The Federal Trade Commission has closed its investigation of whether the Texas Medical Board violated federal antitrust law by adopting rules restricting the practice of telemedicine in the Lone Star state.
The FTC dropped its probe after Texas recently enacted a new law that overrides the board’s restrictive telehealth regulations. Passed last month by the state legislature and signed by Governor Greg Abbott, the law eliminates the need for an in-person consultation to establish a physician-patient relationship prior to providing telemedicine services.
Specifically, the law permits doctors to establish a relationship with a new patient through a virtual visit.
In a written statement, FTC Acting Chairman Maureen Ohlhausen commended Abbott and the Texas state legislature for expanding access to healthcare services for Texans through telehealth and telemedicine, and for addressing competitive concerns raised by the Texas Medical Board’s previous rules.
“I have long advocated for the expansion of telemedicine and telehealth options that enhance competition and benefit consumers, while still protecting public health and safety,” said Ohlhausen.
Under the Texas law, a practitioner is permitted to use:
The enactment of the law ends a legal battle against the Texas Medical Board spearheaded by telehealth vendor Teladoc, which sued the board alleging—among other accusations—that its regulations violated antitrust law and suppressed provider competition by creating an unnecessary obstacle for telemedicine. The litigation was twice stayed to allow the opportunity for an out-for-court settlement to be worked out.
“Teladoc undertook the responsibility to preserve access to telemedicine in Texas more than six years ago, and we are gratified to have been the telehealth company invited to collaborate with the Texas legislature and others in the state to accomplish this laudable goal,” said Teladoc CEO Jason Gorevic. “Our commitment to the state and its citizens has never wavered, and we now look forward to reactivating our industry-leading video capabilities and ending our legal dispute in the state of Texas.”
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Teladoc has inked a contract with the Mississippi Insurance Department to provide telehealth services statewide to the 13,000 Mississippi Volunteer Firefighters and their dependents. By offering telehealth consults to its volunteer firefighters, the Mississippi Insurance Department expects the Teladoc program to be used as a recruiting incentive as demographic changes decrease the pool of available firefighters.
The program with Teladoc will also benefit the state by increasing the availability of its firefighters to respond to emergency calls because routine medical conditions can be dealt with promptly.
In 2015, the Mississippi State legislature authorized funding and directed the Mississippi Insurance Department to establish a telemedicine medical health plan for volunteer firefighters in the state. Volunteer firefighters individually have the option to enroll in the program through the county fire coordinators.
“Teladoc will be a valuable benefit to the state and our volunteer firefighters. Through Teladoc we can offer our volunteer firefighters and their families affordable, convenient access to quality health care, minimize time away due to illness as well as time spent traveling to and awaiting medical care which is not always available in rural areas,” said Mississippi Commissioner of Insurance Mike Chaney, who is also the state Fire Marshal.
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Video consultations between nursing home staffers and specialists may be one way to reduce prescriptions of antipsychotic medication for dementia patients, according to a study by researchers at Beth Israel Deaconess Medical Center and Hebrew SeniorLife.
The researchers used video conferencing at 11 Massachusetts nursing homes, offering staffers sessions with physician specialists, according to a report from the Boston Globe. In those facilities, use of antipsychotics dropped by 17 percent.
"Even very modest efforts at education and
problem-solving can go a long way to improving care for people with dementia
and reducing bad habits in the care of these patients," Jonathan Evans,
M.D., past president of the American Medical Directors Association.
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Telehealth’s value to mental health counseling scored an important victory last week when a Texas regulatory board shot down new restrictions to distance counseling.In a case closely watched in dozens of states and at the national level, the Texas State Board of Examiners of Professional Counselors denied a proposal to require an in-person relationship between a therapist and a new patient before the therapist could use telehealth.
As reported in the Austin American Statesman, the board said there was no need to prevent counselors from seeing patients via video consults or some other telehealth platform, especially when such a ban would negatively affect rural and underserved Texans.
The board’s action is the latest victory for telehealth advocates in a long-running debate, and one that won’t go away any time soon. The argument focuses on whether a clinician can effectively treat a new patient by telehealth – whether it be through video, telephone or online or text messaging – without first meeting that patient in person and establishing a physician-patient relationship.
Secretary of Agriculture Tom Vilsack and the rest of the White House Rural Council hosted the Rural Telemedicine Summit last week in Washington D.C., in an effort to improve healthcare in remote areas.
Vilsack says this Summit was the perfect opportunity to find the intersection of expanding health care and improving technology. He says widening the scope of broadband in the U.S. is crucial in improving rural health care services.
Vilsack mentioned Native American areas are particularly affected, but also Veterans returning from service. According to the White House, 40 percent of Veterans live in rural areas and seldom have easy access to care, especially mental health care. Vilsack says he and the White House want to create easier access for all Americans in remote areas.
"This administration has made an historic investment in expanding broadband, which you obviously have to have,” said Vilsack. "You have to have the equipment, (and be) providing health care facilities and mental health clinics the hardware, which we’re doing through our rural development programs.”
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Telemedicine - connecting health care providers and patients via computer or smart phone for diagnosis and treatment -- has been making it easier, and more cost-effective, to "see" the doctor. Using a camera-enabled computer or smart phone, patients with common health concerns can get some diagnoses without leaving their homes. Emergency room doctors and nurses are able to communicate with their peers in larger trauma centers via computer, as well.
Now a new University of Iowa study, published recently in the journal Pediatrics, shows that parents with children on the autism spectrum are able to have a specialist address challenging behavior in these children by interacting over the computer, too -- and at less than half of the cost of receiving similar care in person.
"A lot of kids who are on the autism spectrum have significant problems with behavior," says Scott Lindgren, PhD, professor of pediatrics in the Stead Family Department of Pediatrics at University of Iowa Carver College of Medicine, and lead author of the study. "These kids may have trouble following directions, or have problems when there are changes in their schedule or routine. They also don't always have good enough communication skills to be able to explain to someone why they're getting upset or having a meltdown."
Parents are often frustrated, Lindgren says, because they don't know how to communicate with their child to find a way to prevent or stop a meltdown. What adds to frustrations, he says, is that many Iowa families live in areas where services for children on the autism spectrum may be hard to come by.
"There are a limited number of professionals with the training and expertise needed to work with these children, which means a lot of families can't get access to the services they need," Lindgren says. "That's the situation we have in Iowa."
With the availability of telemedicine, he says, families with limited access -- particularly those in rural settings - will be able to connect with their provider without causing a big disruption to their child or their family.
Additionally, the study showed that total costs for treating a child for challenging behaviors was cut from nearly $6,000 per child to just over $2,100 through the use of telemedicine - or telehealth, as it is often called. Cost savings were seen in various areas, including travel expenses and staff hours that were saved when no travel was involved.
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