Q&A: Frank Pignanelli discusses telehealth policies and future sessions

Frank Pignanelli is a partner at Foxley & Pignanelli, a bipartisan government relations firm in Utah. Formerly he served in the Utah House of Representatives for 10 years, where he was one of the youngest Utahns to be elected to state office.

In this Q&A, Pignanelli talks about key takeaways from the latest legislative session, especially about telehealth legislation and upcoming health policy developments. 


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Patrick Jones: What are some brief yet important takeaways in health policy from this last session in the Utah State Legislature?

Frank Pignanelli: “The pandemic really supercharged the use of technology and assessment of health care. Telehealth was promoted by insurance companies as a very cost effective way of getting people information from providers, physicians and others. When the pandemic came, we all needed to get that information. So, its [telehealth’s] use was greatly enhanced. The providers also want to be compensated to the same level as they have been for regular visits. This forced the legislature to deal with the issues that came down from that. The pandemic changed the use of health care and that is reflected in the legislature, who dealt with these issues.”

PJ: How do you expect payment equity for telehealth visits to impact the future of Utah providers, payers and patient relations? Are there any moves in the interim that might be happening on these issues?

FP: “The problem with new full parity on telehealth is that you don’t want a mandate. You don’t want there to be push towards telehealth against in person visits. But, you don’t want a mandate against telehealth either. Second thing is you want to allow the telehealth providers to negotiate what technology they’re going to use. You don’t want to mandate on that either. Let’s just do the best to be sensitive because this is a new frontier in health care.“

PJ: how does patient privacy with telemedicine intersect with the future of health care?

FP: “The legislation that came about by BlueCross BlueSheild said that any technology that a telehealth provider is using has to comply with HIPAA [Health Insurance Portability and Accountability Act], which is the federal privacy law. What you don’t want is some inferior product, though it may be cheaper, that is not secure. Insurance companies are not going to trust it. But that issue is becoming greater because you’re gonna get more opportunities for people to interact with the providers. There has to be greater attention placed onto those HIPAA privacy concerns, because we don’t want to have third parties access these telehealth platforms to sell customer information or steal identities.” 

PJ: What strides did legislators take on behavioral health policy in this last session? And how is that going to affect Utahns positively? How did Senate Bill 155, on 988 mental health crisis assistance affect the legislature?

FP: “We did participate in that bill. A lot of technology companies and communications companies were concerned about the cost on that bill since it had a considerable cost, originally. You had some senators who did not want to spend all that money, and it was therefore reduced. There will be revenues of about $14 million dollars for that, then they’ll be using some federal funds to get this thing started. They have well intentioned efforts, but as a state, we wanted to be cutting taxes, not raising taxes. This originally would have implemented a tax on every cell phone user. They got it and it was for a good cause, but the politics made it unlikely to the rate they were asking for. There were a lot of iterations and emotional turmoil. It did pass, but with a program established.”

PJ: What do you look forward to in the interim, and in the next session, in terms of health policy?

FP: “I think the bill that passed on telehealth. You can do mental health therapy and assistance through telehealth, and obviously can’t fix broken bones in terms of medical assistance, but telehealth can do well with mental health. We’re going to start seeing mental health providers who want to expand the scope of services through telehealth. With that, there will be push back on whether that is possible under this telehealth scheme. We’re going to have real in depth conversations as to what works or doesn’t work. Legislation on pharmaceuticals and drug prices and pharmacy benefit managers, especially during this pandemic, will be happening. We’re going to see a lot of discussions about drug pricing, drug distributions and pharmacies.” 

PJ: Any last thoughts?

FP: “It’s important for policymakers and regulators to hear from providers, payers, consumers and family members about all these issues. The legislature provides a lot of accessibility for this. At the end of the day, you want to make sure that the legislature is enhancing the opportunities for consumers.”

This interview was edited for clarity and length