Original Source: Center for Connected Health Policy
An updated Fall 2018 edition of CCHP’s “State Telehealth Laws and Reimbursement Policies” Report is available today! The Fall 2018 edition offers policymakers, health advocates and other interested health care professionals a freshly redesigned compendium of state telehealth laws, regulations and Medicaid policies. The new report features the same detailed telehealth policy information (with references) found in previous reports, but in a fresh new format with policies grouped into three primary categories (Medicaid Reimbursement, Private Payer Laws, and Professional Regulation). This report was made possible through generous support from the Health Services & Resources Administration and the California Health Care Foundation.
The report is being released in conjunction with the launch of CCHP’s redesigned website, which includes its interactive telehealth policy map version of the report, redesigned to correlate with the three primary policy categories listed above. CCHP’s website also now incorporates a new publicly available and free telehealth legislative and regulatory tracking U.S. map tool. The new tool allows users to easily view pending legislation and regulation as it progresses through state and federal legislative sessions and is updated on a daily basis with direct access to primary bill and regulatory text documents.
Updated Report Findings
This round of updates to CCHP’s “State Telehealth Laws and Reimbursement Policies” report revealed very little movement in terms of the number of states reimbursing in Medicaid for live video, store-and-forward and remote patient monitoring (RPM). Live video reimbursement continues to far exceed reimbursement for store-and-forward and RPM services in the Medicaid program. However, states are generally taking steps to revise details within their telehealth reimbursement policies, often expanding reimbursement to additional provider types and/or originating sites and eliminating barriers. For example, Nevada clarified that services covered include physician office services, podiatry, community paramedicine services and medical nutrition therapy and specified that Nevada Medicaid providers are eligible to deliver services via telehealth as long as it is within their scope of practice. Some states, such as Maine, have taken steps to clarify within their Medicaid policy that federally qualified health centers and rural health centers can serve as either an originating or distant site provider for purposes of telehealth reimbursement. Expanding eligible originating site lists is also a frequent policy change with 15 states and DC specifically stating they are allowing schools to be eligible originating sites, and 13 states allowing the home to be an eligible originating site, although certain special conditions often apply. Some states (i.e. D.C., NY, NJ and HI) have passed wide ranging laws requiring telehealth reimbursement in their Medicaid program in recent years, but the programs have yet to respond with official regulation or documentation in their provider manuals or regulations indicating they are actively reimbursing services via telehealth.
In addition to the findings noted in the various sections above, CCHP took note that the most common policy change since Spring 2018 was the number of states with a requirement to obtain a patient’s informed consent, increasing by seven states. A common addition to Medicaid manual telehealth sections was the incorporation of specific documentation and/or confidentiality requirements for telehealth delivered services. Finally, the adoption of the 02 place of services (POS) code (also used in Medicare) and 95 modifier created by the American Medical Association is becoming increasingly common, with twelve states utilizing 02 and seven states utilizing 95.
Significant findings for this Fall 2018 update include:
- Forty-nine states and Washington, DC provide reimbursement for some form of live video in Medicaid fee-for-service. This number has not changed since Spring 2018.
- Eleven states provide reimbursement for store-and-forward. Four states that were previously on the list were removed, due to clarification that their store-and-forward reimbursement only includes teleradiology (which CCHP does not count) and/or lack of information indicating a Medicaid reimbursement law providing for store-and-forward reimbursement has been implemented by the state’s Medicaid program.
- Twenty state Medicaid programs provide reimbursement for remote patient monitoring (RPM). This number has remained unchanged since Spring 2018.
- Twenty-three states limit the type of facility that can serve as an originating site. While some states removed their list of eligible facilities, others added specific facility lists, resulting in this number remaining steady since Spring 2018.
- Thirty-four state Medicaid programs offer a transmission or facility fee when telehealth is used. This number is up two since CCHP’s Spring 2018 update.
- Thirty-nine states and DC currently have a law that governs private payer telehealth reimbursement policy. This is an increase of one (Kansas) since Spring 2018, although three state laws don’t go into effect until 2019.
Visit CCHP’s new website to download an infographic of the key findings, or a full PDF version of State Telehealth Laws and Reimbursement Policies Report. Or use CCHP’s interactive state policy map to conduct specific searches. All of these materials can be located on CCHP’s website.
CCHP NOW HAS TWO INTERACTIVE
CCHP helps you stay informed about telehealth-related laws, regulations and Medicaid programs. Choose below to view either current state laws and policies or pending legislation and regulations. Both interactive maps include a search tool allowing you to easily identify the policies in YOUR state.