In this edition of Health Policy Breakroom, Sarah Raaii and Rachel Stauffer join Julia Grabo to explore a crucial virtual care provision from the recently enacted One Big Beautiful Bill Act, exploring its effects on patients, employers, and the broader landscape of virtual care policy.
Vermont’s governor recently signed S 30 into law. The legislation, which goes into effect on September 1, 2025, requires that health insurance plans provide coverage for healthcare and dental services delivered through telemedicine to the same extent as if the services were provided through in-person consultations. Health insurance plans must also provide the same reimbursement rate for services billed using equivalent procedure codes and modifiers, subject to the terms of the health insurance plan and provider contract, regardless of whether the service was provided in person or through telemedicine.
For more updates on state legislative and regulatory developments related to telehealth, check out the latest Trending in Telehealth published by the Health & Life Sciences Group.
In recent telehealth news, the governor of Mississippi has signed SB 2415 into law, which mandates that health insurance plans cover telemedicine services to the same extent as in-person consultations. The bill also requires that all health insurance and employee benefit plans in Mississippi reimburse out-of-network providers for telemedicine services under the same reimbursement policies applicable to other out-of-network providers.
Read more about other telemedicine-related legislative and regulatory developments in our monthly Trending in Telehealth report.
Over the past two months, the second Trump administration has shifted federal policies and priorities regarding abortion, in vitro fertilization (IVF), contraception, and other reproductive-health-related matters – and it is expected to continue to do so.
Meanwhile, new regulatory developments in this area at the state level are also ongoing. Many states now require that insurance plans provide some combination of fertility benefits, fertility preservation, and coverage for a number of IVF cycles. After July 1, 2025, all large employers in California must provide insurance coverage for fertility treatments, including coverage for unlimited embryo transfers and up to three retrievals.
Healthcare providers, payors, and other healthcare organizations should be aware of a recently announced, “first-of-its-kind” settlement between the Texas attorney general and a healthcare generative artificial intelligence (AI) company resolving allegations that the company made a series of false and misleading statements about the accuracy and safety of its AI products. The settlement highlights the potential for enforcement against companies that utilize AI in a healthcare setting under existing laws that are not specific to AI and the importance of exercising caution in developing claims about an AI product’s efficacy or performance.
In a consequential decision for Health Insurance Portability and Accountability Act (HIPAA)-regulated entities, on June 20, 2024, the US District Court for the Northern District of Texas ruled that the US Department of Health and Human Services Office for Civil Rights exceeded its authority in certain respects in sub-regulatory guidance. The guidance concerned HIPAA’s application to cookies and other online tracking technologies on HIPAA-regulated entities’ unauthenticated webpages.
In California, pending Assembly Bill 3129 could severely limit the ability of digital health companies to grow and operate in the state by prohibiting arrangements between physician, psychiatric, and dental practices and any entity that furnishes business or management services to providers that accept investments from private equity groups and hedge funds. The legislation’s current definition of private equity is arguably broad enough to capture venture capital funds, angel investors, family offices and even the innovation or investment arms of academic and nonprofit medical centers. Digital health companies based in California who provide benefits services should closely monitor the potential impact of this proposed legislation on their businesses.
In this “Trending in Telehealth” installment, Amanda Enyeart and Jay Hyun Lee of McDermott’s Healthcare Group highlight a new Pennsylvania law that requires health insurance coverage for telehealth and in-home program services for pregnant and postpartum women.
One year on from the end of the COVID-19 public health emergency, the Medicare restrictions on telehealth that Congress waived to allow for and expand the use of telehealth and other forms of virtual care are set to expire. Congress has already acted twice to extend the waivers, most recently in the Consolidated Appropriations Act, 2023, which extended them until the end of this calendar year. Thus, starting on January 1, 2025, these waivers will disappear without further Congressional action. The uncertainty about whether Congress will again extend the telehealth waivers (and for how long) will create numerous questions and cause confusion for health plans, patients and providers.
On April 26, 2024, the Federal Trade Commission (FTC) issued a final rule to amend its Health Breach Notification Rule (HBN Rule). The HBN Rule works as a compliment and counterpart to the breach notification requirements established under the Health Insurance Portability and Accountability Act (HIPAA) for HIPAA-regulated entities. Specifically, the HBN Rule requires that vendors of personal health records (PHRs) and related entities that are not covered by HIPAA notify individuals, the FTC and, in some cases, media outlets of a breach of unsecured personally identifiable health data. Stakeholders should carefully review the final rule to understand how organizations will be impacted.
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