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California Archives - National Consortium of Telehealth Research Centers

With a Stroke of a Pen, Gov. Newsom Continues California’s Telehealth Policy Leadership Role

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

 

On October 14, 2019, California governor, Gavin Newsom, signed into law AB 744, a telehealth private payer parity bill.  Authored by Assemblymember Ceclia Aguiar-Curry(D-Winters), AB 744 was sponsored by the California Medical Association (CMA) and supported by over sixty organizations.  AB 744 was supported by the members of the California Telehealth Policy Coalition.

AB 744 will require contracts issued, amended or renewed after January 1, 2021 between a health care service plan and a health care provider to specify that the provider who delivers services appropriately through telehealth be reimbursed on the same basis and to the same extent that the plan would have had the same service been provided in-person.  The health plan cannot require the use of telehealth if the health care provider has determined that it is not appropriate nor does it limit the ability of the health plan and provider to negotiate the rate of reimbursement for a service.
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By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

In early September, Blue Shield of California Promise Health Plan and LA Care Health Plan announced a joint effort to operate 14 community resource centers in Los Angeles County, which will utilize telehealth among other tools to improve health.  LA Care and Blue Shield Promise first opened resource centers over a decade ago as a strategy to improve health and wellness in the community.  The current plan would expand these centers and add to their offerings.  The community resource centers are expected to reach 1 million people in total, offering classes in exercise, nutrition, parenting and health management.  Personalized health services offered by the centers will include health screenings, telehealth and on-site care management for health plan members.  On-site support will also be available from community social service organizations focused on addressing food, income insecurity and other needs.  The effort is aimed at addressing the social determinants of health to improve outcomes and lower costs.  The companies expect to invest $146 million in the effort over a five year period.  To learn more about the new LA Care and Blue Shield of California Promise Health Plan partnership, see their official press release.

Simultaneously, LA Care is also expanding its diabetes self-management education program to include telehealth classes through a partnership with Diabetes Care Partners (DCP).  The telehealth program teaches patients techniques to manage their diabetes and gives them guidance on applying those techniques in their daily life.  Homework given each week helps solidify the information gained in the class and leads to patient empowerment to control and self-manage their diabetes.  Diabetes self-management education has been delivered since 2015 to LA Care members using DCP services and data from 2018 shows that 70 percent of participants were able to maintain or decrease their A1c (a biometric measurement used in diabetes care) by 0.35 percent. DCP announced in mid-September that the telehealth program will include LA Care Family Resource Centers and designated clinics across Los Angeles County.

To learn more about the LA Care and Diabetes Care Partners’ self-management education telehealth program, see this article in HealthData Management.

POLICY ADVANCEMENTS FOR TELEHEALTH AT CMS AND CA MEDICAID

By | Center for Connected Health Policy

Original Source: Center for Connected Health Policy

CMS Proposes Changes to Medicaid Network Adequacy Standards

In a proposal released on Nov. 8, 2018, CMS proposed changes to regulations on network adequacy standards. The changes would allow states to elect alternative quantitative standards to measure network adequacy, including but not limited to, minimum provider-to-enrollee ratios; maximum travel time or distance to providers, maximum wait times for an appointment, and other quantitative standards. Currently, regulations require states to establish network adequacy standards by developing and enforcing time and distance requirements for specified specialty providers. States have commented that these measurements are sometimes inaccurate, especially in locations where telehealth services are heavily used, where a provider-to-enrollee ratio provides a more accurate representation of access.
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Issue in Focus: California Department Health Care Services Solicits Feedback on Major Telehealth Policy Changes

By | Center for Connected Health Policy

The California Department of Health Care Services (DHCS) released two draft proposals impacting telehealth policy in the state’s Medicaid program known as Medi-Cal.  The Department is soliciting feedback from interested stakeholders on both proposals.

California State Plan Amendment

The first proposal is a State Plan Amendment (SPA) intended for submission to the Centers for Medicare and Medicaid Services (CMS), that provides clarification as to when services provided outside of the “Four Walls” of a federally qualified health center (FQHC) or  rural health center (RHC) is eligible for the prospective payment system (PPS).  It is proposed that all such services be paid the PPS when rendered to homebound, migratory, seasonal workers and homeless patients, patients in the hospital, dental services rendered to established patients by a contracted dental provider, and telehealth services provided to its established patients when certain requirements are met.

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