All but 2 states pay for live video Medicaid encounters
- Medicaid programs in 48 states and the District of Columbia reimburse for some form of live video encounters, the Center for Connected Health Policy reported. The two states that don’t have written reimbursement policies for telehealth are Massachusetts and Rhode Island.
- While far more states reimburse for live video than store-and-forward and remote patient monitoring, the latter are starting to gain some traction.
- The new report, which updates CCHP’s annual State Telehealth Laws and Reimbursement Policies guide, focuses mainly on Medicaid fee-for-service policies.
While live video is widely covered, 15 state Medicaid programs reimburse for store and forward, two more — Maryland and Oklahoma — than when the April 2017 edition of the guide was released. However, the extent of reimbursement varies among states. Missouri, for instance, pays for store and forward and RPM, but only for specific specialties, while Connecticut covers doctor-to-doctor email consults exclusively, the guide notes.
In addition, 21 programs pay for remote patient monitoring. Nine state Medicaid programs reimburse for all three types of services: Alaska, Arizona, Illinois, Minnesota, Mississippi, Missouri, Oklahoma, Virginia and Washington.
Other key findings in the updated guide include:
- Thirty-two states reimburse for a transmission, facility fee, or both;
- Just six states currently restrict reimbursable telehealth services to rural or underserved areas, down from nine in the last report.
- Twenty-three states designate specific sites that can be an originating site for a telehealth visit, two fewer than in 2016. Moreover, six states — Delaware, Connecticut, Minnesota, Texas, Washington and Wyoming — include the home as a reimbursable site, increasing reimbursement for RPM.
- Thirty states require some form of informed consent for telehealth.
- Nine state medical boards issue special licenses or certificates to telehealth providers.
“In most cases, states have moved away from duplicating Medicare’s restrictive telehealth policy, with some reimbursing a wide range of practitioners and services, with little or no restrictions,” the report says. Yet while more states are enacting laws that expand telehealth use, some Medicaid programs have yet to issue corresponding regulations for providers, CCHP notes.
Congressional efforts to expand Medicare reimbursement for telehealth have seen broad bipartisan support this year. In September, the House Ways and Means Committee unanimously passed a bill, H.R. 3727, which would make telehealth a core benefit in Medicare Advantage plans. The House Energy and Commerce Committee’s health subcommittee also approved legislation, H.R. 1148, broadening telestroke coverage for Medicare beneficiaries.
Meanwhile, Medicare payments for telehealth rose 28% last year, fueled by an increase in the number of providers offering virtual care to fee-for-service beneficiaries. Total payments rang in at $28.7 million, up from $22.4 million in 2015.
Still, many physicians are frustrated by the pace of telehealth adoption and the plethora of disparate of state laws and regulations. In a survey by SERMO, just 15% of U.S. doctors gave their state high marks on telehealth implementation. By contrast, 41% said their state telehealth program was “fair” and 44% rated it “poor” or “very poor.”
- Center for Connected Health Policy State Telehealth Laws and Reimbursement Policies – Fall 2017