Proposed New Legislation Would Limit Arkansas Patients' Access To Telehealth Services

Proposed new Arkansas legislation includes language that limits patients' access to telehealth. Due to the law's strict interpretation of a certain telemedicine governing definition, executives from Walmart, one of the world’s largest retailers, and J.B. Hunt, one of the nation’s largest transportation companies, are concerned over how this will affect their employees' access to convenient healthcare services.

The Arkansas Legislative Council is expected to approve this ruling by next month, and executives of the nation's largest employers say the new law prevents employees from using their mobile devices to engage in video doctor visits.

The issue is the language of the new legislation that defines both: an “originating or spoke site” and a “distant or hub site.” Telemedicine is defined in Act 887 of 2015 as occurring when a healthcare provider, based at a distant site, engages with a patient at an originating site. The new rule states that such an originating site must be in a healthcare setting, such as a hospital, doctor’s office, clinic or the home of a patient with end-stage renal disease.

Wal-Mart and the AARP recently held a public meeting in Little Rock, in which the chief medical officer of Walmart, Daniel Stein, said the new law would effectively block 50,000 of the Bentonville-based company’s in-state employees’, denying them from the online platform access provided by Doctor On Demand. J.B. Hunt’s senior director of human services, Rick George, based in Lowell, Arkansas, added this would also block his employees from using a similar service while they’re in Arkansas.

Fuss over the definition of an originating site has been ongoing.

The Centers for Medicare & Medicaid Services have been under scrutiny for their strict interpretation of a “rural” location for originating sites, because of how it affects a telehealth program's ability to qualify for reimbursement. Groups including the American Hospital Association, American College of Physicians and National Coalition on Health Care, lobbied the Senate Finance Committee to relax its restrictions to expand telehealth to more populations earlier this year.

“Comprehensive changes to the telehealth statute – such as eliminating the geographic location and practice setting ‘originating site’ requirements and removing restrictions on covered services and technologies (including store-and-forward technology and remote patient monitoring) – are needed to realize fully the promise of telehealth for Medicare beneficiaries,” The AHA wrote in its letter to the Senate Finance Committee and its Chronic Care Working Group (CCWG).

State Senator Cecile Bledsoe, R-Rogers, Act 887 sponsor, said the new legislation was “a good compromise,” and expects that legislators will revisit this issue again during next year’s session, in efforts of enabling Arkansans’ access to telehealth services, while enhancing patient safety through a valid doctor-patient relationship.

"When the Legislature passed (the original) 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," Bledsoe added.