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California’s Telehealth Advancement Act of 2011 (AB 415) –Expanding the Potential of Connected Health

11/30/11 By David Lindeman

Telehealth, as well as the broader ecosystem of connected health, was given a significant boost by the recent passage of California legislation that reduces administrative and regulatory barriers to the use of telehealth technologies. California’s influential legislation, the Telehealth Advancement Act of 2011 (AB 415), offers an important step in promoting the role of technology in achieving the triple aims of improving access to care, improving the quality of health care, and reducing the costs of care. Sponsored by the California State Rural Health Association (CSRHA) with technical support from the Center for Connected Health Policy (CCHP), AB 415 modernizes California telehealth law by updating the legal definitions of telehealth, streamlining approval processes for telehealth services, and supporting the expansion of telehealth services throughout California.

AB 415 provides a major improvement in health care delivery by creating parity among clinical services regardless of whether they are delivered in person or via telehealth. In the national effort to reduce the costs of health care while improving access and quality of care, AB 415 offers a means of significantly improving all three areas. In a report prepared for the Center for Connected Health Policy, the potential for cost savings from AB 415 through remote patient monitoring for patients with heart failure and diabetes alone is estimated to be more than $1.3 billion a year. These savings are projected for Medi-Cal, the state’s Medicaid program, and do not include additional savings from store and forward and other telehealth technologies. Regardless of the specific cost savings, the regulatory and administrative changes introduced through AB 415 will significantly improve access to health care and the quality of life for patients by eliminating restrictions on where telehealth services can be provided.

As reported in a summary prepared by the Center for Connected Health Policy, AB 415 will specifically:

  • Replace the outdated legal terminology of “telemedicine” with “telehealth;”
  • Update the definition of telehealth to reflect the broader range of services in use today, and apply the definition to all licensed health professionals;
  • Change the need for an additional written patient consent specifically for telehealth services to a verbal consent;
  • Remove the Medi-Cal (Medicaid) rule requiring documentation of a barrier to an in-person visit before a beneficiary can receive telehealth services;
  • Remove a twice-extended sunset date in Medi-Cal on store and forward services reimbursement for teledermatology and teleophthalmology;
  • Eliminate restrictions on reimbursement of services provided via email or telephone;
  • Eliminate restrictions on the physical location, such as doctors’ offices or hospitals, where telehealth services may be provided;
  • Allow California hospitals to use new federal rules to more easily establish medical credentials of telehealth providers.

AB 415 incorporated many of the recommendations put forth in the report, “Advancing California’s Leadership in Telehealth Policy: A Telehealth Model Statute & Other Policy Recommendations,” developed by the Center for Connected Health Policy.

While limited to California, the changes introduced in AB 415 portend important changes in existing statutes that can and should occur at a national level. We look forward to the full implementation of the legislation, as well as its potential replication in other states. Attached please find links to the complete legislation as well as reports prepared by the Center for Connected Health Policy. For further information or questions on the legislation please contact the Center for Technology and Aging at info@techandaging.org.

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