On Tuesday, June 30, the Rhode Island Business Group on Health (RIBGH) requested ERIC to review and provide an analysis of the Office of the Health Insurance Commissioner’s (OHIC) Legislative Proposal Related to Telemedicine, Prior Authorization, and Referrals. The proposal may be included in Rhode Island’s budget, which is expected to pass sometime later in July. While there are good aspects to the proposal, it includes two key provisions that are in conflict with ERIC’s policy preferences: a mandate that telehealth payments be the same as in-person, and a ban on the use of medical management in regards to telehealth.
Our memo explained that telehealth reimbursement parity results in higher costs for patients, rather than allowing a competitive environment to drive cost efficiency, value, and quality. ERIC explained that it is wholly inappropriate and unprecedented for federal and state governments to mandate payment rates between two private parties, as mentioned in our telehealth model legislation.
ERIC also highlighted medical management’s beneficial use in lowering health care costs and removing waste so that patients receive high-value, low-cost care without duplication or resorting to high-cost treatments right away. ERIC believes medical management is a beneficial tool for health care plan design, which is best handled by employers.
We appreciate the Rhode Island Business Group on Health requesting our input, and hope our memo provides some insight as they move forward.
To read the memo to RIGBH, click HERE.
Article by James Gelfand, Senior Vice President of Health Policy