Reimbursement For Telehealth Services

The act prohibits a health insurance carrier from:

• Imposing specific requirements or limitations on the HIPAA-compliant technologies used to deliver telehealth services;
• Requiring a covered person to have a previously established patient-provider relationship with a specific provider in order to receive medically necessary telehealth services from the provider; or
• Imposing additional certification, location, or training requirements as a condition of reimbursement for telehealth services.

The act specifies that, to the extent the state board of health adopts rules addressing supervision requirements for home care agencies, the rules must allow for supervision in person or by telemedicine or telehealth.

For purposes of the medicaid program, the act:

• Requires the department of health care policy and financing (state department) to allow home care agencies to supervise services through telemedicine or telehealth;
• Clarifies the methods of communication that may be used for telemedicine;
• Requires the state department to reimburse rural health clinics, the federal Indian health service, and federally qualified health centers for telemedicine services provided to medicaid recipients and to do so at the same rate as the department reimburses those services when provided in person;
• Requires the state department to post telemedicine utilization data to the state department's website no later than 30 days after the effective date of the act and update the data every other month through state fiscal year 2020-21; and
• Specifies that health care and mental health care services include speech therapy, physical therapy, occupational therapy, hospice care, home health care, and pediatric behavioral health care.

The act appropriates $5,068,381 to the state department from the care subfund for telemedicine expansion services and prohibits the state department from using the appropriation for the state-share of medicaid services.

(Note: This summary applies to this bill as enacted.)