Firms push to revise telemedicine law

Wording affects Wal-Mart, J.B. Hunt workers; senator open to revisiting statute

A state senator said Thursday that she's open to revisiting an Arkansas telemedicine law to address concerns that it prevents Arkansans from being able to take advantage of benefits offered by employers such as Wal-Mart and J.B. Hunt.

Act 887 of 2015 defines telemedicine as treatment that occurs when a health care professional at a "distant site" uses technology to examine a patient at an "originating site," which is defined as a health care office, facility or the home of a patient with end-stage renal disease.

Because of that restriction, the 50,000 Wal-Mart employees who work in Arkansas can't use a service that would allow them consult with a doctor using a video connection on their smartphones or computers, Daniel Stein, chief medical officer for Walmart Care Clinics, said.

Likewise, J.B. Hunt employees can't use a a similar, phone-based service when they are in the state, Rick George, J.B. Hunt's senior director of human resources, said.

Sen. Cecile Bledsoe, R-Rogers, who sponsored Act 887, said the law was designed to ensure patient safety while allowing Arkansans in rural areas to have greater access to specialists.

The Arkansas Legislature likely will take up the issue again during its regular session next year, she said.

"As we move forward, we're opening it up, little by little," Bledsoe said.

Bledsoe, George and Stein spoke Thursday at a forum in Little Rock sponsored by the Bentonville-based Wal-Mart and the AARP.

"We think that technology should be used to the maximum extent possible" to allow the elderly to receive care at home, instead of in a nursing home, for as long as possible, Herb Sanderson, the AARP's Arkansas director, said.

The forum was moderated by Krista Drobac, director of the Alliance for Connected Care, a Washington, D.C., group that advocates for coverage of telemedicine by Medicare, Medicaid and private insurers.

Act 887 allows doctors to treat patients they have examined at some point in person, when they have an ongoing professional or personal relationship with the patient, when they have a referral from another doctor or when they are filling in for the patient's regular doctor.

The law also allows the Arkansas State Medical Board to specify other ways the physician-patient relationship can be established.

If approved by the Legislative Council next month, regulations passed by the medical board would allow doctors to establish such a relationship through an examination using "real time audio and visual telemedicine technology."

But David Ivers, an attorney for the Arkansas Medical Society, said Act 887 requires such an exam to take place while a patient is at an "originating site" as defined in the law.

David Wroten, the medical society's executive vice president, said after the forum that the society supports Act 887. But he said expanding the definition of an originating site is a "discussion worth having between now and 2017."

The restriction on the types of sites that can be used is based on Medicare coverage restrictions and helps ensure that patients can be adequately examined, he said.

"When the Legislature passed this law, it was very important to everybody, including legislators, that we go slowly and not just jump out there and have the wild, wild West of people practicing medicine over the telephone with patients they've never seen before," Wroten said.

Stein said Wal-Mart began offering the video-based service, provided by San Francisco-based Doctors on Demand, to the more than 1 million employees on the retailer's health plan this year. Arkansas, Louisiana and Alaska are the only states with laws or regulations preventing employees from being able to use the service, he said.

In the states were it is allowed, the service allows employees to be examined by a doctor on nights and weekends, when doctors' offices in their hometowns are closed, Stein said. The employees pay $40 per consultation and receive a record of the visit that they can give to their primary care doctor, he said.

"Telehealth is another access point," Stein said. "It's not a replacement for that usual source of care."

Metro on 06/24/2016

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