Time for a Telehealth Update

New data indicate that telemedicine has the potential to be a “great equalizer” for maternal health. As we have written previously, the 2024 Telehealth and Telemedicine Modernization Act made strides in making telemedicine accessible to more South Carolinians. But while this legislation made progress, it did not go far enough to decrease the barriers we have in place for both providers and patients. New legislation (2025-26) provides the opportunity to improve outcomes for new mothers and other South Carolinians alike seeking care.

Recent research from the University of South Carolina indicates the importance of telehealth for increasing access to post-partum healthcare. New mothers have the potential to face a myriad of health challenges. Difficulty accessing transportation and childcare can serve as obstacles for attending in-person medical appointments, especially in rural and under-resourced communities. Many common concerns, especially mental health, can be screened for virtually. The researchers found that women using telehealth initiated their post-partum check-ups sooner. Among in-person participants, there were significant disparities between rural and urban mothers accessing care. These differences were lessened when they were given the option to see their doctor online. This is one of many examples of how accessing telemedicine can improve health outcomes for South Carolinians.

Recently, our friends at the Cicero Institute released their annual report on Telehealth Innovation. Our review of the most recent publication reveals a troubling but undeniable fact. Even after the South Carolina Telehealth and Telemedicine Modernization Act attempted to widely expand telehealth access, it appears the Palmetto State has made little progress in the last year in moving a stronger telemedicine ball forward.

Cicero listed South Carolina as “needing improvement” for

• Modality Neutrality: Add definitions for remote patient monitoring and Store-and-Forward in the provider code. (According to the definition in federal regulations, Store and Forward is the transmission of a patient’s medical information from an originating site to the physician or practitioner at the distant site.) 
• Allow Telehealth to Begin Using Any Mode: Make it clear that a patient-provider relationship can start over any mode (smartphone, tablet, computer, email, text, phone call, etc.).

Additionally, South Carolina is categorized as  having “Barriers to Innovation in Place”

• No Barriers to Across-State-Line Telehealth: Pass an easy registration or reciprocity law for all providers. Don’t require providers living out of the state to obtain a full South Carolina medical license.
• Independent Practice: Remove the written protocol requirement with physicians to allow Nurse Practitioners and PAs to practice with more independence. This is a complicated issue that Palmetto Promise addressed in a 2025 report.

These metrics have not changed since the release of Cicero’s last report (2025) and South Carolina has addressed none of them. Without decisive action, we risk remaining stagnant while our peer states make telemedicine progress.

As demonstrated by their analysis and our previous reports, the South Carolina Telehealth and Telemedicine Modernization Act simply did not go far enough. The main pitfall of the Modernization Act? It only made three changes. 

• The Act defined Telehealth as, “the use of electronic communications, information technology, or other means to deliver clinical health care, patient and professional health-related education, public health, or health administration between a licensee in one location and a patient in another location with or without an intervening licensee.” This didn’t eliminate any existing restrictions on telehealth.
• The Act amended the Nurse Practice Act to allow Nurse Practitioners to perform medical acts as well as prescribe medications via telehealth, but did not change their practice arrangement mandate.
• The Act changed the previous requirement of an in-person evaluation to prescribe non-narcotics as well as narcotics. Instead, the Act added exceptions to the previous requirement for patients in palliative care or hospice, when buprenorphine is being prescribed as a medication for opioid use disorder, or when telehealth is being practiced while the patient is physically located in a hospital and being treated.

A new bill (2025-26) provides lawmakers with an opportunity to finish what they started with the Telehealth Modernization Act. The introduction of S.377 represents the next phase of modernization, an opportunity to align South Carolina with national best practices and the needs of our citizens. Unfortunately, that bill, “Expanding Access to Telehealth Services,” has seen little movement since its introduction in early 2025. 

H.3223 expanded telehealth in the Veterinary context and has been signed into law (2026), while S.453 (Teledentistry), passed the Senate in 2026. The Teledentistry bill provides specific definitions for virtual dental appointments, aligns Teledentistry care with other Telehealth, and determines best practices for providers. 

The latter bills are encouraging, but real, meaningful progress will only come when lawmakers take the next step and fully commit to comprehensive telehealth reform legislation that meets the needs of patients, providers, and communities across our state.