CMA urges Aetna to clarify updated telehealth policy does not apply to fully insured enrollees in CA

October 18, 2023

Aetna recently announced plans to discontinue coverage for audio-only and asynchronous telehealth services effective December 1, 2023. 

The California Medical Association (CMA) flagged for Aetna that the updated telehealth policy is inconsistent with California law, which requires plans/insurers to cover health care services appropriately delivered through telehealth on the same basis and to the same extent that the plan/insurer is responsible for coverage for the same service through in-person diagnosis, consultation or treatment. The law does not include a limitation or exception for audio only or asynchronous coverage. Plans and insurers are also required to reimburse for telehealth services at the same rate as in-person services.

While Aetna responded to CMA’s concern by adding a notation to the policy indicating that state requirements may supersede the policy, CMA believes this notation is inadequate to ensure that California patients and physicians are clear on telehealth coverage requirements and to ensure appropriate telemedicine services remain accessible to California patients.

It's important to note that California's telehealth parity law requiring coverage for audio-only and asynchronous telehealth does not apply to self-insured/ERISA plans. Therefore, self-insured/ERISA enrollees will no longer have coverage for these services effective December 1.

CMA is continuing to advocate on this issue and will publish an update when we have more information.

For more on the current state of telehealth in California, see CMA’s Telehealth Policy Update, which is available free to CMA members.

Providers with questions can contact Aetna at (888) 632-3862.


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