New Hampshire lawmakers are debating a bill that would revise the state’s telehealth rules to eliminate payment parity and coverage for audio-only services.

HB 602, recently introduced by State Reps. Jess Edwards, Jason Osborne and John Hunt, seeks to roll back certain provisions of a telehealth bill signed into law by Governor Chris Sununu in July 2020, when the country was in the early stages of the coronavirus pandemic. New Hampshire was one of the first states to make permanent emergency measures that had been enacted months earlier to improve coverage for and access to telehealth services.

The new bill takes aim at two provisions that have been producing a lot of debate: reimbursing care providers for telehealth services at the same rate that they’re paid for in-person care, and coverage for telehealth services delivered via and audio-only phone or platform.

The bill strikes language from state law that compels private payers and Medicaid to reimburse providers “on the same basis as the insurer provides coverage and reimbursement for health care services provided in person.” It also excludes audio-only phones calls and faxes from the list of acceptable telehealth and telemedicine modalities.

Spurred by the rapid adoption and success of connected health services during the COVID-19 public health emergency, some states have moved to make payment parity permanent, in particular for mental health and substance abuse services. Many others are keeping these emergency measures in place until the PHE ends and waiting for the federal government to establish a long-term policy.

Payment parity for telehealth is a contentious issue. Those opposed to the concept feel the payer industry should be able to negotiate coverage with care providers. They also argue that telehealth services should be valued differently than in-person care.

Those in favor of parity say reimbursement should be kept on a par with in-person care – at least for the time being – to give reluctant providers a reason to try telehealth and to spur widespread adoption.

As for audio-only phone calls, telehealth advocates say they should be included in coverage because not everyone has access to reliable broadband connectivity or the resources to use or buy audio-visual telemedicine services. Opponents, meanwhile, say the phone isn’t an adequate platform to establish a doctor-patient relationship and provide proper healthcare services.

Among those opposed to HB 602 is Scot Wilson, LCMHC, a licensed clinical mental health provider at Seacoast Mental Health Center in Portsmouth with a private practice in Concord.

“If HB 602 is passed it will do nothing more than reduce the already sparse amount of services in New Hampshire,” he recently wrote in a post in Seacoast Online. “We will see an increase in wait times for hospital beds as we have more people unable to find a therapist. We will see individuals without access to the internet or the technology to allow telehealth via video to have access to necessary care. We will have more therapists decide that we cannot see people through telehealth because it is not financially viable.”