OIC to begin rulemaking for audio-only telemedicine services

The Washington State Office of the Insurance Commissioner (OIC) on Wednesday released a notice of rulemaking to implement ESHB 1196, a bill passed this year requiring health plans to reimburse for audio-only telemedicine services.

Beginning January 1, 2023, the audio-only reimbursement requirement applies to patients who already have an established relationship with the provider. The bill stipulates that if a provider wishes to bill for audio-only telemedicine, they must obtain a patient’s consent prior to the service being delivered.

Gov. Jay Inslee signed the bill into law in May.


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The OIC’s notice to start rulemaking notes that the current Revised Code of Washington (RCW 48.43.735) excludes audio-only services in its definition of telemedicine. Emergency Orders adopted by the OIC during the COVID-19 pandemic required audio-only telemedicine reimbursement, but the new law puts the requirement into state statute.

Public testimony in support of the bill during committee hearings highlighted the connection between audio-only services and health equity. A staff summary of the bill states:

“Audio-only telemedicine may be the only option in some rural areas and for persons with limited access to, or proficiency with, technology.”

The OIC says the rulemaking will help ensure the law is implemented correctly.

“ESHB 1196 removes the exclusion of audio-only telemedicine from the coverage requirement, establishes several conditions for coverage of such services and amends statutory language related to telemedicine payment parity. Rules may be needed to clarify terms related to several components of the new law. Such rules will facilitate implementation of the law by ensuring that all affected entities understand their rights and obligations under the new law.

Comments on the new rules are due July 7 and the OIC will host a stakeholder meeting on July 12 at 2:00pm.