A bipartisan group of lawmakers hopes to expand the reach of "telemedicine" in Minnesota by requiring health insurers to pay for remote consultations the same way they do for in-person visits.

Clinics and hospitals across Minnesota already use telemedicine, but some insurers don't cover it and some services — such as nurses who educate diabetics how to care for themselves — are not covered by insurance at all.

In addition, the law does not allow for reimbursement of telemedicine delivered in long-term care facilities or group homes. A Senate bill co-sponsored by Sen. Julie Rosen, R-Vernon Center, and Kent Eken, DFL-Twin Valley, would change that. It has support in the House from Rep. Tara Mack, R-Apple Valley, and Jennifer Schultz, DFL-Duluth.

If the proposal passes, Minnesota would join 22 other states and the District of Columbia in mandating coverage for medical care delivered via electronic networks.

The Minnesota Hospital Association, which supports the bill, says it would bring scarce specialists to rural locations and save money "in the long run" by helping patients get care before a health problem escalates into an emergency.

With Minnesota's population aging, and rural communities aging even faster than urban areas, it's important to get specialty care to those living in long-term care and group homes, Eken said.

The Council of Minnesota Health Plans, a trade association for large insurers such as Medica and Blue Cross, expressed guarded support.

"We share the same goals as the Minnesota Hospital Association to expand coverage, reduce costs and improve health care quality for all Minnesotans," said Kathryn Kmit, the group's director of policy and government affairs. "The telemedicine bill needs more work, and we look forward to working with the MHA …"

Maureen Ideker, a nurse from Graceville, Minn., oversees telemedicine services for Essentia Health, which has 17 hospitals and 67 clinics in mostly rural areas. She said current law, which was based on rules from the federal Medicare program, establishes eligible telemedicine sites, such as hospitals and clinics, and eligible providers, such as emergency room doctors.

Ideker said the service is not reimbursable for urban residents, it excludes services provided by audiologists, genetic counselors, pharmacists, diabetic-educator nurses and rehabilitation therapists.

Long commutes

Mack said the bill would bring immediate relief to rural Minnesotans who need to see specialists but who can't manage a lengthy commute to urban areas where they practice.

Many specialists are interested in telemedicine but have been reluctant to practice it because of uncertainty over being reimbursed, said Mandy Bell, director of eCARE Quality and Innovation for Avera Health, which operates hospitals and clinics in South Dakota, Minnesota, Iowa and Nebraska. Avera, she said, has been using telemedicine for more than 20 years.

"We know it makes a difference," Bell said. "We've even shown that it can save lives."

Dr. Jon Pryor, CEO of Hennepin County Medical Center, said uncertainties over reimbursement are what kept his organization from getting involved. But he said there's little doubt that it would save money overall by reaching people before their health problems become severe. That goes for some urban residents as well as rural residents, he said.

Rosen said legislative staff haven't yet produced an estimate for the financial effect of the legislation. She said it would affect insurers, at least in the short run, and possibly state Medical Assistance expenditures.