Virginia Lawmakers Pass Bill Requiring Insurance Coverage for Remote Patient Monitoring

Virginia lawmakers have taken new steps to expand the use of remote patient monitoring among the State’s residents, with both the House and Senate unanimously passing bipartisan legislation ensuring that commercial health plans and the Virginia Medicaid program will cover remote patient monitoring services. The bill now heads to the office of Governor Ralph Northam for signature.

The legislation (HB 1970 and SB 1221) amends Virginia’s current telehealth commercial insurance coverage law (Va. Code § 38.2-3418.16) to expressly add remote patient monitoring as a covered service.  It defines remote patient monitoring as follows:

“ ‘Remote patient monitoring services’ means the delivery of home health services using telecommunications technology to enhance the delivery of home health care, including monitoring of clinical patient data such as weight, blood pressure, pulse, pulse oximetry, blood glucose, and other condition-specific data; medication adherence monitoring; and interactive video conferencing with or without digital image upload.”

The bill also adds remote patient monitoring coverage to the State Medicaid program, administered by the Virginia Department of Medical Assistance Services. Prior to this bill, Virginia had sought to advance telemedicine and digital health in the State, including promulgating forward-looking telemedicine guidelines.

Remote patient monitoring is positioned to become the next big thing in patient-centered digital health care. User-friendly software and equipment already exist; there simply has been little third party reimbursement historically to drive adoption. This is quickly changing however, led by CMS’ addition of three new remote patient monitoring codes for 2019. In addition to the three new codes, Medicare also covers a fourth remote patient monitoring code.

Ensuring that payers and health insurance plans pay for remote patient monitoring as a covered member benefit will incentivize providers to invest in these technologies. This will equip them to better monitor and manage patient care needs, allowing patients to avoid unnecessary hospitalizations, and more proactively manage chronic conditions.

Entrepreneurs and companies offering remote patient monitoring technologies and services should take steps now to understand these new billing opportunities under Medicare and state laws. With the new CPT codes live, remote patient monitoring will become an area of significant upside potential over the coming years. Hospitals and providers using remote patient monitoring and other non-face-to-face technologies to develop patient population health and care coordination services should take a serious look at these new codes, and keep abreast of developments that can drive recurring revenue and improve the patient care experience.

Want to learn more?

Join us for a deeper discussion of remote patient monitoring and digital health at the American Telemedicine Association’s 2019 Annual Conference and Expo in New Orleans on April 14-16, 2019. Read the current program agenda and register here.

For more information on telemedicine, telehealth, virtual care, remote patient monitoring, digital health, and other health innovations, including the team, publications, and representative experience, visit Foley’s Telemedicine & Digital Health Industry Team.