A fight over the use of telemedicine rages behind the scenes at the Mississippi Board of Medical Licensure. Telemedicine is used by tens of thousands of patients in Mississippi as its growth has exploded over the last few years. However, emails and other correspondence show the Board has been waging its own war on telemedicine as it seeks to control the market and limit its use. One board member even calls his employer "shameful" for offering telemedicine to its employees. The Executive Director chews out the board attorney for daring to offer an opinion whether some forms of telemedicine are legal. Other emails show the lengths the board has gone to to regulate the market while avoiding the rules it must follow in doing so. JJ obtained emails through a public records request.
|Governor Phil Bryant talks to Dr. Randy Easterling|
That was the background, now its time to look at some emails. One heated exchange took place when Merit Health decided to offer MDLive to its employees at its Vicksburg hospital. MDLive is Merit's telemedicine service. The email posted below promotes the use of MDlive to Merit Health's River Region Medical Center.
Well, Board member Dr. Randy Easterling took great offense to this email. The word "conniption" comes to mind when reading his reaction. He fired off his own email in response that was um, rather strident in nature. Keep in mind that he is chewing out the CEO of River Region.
Then there is the matter of the Board attorney. River Region asked MBML attorney Ellen O'Neal for an opinion on whether telephone-only telemedicine was legal. Ms. O'Neal is actually an Attorney General staff attorney assigned to represent the Board. She told River Region it was legal:
Remember the history of this fight as it has taken place over the last year. The Board announced it was going to amend its telemedicine regulations to ban the use of telephone-only telemedicine. There would be no hearings nor an analysis on its economic impact on patients and telemedicine providers. This action generated some heat because there is a rulebook for making rules. The rulebook contains antiquated ideas such as due process, notice, and a cost/benefit analysis. Senate Public Health Committee Chairman Dean Kirby told the Board in an April 13, 2015 email that it needed to hold a public hearing on its proposed rule changes:
The Board took the hint and held a hearing in May. More than a few interested parties showed up to comment on the proposed rule changes that were not rule changes (sarcasm). The Board withdrew the proposed amendment in June but this was only a respite from the telemedicine war as the Board sought to "clarify" the rules in October. Why change rules when a government agency can just reinterpret or reimagine them?
The telemedicine providers and others protested that the Board was again rule-making without conducting a cost/benefit analysis. An agency is supposed to determine whether a new regulation or policy will "help or hurt" before it adopts the new rule. The Board relented and hired Dr. Mimmo Parisi at Mississippi State University to conduct the analysis. Dr. Kristi Henderson recommended the use of Dr. Parisi. However, the economic impact statement is not complete.
The emails show a government board is trying to restrict the use of telemedicine and is cheered on by a few groups who have a vested interest in limiting competition. The Mississippi Medical Association immediately comes to mind. The fight has expanded to the Mississippi legislature as the Senate takes up HB #1178. Stay tuned.
* "store and forward” means the transmission of a patient’s health care information from the location of a patient to a physician or supervised provider at another location over a secure connection that complies with state and federal security and privacy laws.