On April 19, 2021, Montana Governor, Greg Gianforte, signed House Bill 43 (“HB43” or the “Bill”) into law. The Bill, which is effective on January 1, 2022, expands access to telehealth services in Montana that was originally extended because of the public health emergency (the “Pandemic”).  HB43 continues in a long line of legislation across the country that have made permanent changes to telehealth exceptions implemented at the height of the Pandemic.
The Bill permanently lifts telehealth limitations that were paused during the Pandemic, like requiring an established patient-provider relationship in order to enable a provider to render certain  types of services via telehealth, as well as restrictions on geographic proximity and location restrictions for patients. HB43 also allows for additional types of technology to be used for telehealth services, such as audio-only calls.
In an April 19, 2021 Press Release (“Press Release”), Gov. Gianforte states that “Telehealth services are transforming how care is delivered in Montana, particularly in our frontier and rural communities”.  As discussed in our December 7, 2020 Blog Post “The Permanency for Audio-Only Telehealth Act: A Matter of Healthcare Equity?”, a number of states have adopted audio-only practices as a means of allowing residents in more rural neighborhoods without access to broadband internet to still have access to medical care.  Montana’s Bill continues the trend of “telehealth equity” by allowing audio and audio-only communication to serve as an appropriate method of receiving medical service.
Additionally, HB43 extends telehealth coverage requirements to public employee benefit plans and self-insured student health plans. According to the Bill “[t]he commissioner may establish a self-insured student health plan for enrolled students of the system and their dependents, including students of a community college district”, and shall “design group benefit plans and establish premium levels for employees.” The Bill also provides that prior established patient-health care provider relationships are not required to receive services via telehealth, allowing more residents to have access to telehealth services with less hurdles.
Critics of audio-only telehealth measures argue that the use of an audio-only communication is not a sufficient measure for establishing appropriate patient-provider relationships. By removing the requirement for previously established patient-provider relationship, HB43 only exacerbates these concerns. Others, like the Montana Commissioner of Securities and Insurance, Troy Downing, believe that the new telehealth measures would be “particularly useful to those in rural communities, our elderly, and our veterans” (See, Press Release).
We will continue to update this article, and others in our “State of Telehealth” series as additional information regarding the permanency of telehealth services becomes available.