients in new markets around the block and around the world. Nationally recognized by Chambers USA, where clients have called Foley “the premier firm for telehealth counsel,” “a market leader in telemedicine issues,” and “the Dream Team,” Foley’s Telemedicine and Digital Health Industry Team members are frequently recognized for their unparalleled insight and knowledge of the industry.
