Telehealth measure draws debate ahead of veto decision
HONOLULU (HawaiiNewsNow) - There is growing debate over a bill that could significantly impact Hawaii’s mental health services.
It’s called House Bill 1980 and as currently written, it would cover telehealth appointments via digital platforms such as Zoom or Facetime. However, telephone-only appointments would only be covered under certain criteria.
Supporters say it helps expand healthcare access while opponents argue it creates barriers.
“The goal of this measure is for those important needed services from our local providers to be available and reimbursed to our local residents,” said state Rep. Ryan Yamane, who introduced the legislation.
Yamane also chairs the Health, Human Services, and Homelessness Committee and says the bill carries over portions of the state’s pandemic emergency orders that ensured telehealth and telephone appointments were covered by insurance providers.
“The concern was then that once we started moving out of the pandemic, we wanted to make sure that these services were able to be continued and also be billed fairly, so that was the nexus behind the development of this bill,” Yamane said.
Yet this piece of legislation says telephonic services ― meaning audio-only appointments by phone ― may only be covered under certain guidelines such as access to technology is unavailable, it’s deemed medically necessary, and the provider has had an in-person visit with the patient in the last 12 months.
“The reason why some of the healthcare providers felt that we needed some criteria was that certain services, they would prefer having an actual doctor or primary care physician or an APRN actually see the patient,” Yamane said.
“To make sure that in person the services are being done accurately and consistently.”
Becky Gardner represents the Hawaii Psychological Association, which supports the intent of the bill but questions why there are so many hurdles for telephone appointments.
“What is that about?” Gardner said. “That’s not about meeting the patients where they are. That’s not about access. That’s a barrier.”
She says this current version will have a significant impact on rural communities, the disabled, and those who aren’t proficient or have access to technology.
“They can’t maybe perhaps afford the broadband coverage, they don’t have a smartphone, maybe they don’t like using the Zoom,” Gardner said. “There’s all sorts of reasons why these marginalized groups don’t like to connect via telehealth.
“They want to use the phone.”
Gardner says many mental health service providers are expecting to run into billing challenges with insurance companies, but Yamane says the companies should be flexible.
“If you look at what we’re requiring from the insurance companies, the expectation is that they’ll reimburse and pay for it,” Yamane said. “If the insurance companies do not maintain the services, then rest assured the legislature will take this up again and make sure that this becomes a mandated service.”
Gov. David Ige has until next Monday to decide whether he’ll veto the bill.
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