Monthly Archives

January 2019

California DHCS Releases Comment Responses to Proposed Telehealth Policy

By | National Telehealth Policy Resource Center Blog

In late 2018, the California Department of Health Care Services (DHCS), which administers California’s Medicaid program (Medi-Cal), released proposed updates to their telehealth policy manuals, including those for fee-for-service, managed care, Indian Health Services, Family Plan, Access, Care and Treatment (Family PACT), dentistry and federally qualified health centers/rural health clinics (FQHC/RHCs).  Proposed policy changes included allowing the distant site/treating provider to decide when it is appropriate for telehealth to be used and whether it should be via live video or store-and-forward.  E-consult (provider to provider consultation), falling under the auspice of store-and-forward, would also be reimbursed under the new policy.  As part of their drafting process, DHCS solicited feedback from telehealth stakeholders on their proposed policy.
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CCHP Publishes Analysis of Occupational and Physical Therapy Policy

By | National Telehealth Policy Resource Center Blog

Last year, CCHP conducted a 50-state scan of occupational therapy and physical therapy policies that was published in the fall 2018 edition of the International Journal of Telerehabilitation. The survey results show the current level of adoption of both laws and regulations that allow physical and occupational therapists to use telehealth to engage in patient care services as of August 2018. CCHP found that twenty-seven states had enacted at least one policy that allows patient-to-provider or provider-to-provider services in occupational therapy, while twenty-eight states had done the same for physical therapy. The specific requirements laid out through these policies varied by state, but none appeared to add additional burdens to providers.

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2019 KICKS OFF WITH EXPANDED REIMBURSEMENT ANTICIPATED IN MEDICARE ACOs & CA MEDICAID (Medi-Cal)

By | National Telehealth Policy Resource Center Blog
ACO Telehealth Expansion in Medicare Shared Savings Program

As required by the Bipartisan Budget Act, CMS has finalized their rule to broaden telehealth reimbursement for Medicare Accountable Care Organizations (ACOs) in the Shared Savings Program under the BASIC track (under a two sided model) and ENHANCED track when the ACO elects prospective assignment.  The finalized regulation allows eligible physicians and practitioners in the applicable ACOs to be reimbursed regardless of the geographic location of the patient and allows the home to be the originating site.  If the home was the originating site, there would be no facility fee allowed.  Other locations, besides the patient’s place of residence, would not qualify for reimbursement under the new rule, such as a school.  Other Medicare telehealth requirements would still apply, such as provider type and service code limitations.  Additionally, CMS also clarifies in the rule that in the case where the beneficiary’s home is the originating site, Medicare will not pay for telehealth services that are inappropriate to be furnished in the home even if the services are on the approved list of telehealth services, such as inpatient hospital visits.  The change would not be applicable until plan year 2020.

To learn more, read the full text of the rule.

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Looking Forward to 2019: Insights from CCHP’s Executive Director

By | National Telehealth Policy Resource Center Blog

For telehealth policy development, 2018 has been a major year.  Activity on both the state and federal level have pushed for greater utilization and integration in using telehealth to provide health care services.  For the first time since 2008, there were changes to federal law to expand the location of where telehealth could take place for Medicare enrollees.  The Bipartisan Budget Act of 2018 expanded to include the home as an eligible originating site for end stage renal disease services and allowed acute stroke services to be provided in both rural and urban locations.  The SUPPORT for Patient and Communities Act had similar changes.  The SUPPORT Act removed the originating site geographic requirements and allowed the home to be an eligible originating site but only for individuals being treated for substance use disorders or a co-occurring mental health disorder.  These were narrow exceptions and have been specifically tailored to address certain conditions, but are the first major federal statutory changes to the limited telehealth policy that has been seen in a decade.
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