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Pennsylvania may reconsider telehealth insurance coverage

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(The Center Square) — Though it didn’t gain traction last session, one legislator is again pushing for mandating that health insurance covers telehealth-related costs in Pennsylvania.

Introduced by Rep. Christina Sappey, D-Kennett Square, House Bill 1512 would require insurers to cover health care services that aren’t provided in-person, aligning with insurance requirements in most other states.

Costs deemed appropriate and medically necessary could not be denied for reimbursement due to remote delivery — and telehealth services would need to meet the same standard of care as in-person services.

“Telemedicine is vital for improving population health and patient outcomes,” Sappey wrote in a legislative memo. “Telemedicine is now a lifeline for providing health care to patients — especially in rural parts of our state — while promoting public health practices that mitigate the spread of infectious diseases.”

She argued that without insurance coverage for telehealth, Pennsylvanians would be “exposed to the possibility that they may not be able to access timely and quality health care when they are sick, or that their care will cost too much.”

Though dozens of states embraced telehealth and insurance rules due to the pandemic, the details differ. Since 2021, 25 states have changed their laws to accommodate remote medicine. The majority, 41 states and the District of Columbia, have laws requiring coverage parity that means private insurers must cover telehealth similarly to in-person care.

Much of the regulatory flexibility that happened during the pandemic, though, was temporary. Pennsylvania received high marks for its embrace of telehealth in one study, but restricted patient access to out-of-state doctors.

With expansion of access, rural communities may have the most to gain because they have fewer providers. Telehealth has also helped with the opioid crisis, some health care workers argued, because it gives them flexibility to connect with patients across multiple sites and ensure compliance.

The House Insurance Committee gave HB1512 its first consideration on March 25 and awaits further action in the House.