Coverage for Telemedicine Expanded

On March 24, 2021, Gov. Northam signed HB 1987 into law. The new law, effective July 1, 2021, states that a healthcare provider may prescribe a Schedule II through VI controlled substance via telemedicine if the provider maintains a physical location in Virginia or is able to make referral to a licensed provider in Virginia to ensure an in-person examination if required by the standard of care.

Additionally, the healthcare provider must have an established relationship with the patient as evidenced by the following criteria:

• The patient has provided a medical history that is available for review by the prescriber.
• The prescriber obtains an updated medical history at the time of prescribing.
• The prescriber makes a diagnosis at the time of prescribing.
• The prescriber conforms to the standard of care expected of in-person care as appropriate to the patient's age and presenting condition, including when the standard of care requires the use of diagnostic testing and performance of a physical examination, which may be carried out using peripheral devices appropriate to the patient's condition.
• The prescriber is actively licensed in Virginia and authorized to prescribe.
• If the patient is a member or enrollee of a health plan or carrier, the prescriber has been credentialed by the health plan or carrier as a participating provider and the diagnosing and prescribing meets the qualifications for reimbursement by the health plan or carrier.
• Upon request, the prescriber provides patient records in a timely manner in accordance with state and federal laws and regulations.
• The establishment of a bona fide practitioner-patient relationship via telemedicine is consistent with the standard of care, and the standard of care does not require an in-person examination for the purpose of diagnosis.
• The establishment of a bona fide practitioner patient relationship via telemedicine is consistent with federal law and regulations and any waiver thereof.

Employers should be aware of these developments.

HB 1987 »