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Medicaid pays for live telehealth in most states but lack of definition creates confusion

Dive Brief:

  • The Center for Connected Health Policy released its annual guide on state telehealth laws and reimbursement policies, which found several telehealth trends in 2015.
  • While some states are expanding telehealth reimbursement, others are placing more limits and restrictions on telehealth delivered services, the report stated.
  • The survey specified 11 telehealth-related policy areas ranging from the definition of the word telehealth/telemedicine to various reimbursements, consent issues, and online prescribing.

Dive Insight:
The most predominant reimbursed form of telehealth is live video. The District of Columbia and 47 states provided reimbursement for live video in Medicaid fee-for-service last year.

According to the report, each state has its own definition of telehealth and how it is regulated, which creates confusion for telehealth participants. Alabama, New Jersey, and Rhode Island still lack a definition for telehealth/telemedicine.

Only five state Medicaid programs – Alaska, Illinois, Minnesota, Mississippi, and Washington – reimbursed for live video in Medicaid fee-for-service, store-and-forward delivered services, as well as remote patient monitoring (RPM) last year, although with certain limitations.

Only 16 states have some form of reimbursement for RPM in Medicaid programs, the report found.

Some of the other key findings in the report include:

  • 47 states have some type of reimbursement for telehealth in their public program but Massachusetts, Rhode Island and Utah do not have a definitive reimbursement policy.
  • 29 states have some form of informed consent requirement.
  • Nine state medical boards issue special licenses or certificates for telehealth.

Over the 2016 legislative session, 44 states have introduced more than 150 telehealth-related pieces of legislation. Many of the bills address different aspects of reimbursement in regards to private payers and Medicaid. Many states have proposed legislation for adoption of the Federation of State Medical Board’s model language for an Interstate Medical Licensure Compact.

source: | By: Nina Flanagan