South Carolina's legislature was considering a bill this year that would have required commercial payers to reimburse for telemedicine services. A Senate health committee approved the proposal, which would have also set up a Telemedicine Advisory Council, but the bill lost support in the state House.
Using shared, secure video connections to pair patient and specialist has been seen as a pathway to help residents in rural areas gain greater access to healthcare, but reimbursement remains a big challenge, says Jee-Young Kim, a healthcare attorney in the California offices of Philadelphia–based law firm Pepper Hamilton LLP.
"One of the big challenges is how are you going to get paid for doing it," says Kim. "There seems to be a trend among states to leave a certain amount of discussion and decision-making up to the market."
Besides BlueCross BlueShield of South Carolina, UnitedHealth and Carolina Care Plan also cover some telemedicine claims in the state. And though South Carolina's telemedicine coverage law didn't make it into statute this year, Capistrant says support for telemedicine is building among states.
"There is a lot of state activity, state interest" in telemedicine, he says. "This was the biggest year for bills introduced, bills being approved. There's clearly momentum; we expect a bigger year for 2014."