Permit Greater Use of Telemedicine

Author: Paul J. Larkin, Senior Legal Fellow

Affordability 101 · Chapter 1: Consumer Choice

The Edwin Meese III Institute for the Rule of Law

Topline

Congress should allow greater use of telemedicine to enable patients to have access to a larger pool of available physicians.

Background

Telemedicine is the use of audio-visual technology for the real-time transmission of medical information and other communications with one or more physicians who are located remotely for the purpose of assessing or monitoring the patient’s medical condition; making or confirming a diagnosis, prognosis, or course of treatment; and, if necessary, prescribing medications.

Originally used for accident care in remote settings, telemedicine expands the availability of a physician’s expertise beyond evaluating electrocardiographic and other data to include individual patient diagnostics. Telemedicine also is a particularly valuable option in states such as Alaska, Montana, and the Dakotas where the distance between patients and physicians, and therefore the travel time between them, often vastly exceeds that in places like New York City. With the federal government’s approval, telemedicine was used extensively during the COVID-19 pandemic. Reports of increased use ranged from 100–4,300%. Given telemedicine’s proven success during the pandemic, the federal government should consider permanently authorizing Medicare and Medicaid funding for telemedicine visits and consultations.

Action Items (States and Congress)

• States should revise their medical licensing laws to authorize licensed out-of-state physicians to treat in-state patients.
• Congress should authorize greater use of telemedicine under its authority to regulate the instrumentalities of interstate commerce and communications.

Caveats: Some limitations are necessary for prescribing addictive or dangerous medications. For example, physicians should not be free to prescribe Schedule II opioids (e.g., OxyContin) over the Internet without regular (e.g., no less than monthly) face-to-face physician-patient meetings. Also, the risk of fraudulent claims for phantom Internet-based meetings justifies new recordkeeping requirements (e.g., recorded face-to-face Internet meetings) to prevent charges for phantom discussions.

How It Would Make Life More Affordable:

• Greater use of telemedicine helps expand the pool of available physicians, allows greater access to out-of-state specialty (e.g., cardiology) and subspecialty (e.g., pediatric cardiology) experts, and helps lower the cost of medical care.

Bottomline

Modern telecommunication technology makes telehealth a more viable, convenient option for many patients. Lawmakers should avoid unnecessary restrictions on this innovative, cost-saving approach to medicine.

This memo is part of Affordability 101, Advancing American Freedom’s playbook of 101 policy solutions to make life more affordable.

More Affordability 101 memos »