9. Health Insurance Exchange -
Network Adequacy
• Colorado to recognize telemedicine
providers for network adequacy
requirements for some specialties
(2017)
• Seems to be isolated instance thus far,
even though NAIC has built
telemedicine providers into its model
approach to assessing network
adequacy
• Urban Institute report
15. The Supremes said:
“a state board on which a controlling number of
decisionmakers are active market participants in the
occupation the board regulates” may invoke the state action
defense only when two requirements are satisfied: first, the
challenged restraint must be clearly articulated and
affirmatively expressed as state policy; and second, the
policy must be actively supervised by a state official (or state
agency) that is not a participant in the market that is being
regulated. N.C. State Bd. of Dental Exam’rs v. FTC, 135 S. Ct.
1101, 1114 (2015).
17. Texas – Board Bars Prescription
Without F2F Encounter & Teladoc Sues
• This fight has dragged on for five years already …
• Initial bar: By letter … Eventually: By regulation
• Teladoc won in US District Court, Texas Medical
Board appealed to 5th Circuit Court of Appeals
18. Bringing up the rear …
• Indiana’s F2F rule for Rx
writing has been
eliminated (except for
controlled substances)
effective July 1, 2016.
• Alaska, Arkansas & Texas
still require F2F visit to
establish physician-patient
relationship
19. Massachusetts
• Prescribing physician must have physician-
patient relationship
• Rule arose in context of online
pharmacies
• State licensure required (not part of
compact)
31. for contact info
txt dharlow to 50500
or scan the QR code
harlowgroup.net
healthblawg.com
twitter.com/healthblawg
david@harlowgroup.net
Thank You
David Harlow JD MPH
THE HARLOW GROUP LLC