Nevada already has one of the lowest doctor-to-patient ratios in the nation — 47th to be precise. Add to that the time and expense to bring the two together for in-person visits when the patient is living in a remote rural area.
This is where a bill sponsored by Assemblyman James Oscarson, R-Pahrump, comes into play. Assembly Bill 292 — co-sponsored by state Sens. Pete Goicoechea, R-Eureka, and Joe Hardy, R-Boulder City — would require private insurers and Medicaid to reimburse for medical care provided electronically, such as videoconferencing, known as telehealth.
In the past, insurance companies have been reluctant pay for anything other than in-person doctor visits.
“It’s a bill that will really open a lot of areas to be able to access health care in a health process that is sweeping the country,” Oscarson said during a recent interview. “Open up specialists so people don’t have to travel. Open up to Medicaid. Open up to all kinds of different specialty services to be available. We’ve been having meetings on telehealth for the last 18 months in the governor’s office every month and having virtually ever person engaged in those conversations from the medical boards to the nursing boards to the EMS providers to the physicians boards, everybody engaged. We’re fine-tuning it right now.”
In a recent hearing before the Assembly Committee on Commerce and Labor on the bill, Dr. Tracey Green, chief medical officer for the Nevada Department of Health and Human Services, noted that Nevada now has more than 600,000 people enrolled in Medicaid and the percentage of uninsured has dropped dramatically, but there are no more doctors to see this greater patient load.
“We are looking at a health provider shortage across our state,” she testified, especially in many rural and in many specialty practices.
Dr. Green said the state needs to look at alternative ways to efficiently use the health care providers we do have.
“Telehealth across the nation has really opened up an opportunity for individual patients to receive access to services,” she said, “but as importantly it also opens up a consulting network for our current providers.”
For example, she noted that in an area that has no psychiatrist, a primary care physician could consult with a psychiatrist in another part of the state, allowing the doctor to provide appropriate care.
The bill allows a physician to practice wherever they are rather than always having to bring the patient and physician together, often over great distances.
Also during that committee hearing, Oscarson noted, “As we all know the Affordable Care Act mandates that all persons have health insurance, but we also know the distribution of Nevada’s population poses a challenge to providing health care services to people living in our rural and frontier areas. Access to health insurance and finding a creative solution to address our shortage of health care workers is a topic of great importance to me.”
He also said, “Use of telehealth technologies is not a new concept to Nevada, in fact some providers already have well established systems, I’ve been able to view several of those systems, had demonstrations of those systems …”
Telehealth also allows the practice of preventative medicine and could reduce the need for expensive emergency room visits.
“The intent of this legislation is to fully capitalize on opportunities which existing technology provides in order to expand health care to all Nevadans,” Oscarson testified.
Some insurance company co-pays for telehealth are less expensive than for an in-person visit, Oscarson noted, adding that the market should set the price of care.
AB292 has the potential to save countless hours and considerable amounts of money, perhaps even lives. We urge the Legislature to pass this vital piece of legislation. — TM
