Lawmakers debate whether patients receiving telehealth services should require an initial in-person visit

Alaska lawmakers debated whether health care patients should be required to have an in-person visit with a provider prior to receiving telehealth services during a meeting on Thursday.

 

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Senate Health & Social Services Committee members discussed a proposed amendment to Senate Bill 175, which would address medical assistance coverage for telehealth services, during the meeting. 

The bill does not currently require a patient to attend an in-person visit with a physician before receiving telehealth services. But Sen. Lora Reinbold (R-Eagle River) said she supported an amendment that would require an initial in-person visit–after which the patient could receive telehealth services–in order to protect Alaska physicians from being undercut by those working out of state.

“I made a promise years ago working on a telehealth bill to Alaska physicians that I would never undercut them,” Reinbold said. “This amendment keeps the promise that I made years ago. I truly believe that if we have all these doctors moving [services] up here, and they want to treat Alaskans, and we’re doing telemedicine, you miss so much. It is so important.”

Reinbold previously served as the chief operating officer at Medical Park Family Care, where she said she learned the importance of in-person health services.

“To me, that in-patient care, you learn so much more seeing that patient and talking to them, rather than the coldness of telehealth medicine,” Reinbold said. “It’s really important to protect the health care workers in the state.”

Sen. David Wilson (R-Wasilla) said the bill aims to allow Alaskans who have established out-of-state health care services to continue receiving treatment. 

 “We’re trying to allow the continuation of expanding telehealth with all Alaskans,” Wilson said.

Sara Chambers–director of the state’s Division of Corporations, Business and Professional Licensing–said the bill reinforces current practices for utilizing programs like Teladoc Health, a multinational telemedicine and virtual health care company, to continue providing services. It protects providers who are licensed in Alaska, but may not be working in the state physically, she said. Physicians must be licensed in Alaska in order to practice telehealth services there.

“Teladoc is a large health care provider utilizing Alaska-licensed physicians,” Chambers said. “The [bill’s] current language allows them to do that. Adopting [the amendment] would mean that they could no longer practice in Alaska. They would have to physically be located in Alaska in order to conduct any kind of health care relationship with an Alaska resident.”

Sen. Shelley Hughes (R-Palmer) said she was concerned about the possibility of in-state physicians charging more for services than telehealth providers, and voted against the amendment.

“I actually want to introduce competition,” Hughes said. “I don’t want to inhibit that. I love our in-state providers, but I do believe the health care cost situation has become so severe that we should not be trying to stop Alaskans from seeking more affordable care.”

The amendment failed with a 4-1 vote.