CHIA PRESENTATION HANDOUT
|
|
- Adam Fox
- 5 years ago
- Views:
Transcription
1 5055 E. McKinley Ave, Fresno CA Tel: (559) CHIA PRESENTATION HANDOUT 2018 CHIA CONVENTION & EXHIBIT SAN DIEGO, CA Transforming Health Care with Connected Health Technology: An Update on Telehealth Policy Trends and Issues Presented by: Mei Wa Kwong, JD Presented on: Wednesday, June 06, 2018 California Health Information Association, AHIMA Affiliate
2 Transforming Health Care with Connected Health Technology: A Update on State and National Telehealth Policy Trends and Issues Mei Wa Kwong, JD Executive Director Center for Connected Health Policy 2017 California Health 2017 Information California Health Association Information Association Disclaimer Any information provided in today s talk is not to be regarded as legal advice. Today s talk is purely for informational purposes. Always consult with legal counsel. CCHP has no relevant financial interest, arrangement, or affiliation with any organizations related to commercial products or services discussed in this program. 1
3 About the Presenter Mei Wa Kwong, JD Executive Director, Center for Connected Health Policy Over two decades of policy experience Recognized national expert on telehealth policy Published author on telehealth policy Goals/Objectives or Agenda Gain a clear understanding of what telehealth is---and how its being used Understand the breadth of public policy issues affecting the use of telehealth on the federal and state levels Learn how telehealth policies are being developed and implemented at the state and federal level Become aware of the State of California telehealth policies and issues Gain a better understanding of how technology is changing and improving the delivery of health care and improving health Enhance your vision of how to best harness the power of technology to advance a healthier population 2
4 CCHP is an independent, public interest organization that strives to advance state and national telehealth policies that promote better systems of care improved health outcomes and provide greater health equity of access to quality, affordable care and services. HEATH POLICY 3
5 TELEHEALTH STATE-BY-STATE POLICIES, LAWS & REGULATIONS Current Laws, Regulations, Pending Bills State & Federal Interactive Policy Map THE VALUE OF TELEHEALTH Advances in telecommunication technologies can help redistribute health care expertise and resources to where and when it is needed, and create greater value among consumers, public & private payers, and health systems 4
6 TIMELY ACCESS TO QUALITY CARE Primary and Specialty Care Diagnosis & Treatment (Live or Asynchronous Store & Forward) including Direct to Consumer Acute, Chronic, & Emergency Care Where The Consumer Is Located 5
7 ENHANCED CONSULTATION/COMMUNICATION Patient/Consumer Health Care Team Uses secure portal for communication or live video using smart phone, tablet or computer. Directly Connects Consumers to Care Team Primary To Specialist Consultation econsult: a web-based system that allows PCPs and specialists to securely share health information and discuss patient care Improves timely access to specialist while enhancing the PCP knowledge and services using Web-based, asynchronous communication 6
8 REMOTE MONITORING Management of Chronic Conditions In Home-Aging in Place Acute Intensive Care (Tele-ICU) Bluetooth or broadband connected Remote Monitoring Can Improve Quality & Save Money Congestive heart failure best managed by longterm telemonitoring Obstructive pulmonary disease best treated with telepulmonology that remotely measures lung function Stroke most effectively treated via telestroke methods that prompt early tpa interventions A 2014 Canadian study showed telehomecare saved 14% ($1,613 per patient per year) over traditional care, by reducing hospitalizations by 45%, emergency department visits by 35%, and achieving 50% shorter hospital stays 7
9 VALUE OF TELE-MONITORING: AGING IN PLACE Close to Family /Social Supports Improves Well- Being Enhances the Care Giver Support Reduces Sense of Isolation-Connected to the World Mobile Connected Health Health care, public health, and health, education & personal health monitoring Supported by mobile phones, tablet computers, and other mobile communication devices Can be targeted (promoting healthy behavior and disease management) to wide-scale (disease outbreak alerts) 8
10 FEDERAL UPDATE Current Medicare policy Current Legislation MEDPAC/MACPAC Office of the Inspector General Report Recently passed policies Net neutrality MEDICARE - History Balanced Budget Act of 1997 Benefits Improvement & Protection Act 2000 Medicare Improvements for Patients & Providers Act, 2008 Various Changes Made Administratively Medicare beneficiaries in rural HPSAs may receive care via telehealth Practitioner required to be w/patient during consult Consulting & Referring physicians share fee (75/25) Included non-msa sites Eliminated fee sharing Expanded eligible services for reimbursement Expanded list of facilities that may act as an originating (patient location) site Credentialing & Privileging Regulations Increase in number of codes reimbursed Redefinition of rural Inclusion of Chronic Care Management Codes Medicare telehealth policy very limited & has not changed much in recent years 9
11 MEDICARE SOCIAL SECURITY ACT OF 1835(m) or 42 USC 1395m Only Live Video reimbursed Store & Forward (Asynchronous) only for Alaska & Hawaii demonstration pilots Specific list of providers eligible for reimbursement Limited to rural HPSA, non-msa, or telehealth demonstration projects Limited types of facilities eligible Limited list of reimbursable services, but CMS decides what can be delivered via telehealth and reimbursed MEDICARE ELIGIBLE PROVIDERS Physicians Nurse practitioners Physician assistants Nurse midwives Clinical nurse specialists Certified registered nurse anesthetists Clinical psychologists & clinical social workers Registered dietitians or nutrition professionals ELIGIBLE SITE (FACILITY) Offices of physicians or practitioners Hospitals Critical Access Hospitals Rural Health Clinics Federally Qualified Health Centers Hospital-based or CAH-based renal dialysis centers (including satellites) Skilled Nursing Facilities Community Mental Health Centers 10
12 MEDICARE REIMBURSED SERVICES SERVICE HCPCS CODE CPT CODE Telehealth consultations, emergency department or initial inpatient G0425 G0427 Follow up inpatient telehealth consultations furnished to beneficiaries in hospitals or SNFs G0406 G0408 Office or other outpatient visits Subsequent hospital care services, w/limitation of 1 telehealth visit every 3 days Subsequent nursing facility care services, w/limitation of 1 telehealth visit every 30 days Individual and group kidney disease education services G0420 G0421 Individual & group diabetes self management training services w/min. 1 hour of in person G0108 G0109 instruction in initial year training period to ensure effective injection training Individual & group health & behavior assessment & intervention Individual psychotherapy , Telehealth Pharmacologic Management G0459 Psychiatric diagnostic interview examination ESRD related services included in the monthly capitation payment , , , ESRD related services for home dialysis per full month for patients <2 years to 19 includes monitoring for nutrition, growth & development & counseling of parents ESRD related services for home dialysis per full month patients 20 & older Individual & group medical nutrition therapy G Neurobehavioral status examination Smoking cessation services G0436 G Alcohol and/or substance (other than tobacco) abuse structured assessment & intervention services G0396 G0397 MEDICARE REIMBURSED SERVICES Annual alcohol misuse screening, 15 minutes Brief face to face behavioral counseling for alcohol misuse, 15 minutes Annual depression screening, 15 minutes High intensity behavioral counseling to prevent sexually transmitted infection; face to face, individual, includes: education, skills raining & guidance, performed semi annually, 30 minutes G0442 G0443 G0444 G0445 Annual, face to face intensive behavioral h therapy for cardiovascular disease, individual 15 minutes Face to face behavioral counseling for obesity, 15 minutes Transitional care management services w/moderate medical decision complexity (face to face w/in 14 days of discharge Transitional care management services w/high medical decision complexity (face to face visit w/in 7 days of discharge) Psychoanalysis Family psychotherapy w/o the patient present Family psychotherapy (conjoint psychotherapy w/patient present) Prolonged service in office or other outpatient setting requiring direct patient contact beyond the 99354, usual service; first hour & additional 30 minutes Prolonged service in inpatient or observation setting requiring unit/floor time beyond usual service, first hour & each additional 30 minutes Annual Wellness Visit, first visit & subsequent visit G0446 G0447 G0438, G ,
13 OTHER MEDICARE POLICIES Reimbursement for non face-to-face chronic care management - Not considered telehealth 2018 changes: Addition of more codes for reimbursement (Psychotherapy codes, add on codes related to administration and assessment of chronic care management services) Removal of use of GT modifier; use of 02 place of service Establishment of Chronic Care Management codes to be used by RHCs and FQHCs Request for information on ways they can expand telehealth services without a law change, particularly around RPM Unbundling RPM code FEDERAL UPDATE Current Legislation Opioid bill passes Senate Health Panel Opioid Crisis Response Act of 2018 (S 2680) Makes changes to Ryan Haight Forces DEA to create special registration to prescribe via telehealth without an in-person exam Existing legislation that continues to look at expanding the utilization of telehealth, but has not moved HR 5603 (Matsui) - Access to Telehealth Services for Opioid Use Disorders Act For treatment of SUD waive certain telehealth limitations under Medicare around originating site, geography and S&F. Passed out of committee. VA legislation passed Senate but remains in the House House introduced VA Mission Act of 2018 VA proposed regs became final May 14 allows providers practice across state lines regardless of provider or patient location. RAND ECHO report 12
14 FEDERAL UPDATE MEDPAC/MACPAC Recent reports from both MEDPAC & MACPAC MACPAC more general recommendations, first report on telehealth MEDPAC continues to express caution in expanding telehealth suggestions mainly for pilots and in Medicare Advantage and ACOs FEDERAL UPDATE Office of the Inspector General Report Reported that $3.7 million in payments that should not have been made Issues were primarily regarding oversight in not disallowing inaccurate payments, certain edits/requirements not put in place and lack of knowledge by providers on what and how to bill 13
15 MEDICARE ADVANTAGE Beginning 2020 MA plans allowed to provide additional telehealth benefits Treated the same as Medicare fee-for-service option Additional telehealth benefits include: Part B benefits without restrictions Other services identified as clinically appropriate HHS Secretary must solicit comments on types of telehealth services that should be considered additional telehealth benefits by Nov. 30, Secretary shall establish requirements around: Physician or practitioner licensure Care coordination with in-person services Other areas specified by the Secretary ACCOUNTABLE CARE ORGANIZATIONS Beginning 2020 ACOs have the ability to expand telehealth services by: Including home as originating site Eliminating geographic requirements The Secretary required to conduct study on utilization and expenditures for telehealth by applicable ACOs and report to Congress no later than Jan. 1, Similar waiver made in: Next Generation ACO Comprehensive Care for Joint Replacement Model 14
16 ACUTE STROKE AND END STAGE RENAL DISEASE Beginning Jan. 1, 2019, the following sites are eligible originating sites and exempt from the rural geographic requirement, but NOT eligible for the facility fee: ESRD-related visits Renal dialysis facility * Hospital based or CAH based renal dialysis center Home (in-person visit 1/month)* Acute Stroke Treatment Hospital CAH Mobile Stroke Unit* Any site determined appropriate by the Secretary* * Not currently an eligible originating site. FEDERAL UPDATE Net neutrality FCC Roll back of net neutrality is partly in effect Parts of the rollback delayed by the FCC because they say OMB needs to sign off on parts of it. Would need to publish these parts in the Federal Register. More than two dozen states looking to pass own net neutrality state laws Fully in effect June 11, 2018 Likely lawsuits will be filed Senate passed legislation to stop end of net neutrality 15
17 PROPOSED LEGISLATIVE SOLUTIONS HR 2550 (Thompson & Harper) - Medicare Telehealth Parity Act of 2017 Expands under Medicare eligible facilities and a phased-in approach to eliminate geographic restrictions Allow FQHCs and RHCs to act as distant sites Expand list of eligible providers Include RPM HR 2291 (Duffy) - Helping Expand Access to Rural Telemedicine (HEART) Act of 2017 For Medicare, allow S&F for CAHs, RHCs and sole community hospitals Allow for RPM under certain circumstances Distant site can be an RHC Adds sole community hospital to originating site Expands list of eligible providers to some allied professionals (PT, OT, etc.) HR Telehealth Enhancement Act Of 2017 Exempt new sites from Medicare s current geographical restrictions (CAHs, sole community hospitals, home) Allow for S&F for CAHs and sole community hospitals Encourages but not mandates use of telehealth in certain programs such as authority to CMS to contract with State Medicaid agencies to coordinate care through a home health for patients with chronic conditions and requires provider to report a plan for use of RPM States may reimburse for telehealth under Medicaid so as long as the service satisfies federal requirements of efficiency, economy, and quality of care. 16
18 NO TWO STATES ARE ALIKE 45 states have a definition for telemedicine 1 states Alabama has no definition for either 36 states (and DC) have a definition for telehealth As of October
19 MEDICAID REIMBURSEMENT BY SERVICE MODALITY Live Video 49 states and DC Store and Forward Only in 15 states Remote Patient Monitoring 20 states As of October 2017 PARITY IN PAYMENT WITH IN-PERSON 38 states and DC have telehealth private payer laws Some go into effect at a later date. This is the most common policy change at the state level! Parity is difficult to determine: -Parity in services covered vs. parity in payment -many states make their telehealth private payer laws subject to the terms and conditions of the contract As of October
20 2018 LEGISLATIVE TRENDS 2018 State Legislation So Far 13% 4% 8% 11% Broadband Licensing Miscellaneous 12% 11% Medicaid Reimbursement Pilots Prescribing 6% Practice Standards Private Payer 19% 16% Worker's Comp 2018 BILLS IN STATE LEGISLATURES Connecticut HB 5152: Creates an exception to Connecticut s requirement that no provider is allowed to prescribe a controlled substance through telehealth, allowing for only the prescribing of controlled substances used in medication-assisted treatment of substance use disorders through the use of telehealth. (2/16/18: Joint Committee on Public Health) New Hampshire HB 1471: This bill requires the same rate of payment for services delivered through telehealth, as those delivered in the office or facility as long as the rate doesn t exceed the rate for an in-person consultation at the originating site. (3/2/18: Subcommittee work session) Kansas HB 2674: Establishes telehealth practice standards and coverage parity between in-person and telemedicine-delivered healthcare services and providers (3/1/18: To Senate Committee on Public Health and Welfare.) 19
21 OTHER COMMON THEMES Allowing schools to be originating sites Prohibiting insurers from limiting reimbursement to a specific technology Allowing telehealth to meet network adequacy standards Pilots related to incorporating telehealth into substance use treatment programs CALIFORNIA TELEHEALTH POLICIES Reimbursement CA has a private payer law, but payers are not mandated to reimburse, only to have a telehealth reimbursement policy Medi-Cal does reimburse for some telehealth delivered services Limited list of live video Store & Forward dermatology, ophthalmology, dentistry No RPM No geographical restrictions Patient location essentially a clinical setting unless provider is w/patient Limited list of providers Not explicitly clear written policies in telehealth provider manual 20
22 CALIFORNIA LEGISLATION AB 2315: CDE and DHCS will develop guidelines on use of telehealth to provide behavioral and mental health services in public schools. AB 2576: Authorizes the Governor, during a state of emergency, to direct all state agencies to utilize, employ, and direct state personnel, equipment, and facilities for the performance of any and all activities that are designed to allow community clinics and health centers to provide and receive reimbursement for services provided during or immediately following the emergency. Authorizes any agency directed by the Governor to perform those activities to expend any of the moneys that have been appropriated to it. Includes telehealth services. AB 2861: Requires the State Department of Health Care Services to allow a licensed practitioner of the healing arts or a certified substance use disorder counselor to receive Medi-Cal reimbursement for substance use disorder services provided through telehealth in accordance with the Medicaid state plan. OTHER STATE DEVELOPMENTS Medi-Cal Call for Comments Changes to Provider Manual December 2017 call for comments on proposed changes Comments on allowing home as an originating site Increase number of CPT codes eligible for reimbursement California Children Services Changes All CCS and GHPP providers can bill new codes. New codes include approx. 40 new codes Examples include: Genetic counseling Audiology Speech language pathology Physical therapy services Occupational therapy services Physician/Dentist coordinating activities 21
23 COMMUNITY HEALTH CLINICS STATES MEDICAID - California No specific mention regarding telehealth and FQHCs, but allowed Allow FQHCs bill PPS rate Allow FQHCs bill for S&F Recently considered submitting State Plan Amendment for FQHCs & RHCs, included some changes for how to bill for telehealth As of October 2017 Summary Telehealth Is: An essential tool for improving access, quality and efficiency of health care into the future Becoming more consumer-centric and driven Health technology developing faster than the policy Policymakers are increasingly looking to telehealth Increase in telehealth policy proposals Telehealth being looked to as solution to some of our major health concerns, particularly opioid crisis 22
24 Question & Answer Open to Questions for attendees Resources
NATIONAL CONSORTIUM OF TELEHEALTH RESOURCE CENTERS
NATIONAL CONSORTIUM OF TELE RESOURCE S For the California Telehealth Resource Center Conference May 17, 2018 877-707-7172 cchpca.org Mario Mei Guttierez Wa Kwong, JD DISCLAIMERS Any information provided
More information19 th Annual Western Regional Conference Women in Government May 21, 2016 Seattle, WA
TELE TODAY 19 th Annual Western Regional Conference Women in Government May 21, 2016 Seattle, WA 877 707 7172 cchpca.org Mei Wa Kwong, JD Senior Policy Associate & Project Director DISCLAIMERS Any information
More informationTelemedicine Compliance Maximizing Patient Care & ROI While Minimizing Legal Risks
Live tweet - #telehealth2016 Telemedicine Compliance Maximizing Patient Care & ROI While Minimizing Legal Risks Mei Wa Kwong, JD Senior Policy Associate & Project Director Center for Connected Health Policy
More informationTELEHEALTH & BEHAVIORAL HEALTH
TELE & BEHAVIORAL NATIONAL COUNCIL FOR BEHAVIORAL INSTITUTE October 2, 2017 877-707-7172 cchpca.org Mei Wa Kwong, JD Policy Advisor & Project Director DISCLAIMERS Any information provided in today s talk
More informationTRANSFORMING HEALTH CARE WITH CONNECTED HEALTH TECHNOLOGY
TRANSFORMING CARE WITH CONNECTED TECHNOLOGY TELE STATE TRENDS Florida Telehealth Advisory Council April 21, 2017 877-707-7172 cchpca.org Mario Gutierrez We are part of the Public Health Institute, an independent,
More informationTelehealth and Children With Special Health Care Needs. Improving Access to Care and Care Coordination
Telehealth and Children With Special Health Care Needs Improving Access to Care and Care Coordination Jacob Vigil, MSW Program Associate The Children s Partnership Mei Wa Kwong, JD Senior Policy Associate
More informationH.R MEDICARE TELEHEALTH PARITY ACT OF 2017
FACT SHEET CENTER FOR CONNECTED HEALTH POLICY The Federally Designated National Telehealth Policy Resource Center Info@cchpca.org 877-707-7172 H.R. 2550 MEDICARE TELEHEALTH PARITY ACT OF 2017 SPONSORS:
More informationTelemedicine Guidance
Telemedicine Guidance GEORGIA DEPARTMENT OF COMMUNITY HEALTH DIVISION OF MEDICAID Revised: October 1, 2017 Policy Revisions Record Telemedicine Guidance 2017 REVISION DATE Oct. 1, 2017 SECTION REVISION
More informationTELEHEALTH REIMBURSEMENT
FACT SHEET CENTER FOR CONNECTED HEALTH POLICY The Federally Designated National Telehealth Policy Resource Center Info@cchpca.org 877-707-7172 TELEHEALTH REIMBURSEMENT Telehealth is a well-established
More informationTelemedicine and Reimbursement
Telemedicine and Reimbursement Presented for : March 14 th 2018 About Acevedo Consulting Incorporated Acevedo Consulting Incorporated prides itself on not providing cookie-cutter programs, but a quality
More informationJOHNS HOPKINS HEALTHCARE
Page 1 of 16 ACTION: New Policy Effective Date: 10/01/2013 Revising : Review Dates: 03/29/16, 06/29/17, Superseding 09/01/17, 12/01/17 Archiving Retiring Johns Hopkins HealthCare LLC (JHHC) provides a
More informationTelehealth. Administrative Process. Coverage. Indications that are covered
Telehealth These services may or may not be covered by your HealthPartners plan. Please see your plan documents for your specific coverage information. If there is a difference between this general information
More informationTelehealth 101. Telehealth Summit May 24, 2018
Telehealth 101 Telehealth Summit May 24, 2018 Tim Bickel Telehealth Director, University of Louisville Deborah Burton, Telehealth Program Manager, KentuckyOne Health, Lexington; Chair, Kentucky Teleheath
More informationTELEMEDICINE POLICY. Policy Number: ADMINISTRATIVE T0 Effective Date: January 1, 2018
TELEMEDICINE POLICY UnitedHealthcare Oxford Reimbursement Policy Policy Number: ADMINISTRATIVE 114.28 T0 Effective Date: January 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE... 1 APPLICABLE LINES
More informationTelehealth and Telemedicine Policy
Reimbursement Policy CMS 1500 Telehealth and Telemedicine Policy Policy Number 2018R0046B Annual Approval Date 7/12/2017 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT
More informationTelemedicine Reimbursement. An Overview for Oregon
Telemedicine Reimbursement An Overview for Oregon A Brief History - Medicare In 1997 the Balanced Budget Act first authorized Medicare to reimburse for telemedicine services Since 2000 there have been
More informationTelemedicine Policy Annual Approval Date
Policy Number 2017R0046A Telemedicine Policy Annual Approval Date 7/13/2016 Approved By REIMBURSEMENT POLICY CMS-1500 Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You
More informationCheryl A Skiffington, CCO & Interim CFO Columbia County Health System
Cheryl A Skiffington, CCO & Interim CFO Columbia County Health System Telemedicine is A mode of delivery The service provided is basically the same as if the patient and provider were face-to-face. A modifier
More informationTelehealth and Telemedicine Policy
Reimbursement Policy CMS 1500 Telehealth and Telemedicine Policy Policy Number 2018R0046J Annual Approval Date 7/11/2018 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT
More informationTelehealth Reimbursement Policy in
Telehealth Reimbursement Policy in New York State Greater New York Hospital Association Telehealth Webinar Series July 11, 2016 July 2016 2 Agenda Telehealth NY State Telehealth Parity Statutory Changes
More informationTelehealth and Telemedicine Policy
Telehealth and Telemedicine Policy Policy Number Annual Approval Date 7/11/2018 Approved By Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable to UnitedHealthcare
More information9/21/2017. Telemedicine vs. Telehealth. Telemedicine vs. Telehealth. Telemedicine vs. Telehealth. Time is Money. Disruptive Technology
Telemedicine vs. Telehealth Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients health status. Telemedicine The Virtual Experience
More informationTHE TELEMEDICINE MARKET LANDSCAPE
How Telehealth is Changing the Care Provided to Patients Anne Cadwell, The Permanente Medical Group THE TELEMEDICINE MARKET LANDSCAPE Approximately 1 million virtual doctor visits in the U.S. in 2015 1
More informationExpanding Urologic Practice Through Telehealth
Expanding Urologic Practice Through Telehealth Great Lakes SUNA Chapter Spring Conference Chad Ellimoottil, MD, MS Assistant Professor of Urology Director of Telemedicine, Department of Urology ehealth
More informationTelehealth and Telemedicine Policy Annual Approval Date
Policy Number Telehealth and Telemedicine Policy Annual Approval Date 04/12/2017 Approved By Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY This policy is applicable to UnitedHealthcare
More informationTelemedicine Policy. Approved By 4/08/2015
Telemedicine Policy Policy Number 2016R0046B Annual Approval Date 4/08/2015 Approved By Payment Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission
More informationu Telemedicine The Virtual Experience
Telemedicine The Virtual Experience April 2017 Telemedicine vs. Telehealth Telemedicine is the use of medical information exchanged from one site to another via electronic communications to improve patients
More informationJOHNS HOPKINS HEALTHCARE
Page 1 of 19 ACTION: New Policy Effective Date: 10/01/2013 Revising : Review Dates: 03/29/16, 06/29/17, Superseding 09/01/17, 12/01/17, 05/15/18 Archiving Retiring Johns Hopkins HealthCare LLC (JHHC) provides
More informationHR Telehealth Enhancement Act of 2015
HR 2066 - Telehealth Enhancement Act of 2015 Rep. Harper (R-MS), Rep. Thompson (D-CA), Rep. Black (R-TN) & Rep. Welch (D-VT) Author Intent: To promote and expand telehealth application under Medicare and
More informationTRANSFORMING HEALTH CARE WITH TELEHEALTH
TRANSFORMING CARE WITH TELE STATE AND NATIONAL TELE TRENDS AND ISSUES NATIONAL CONFERENCE OF STATE LEGISLATURES December 10, 2015 877-707-7172 cchpca.org Mario Gutierrez We are an independent, public interest
More informationFACT SHEET Congressional Bill
HR 3306 - Telehealth Enhancement Act of 2013 Rep. Gregg Harper (R-MS) Purpose: To promote and expand the application of telehealth under Medicare and other Federal health care programs. Positive Incentives
More informationTelemedicine Policy. 7/12/2017 Approved By
Telemedicine Policy Policy Number 2018R0046A Annual Approval Date 7/12/2017 Approved By Reimbursement Policy Oversight Committee IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY You are responsible for submission
More informationTelemedicine and Fair Market Value What You Need to Know
Telemedicine and Fair Market Value What You Need to Know By Chris W. David, CPA/ABV, ASA August, 2017 Telemedicine (also known as telehealth) is a rapidly-evolving trend in the healthcare delivery space
More informationMISSOURI TELEHEALTH NETWORK TRAINING CONFERENCE January 31, 2018 CENTER FOR CONNECTED HEALTH POLICY POLICY DISCLAIMERS
LEGAL & REGULATORY ISSUES TO CONSIDER IN A TELE PROGRAM MISSOURI TELE NETWORK TRAINING CONFERENCE January 31, 2018 877-707-7172 cchpca.org Mei Wa Kwong, JD DISCLAIMERS Any information provided in today
More informationTransforming Health Care with Telehealth: Today s Barriers and Tomorrow s Solutions
Transforming Health Care with Telehealth: Today s Barriers and Tomorrow s Solutions Mario Gutierrez, Executive Director August 28, 2014 Webinar for the Northwest Telehealth Resource Center Center for Connected
More informationDIVISION OF HEALTHCARE FINANCING CMS 1500 ICD-10. October 1, 2017
DIVISION OF HEALTHCARE FINANCING CMS 1500 ICD-10 October 1, 2017 General Information Overview Thank you for your willingness to serve clients of the Medicaid Program and other medical assistance programs
More informationTelemedicine and Telehealth Services
INDIANA HEALTH COVERAGE PROGRAMS PROVIDER REFERENCE M ODULE Telemedicine and Telehealth Services L I B R A R Y R E F E R E N C E N U M B E R : P R O M O D 0 0 0 4 8 P U B L I S H E D : J A N U A R Y 1
More informationMedicaid Program Administrator: Bureau for Medical Services, under the West Virginia Dept. of Health and Human Resources
West Virginia Medicaid Program: West Virginia Medicaid Medicaid Program Administrator: Bureau for Medical Services, under the West Virginia Dept. of Health and Human Resources Regional Telehealth Resource
More information5/1/2017. Medicare Coverage Guidelines for DSMT and MNT Telehealth. Telehealth Defined
Medicare Coverage Guidelines for DSMT and MNT Telehealth Mary Ann Hodorowicz, RDN, MBA, CDE Certified Endocrinology Coder Mary Ann Hodorowicz Consulting, LLC 4-30-17 MEDICARE DSMT - MNT TELEHEALH KEY TOPICS
More informationCMS Changes Expanding Coverage of Telehealth
CMS Changes Expanding Coverage of Telehealth WASHINGTON Saturday, Nov. 30, 2013 -- Medicare beneficiaries received good news on the eve of Thanksgiving as the Centers for Medicare and Medicaid Services
More informationTelehealth 101: Key Concepts for Starting and Sustaining
Telehealth 101: Key Concepts for Starting and Sustaining Telehealth 101 Danielle Louder Program Director NETRC, MCD Public Health Andrew Solomon, MPH Project Manager NETRC Nina Antoniotti, PhD, MBA, RN
More informationTelehealth. Clinical Applications 6/28/2011 TELEHEALTH UPDATE: MONTANA AND BEYOND
TELEHEALTH UPDATE: MONTANA AND BEYOND Telehealth Telehealth is the delivery of healthrelated services via telecommunications technologies Clinical Applications Allergy Cardiology * Dermatology Oncology
More informationMaryland. Center for Connected Health Policy. Medicaid Program: MD Medical Assistance Program. Program Administrator: MD Dept. of Social Services
Maryland Medicaid Program: MD Medical Assistance Program Program Administrator: MD Dept. of Social Services Regional Telehealth Resource Center Mid-Atlantic Telehealth Resource Center PO Box 800711 Charlottesville,
More informationNortheast Legislative/Regulatory March-April 2018 Update
Northeast Legislative/Regulatory March-April 2018 Update Please Note: CCHP has a pending legislation/regulation webpage located at the following link: http://cchpca.org/state-laws-and-reimbursement-policies
More informationTelehealth in Peritoneal Dialysis Patient Management
Telehealth in Peritoneal Dialysis Patient Management Susie Lew, MD George Washington University March 3, 2018 Disclosures CareFirst Foundation: grant ACT/ The App Association: Steering committee member
More informationWhat is Telemedicine and How is It Being Used?
What is Telemedicine and How is It Being Used? March 14, 2018 Presented by: Attorney Karina P. Gonzalez Florida Healthcare Law Firm www.floridahealthcarelawfirm.com 2016 The Law Offices of Jeff Cohen,
More informationProject: Telemedicine Engaging Your Providers in Your Telehealth Development and Program
Project: Engaging Your Providers in Your Telehealth Development and Program Presented by: James Dunnick, MD, FACC, CHCQM, CPC, CMDP - The Dunnick Group, LLC Learning Outcome Standard: This program is based
More informationCruising Through Key Legal Compliance Issues in Telemedicine
April 12, 2018 Cruising Through Key Legal Compliance Issues in Telemedicine Presented by Cal Marshall 2018 Chambliss, Bahner & Stophel, P.C. All Rights Reserved. Chambliss, Bahner & Stophel, P.C. Liberty
More informationWHITE PAPER #2: CASE STUDY ON FRONTIER TELEHEALTH
WHITE PAPER #2: CASE STUDY ON FRONTIER TELEHEALTH I. CURRENT LEGISLATION AND REGULATIONS Telehealth technology has the potential to improve access to a broader range of health care services in rural and
More informationAligned TeleHealth, Inc. On-site Staffing & TelePsychiatry
Aligned TeleHealth, Inc. On-site Staffing & TelePsychiatry Aligned s History Dr. Nitin Nanda, P.C. Founded in 2000 Founded as a Private Psychiatry Practice in Los Angeles by Dr. Nitin Nanda upon Completing
More informationCMS-1676-F 120. and makes a separate payment to the distant site practitioner furnishing the service.
CMS-1676-F 120 C. Medicare Telehealth Services 1. Billing and Payment for Telehealth Services Several conditions must be met for Medicare to make payments for telehealth services under the PFS. The service
More informationTelemedicine and Health Reform. Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center
Telemedicine and Health Reform Jonathan Neufeld, PhD Clinical Director Upper Midwest Telehealth Resource Center 1 telehealthresourcecenters.org Links to all TRCs National Webinar Series Reimbursement,
More informationMEDICAL POLICY No R1 TELEMEDICINE
Summary of Changes MEDICAL POLICY TELEMEDICINE Effective Date: March 1, 2016 Review Dates: 12/12, 12/13, 11/14, 11/15 Date Of Origin: December 12, 2012 Status: Current Clarifications: Deletions: Pg. 4,
More information2015 MEDICARE UPDATES
Disclaimer 2015 MEDICARE UPDATES The information contained in these slides are current at the time of writing. However, CMS can change the information at any time. Please monitor the ISMA website and all
More informationRegents University of California Telehealth Network Ware County Telehealth Network
TMC72 Response to Telemedicine Inquiry (Attachment and Appendix): The Health Resources and Services Administration (HRSA) oversees the Telehealth Network Grant Program (TNGP) which aims at: helping communities
More informationLEGAL CONSIDERATIONS FOR FQHCS: REIMBURSEMENT FOR TELEMEDICINE SERVICES
LEGAL CONSIDERATIONS FOR FQHCS: REIMBURSEMENT FOR TELEMEDICINE SERVICES SOUTH CAROLINA PRIMARY HEALTH CARE ASSOCIATION SOUTH CAROLINA PRIMARY HEALTH CARE ASSOCIATION 2017 STATE POLICY & ISSUES FORUM Jeanne
More informationMEDICAL POLICY No R2 TELEMEDICINE
Summary of Changes Clarifications: Page 1, Section I. A 6, additional language added for clarification. Deletions: Additions Page 4, Section IV, Description, additional language added in regards to telemedicine.
More informationREVISION DATE: FEBRUARY
Mary Ann Hodorowicz, MBA, RDN CDE, CEC, Owner, Mary Ann Hodorowicz Consulting LLC, Palos Heights, IL Coverage: In-Person Payable Places of Services Excluded Places for Part B Payment Excluded Places: 0
More informationI. LIVE INTERACTIVE TELEDERMATOLOGY
Position Statement on Teledermatology (Approved by the Board of Directors: February 22, 2002; Amended by the Board of Directors: May 22, 2004; November 9, 2013; August 9, 2014; May 16, 2015; March 7, 2016)
More information08/07/2015. Next Generation ACO Model. What is an ACO? Preliminary Beneficiary Engagement Timeline
Next Generation ACO Model National Training Program RO V and RO VII St. Louis August 10-11, 2015 What is an ACO? Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other health
More information2017 Telehealth Policy for the National Rural Health Association
2017 Telehealth Policy for the National Rural Health Association Introduction Telemedicine has been around for decades, but is just now really becoming mainstream with the congruence of technology, lower
More informationCorporate Reimbursement Policy Telehealth
Corporate Reimbursement Policy Telehealth File Name: Origination: Last Review Next Review: telehealth 11/1997 12/2017 12/2018 Description Telehealth is a potentially useful tool that, if employed appropriately,
More informationTELEHEALTH & THE SAFETY-NET
TELEHEALTH & THE SAFETY-NET Sacramento Region Health Care Partnership Safety Net Learning Institute July 23, 2015 Sierra Health Foundation 877-707-7172 cchpca.org Mario Gutierrez POLICY We are an independent,
More informationTelemedicine: Improving Access to Specialty Care in Wisconsin s Rural Communities
Telemedicine: Improving Access to Specialty Care in Wisconsin s Rural Communities David Guggenbuehl, RN, MBA, Director Jessica Miller, RN, Telemedicine Program Manager Department of Regional Services and
More informationTelehealth: Using technology in the delivery of healthcare
Telehealth: Using technology in the delivery of healthcare Using Telemedicine to Treat Chronic Disease in Rural Communities "Rural Americans face a unique combination of factors that create disparities
More informationConflict of Interest Disclosure. Telemedicine: Credentialing And Best Practices. Learning Objectives. Learning Objectives. Telehealth.
Conflict of Interest Disclosure Telemedicine: Credentialing And s Catherine M. Ballard Partner Bricker & Eckler LLP 614-227-8806/cballard@bricker.com Use the following statement or disclose any relationships
More informationFrequently Asked Questions Approaches to Integrated Care
Frequently Asked Questions Approaches to Integrated Care These Frequently Asked Questions (FAQs) issued by the New York State Department of Health (DOH), the New York State Office of Mental Health (OMH)
More informationState Resources, Policy, and Reimbursement Information
State Resources, Policy, and Reimbursement Information Policies, billing procedures, and referral procedures related to suicide prevention in primary care vary significantly across states. Understanding
More informationState of New Jersey Department of Human Services Division of Medical Assistance & Health Services (DMAHS)
State of New Jersey Department of Human Services Division of Medical Assistance & Health Services (DMAHS) Outpatient Facility Behavioral Health Integration Billing Frequently Asked Questions (FAQs) 1.
More informationKY Medicaid Co-pays Except for the Pharmacy Non-Preferred co-pay, co-pays do not apply to the following:
This is a list of current covered services and co-pays. Except for the Pharmacy Non-Preferred co-pay, co-pays do not apply to the following: Non-KCHIP children Children under 19 in foster care Pregnant
More informationKY Medicaid Co-pays. Acute admissions medical Per admission diagnoses $0 Acute health care related to. Per admission substance abuse and/or for
This is a list of current covered services and co-pays. Except for the Pharmacy Non-Preferred co-pay, co-pays do not apply to the following: Non-KCHIP children Children under 19 in foster care Pregnant
More informationNote: Telemedicine is not the use of the following. (1) Telephone transmitter for transtelephonic monitoring; or
INDIANA HEALTH COVERAGE PROGRAMS P R O V I D E R B U L L E T I N B T 2 0 0 8 0 2 J A N U A R Y, 8 2 0 0 8 To: All Providers Subject: Overview Effective April 1, 2007, telemedicine services are covered
More informationMid-Atlantic Legislative/Regulatory June 2018 Update
Mid-Atlantic Legislative/Regulatory June 2018 Update Please Note: CCHP has a pending legislation/regulation webpage located at the following link: http://cchpca.org/state-laws-and-reimbursement-policies
More informationTelehealth: Frequently Asked Questions
Telehealth: Frequently Asked Questions WHAT IS TELEHEALTH? Telehealth is the use of electronic information and telecommunications technology to support: THE DELIVERY OF HEALTH CARE PATIENT AND PROFESSIONAL
More informationEDITED DATE: 08/27/09, 08/26/10) CATEGORY: Miscellaneous
MEDICAL POLICY SUBJECT: TELEMEDICINE and TELEHEALTH (ARCHIVED DATE: 06/25/09-12/08/11; PAGE: 1 OF: 10 If a product excludes coverage for a service, it is not covered, and medical policy criteria do not
More informationTelehealth Policy Barriers Fact Sheet
FACT SHEET Telehealth Policy Barriers Fact Sheet Introduction August 2016 Telehealth has existed for decades in some form or another, but it is only in the last few years it has received increasing attention
More informationLegal Issues You Should Know April 25, 2018 In-House Counsel Conference
1 TELEMEDICINE Legal Issues You Should Know April 25, 2018 In-House Counsel Conference Disclaimer: These materials and presentation are intended to be a general and brief summary of the law. This is not
More informationMedicare Mental Health Services Billing Guide 2012
Medicare Mental Health Services Billing Guide 2012 Basic Medicare Resources for Health Care Professionals, 15.17: Establishing an Effective Date of Medicare Billing Privileges. 10.9: Inpatient Psychiatric
More informationThe Telemedicine Opportunity. Presented By: Marybeth McCall, MD
The Telemedicine Opportunity Presented By: Marybeth McCall, MD 1962 Episode of the The Jetsons Presentation Objectives Identify telemedicine utilization projections Describe New York s Telemedicine Mandate
More informationSTATE TELEHEALTH LAWS AND REIMBURSEMENT POLICIES A COMPREHENSIVE SCAN OF THE 50 STATES AND DISTRICT OF COLUMBIA
STATE TELEHEALTH LAWS AND REIMBURSEMENT POLICIES A COMPREHENSIVE SCAN OF THE 50 STATES AND DISTRICT OF COLUMBIA SPRING 2018 State Telehealth Laws and Medicaid Program Policies Introduction The Center for
More informationTelehealth Legal and Compliance Issues. Nathaniel Lacktman, Anna Whites, Esq.
Telehealth Legal and Compliance Issues Nathaniel Lacktman, Esq. @Lacktman Anna Whites, Esq. Anna Whites Law Office Attorney Advertising Prior results do not guarantee a similar outcome Models used are
More informationOpportunities to Leverage Telehealth Within Your ACO Strategy
Opportunities to Leverage Telehealth Within Your ACO Strategy Shawn Valenta RRT, MHA Administrator of Telehealth Center for Telehealth Phillip Warr, MD Interim Chief Medical Officer Case Management and
More informationState Telehealth Laws and Medicaid Program Policies. A Comprehensive Scan of the 50 States and District of Columbia. August 2016
State Telehealth Laws and Medicaid Program Policies A Comprehensive Scan of the 50 States and District of Columbia August 2016 State Telehealth Laws and Medicaid Program Policies Introduction The Center
More informationPrimary Care 101: A Glossary for Prevention Practitioners
PREVENTION COLLABORATION IN ACTION Engaging the Right Partners Primary Care 101: A Glossary for Prevention Practitioners As the U.S. healthcare landscape continues to change under the Affordable Care Act
More informationReimbursement Environment
Reimbursement Environment 1 2017 Medicare Physician Fee Schedule Enhancing Integrative Medicine: CMS adopting additional care management codes in 2017 MPFS. Support patient centered and collaborative strategies.
More informationHighlights of the 2018 Medicare Physician Fee Schedule (MPFS) Final Rule
Highlights of the 2018 Medicare Physician Fee Schedule (MPFS) Final Rule Physician Payment Update & Misvalued Codes Target The update to payments under the PFS in 2018 will be +0.31 percent. This reflects
More informationAgency telemedicine rules are revised to clarify that telemedicine networks be approved at the OHCA's discretion to ensure medical necessity.
POLICY TRANSMITTAL NO. 11-35 April 18, 2011 HEALTH POLICY OKLAHOMA HEALTH CARE AUTHORITY TO: SUBJECT: STAFF LISTED MANUAL MATERIAL CHAPTER 30. MEDICAL PROVIDERS-FEE FOR SERVICE OAC 317:30-3-27. EXPLANATION:
More informationTelehealth Billing, Licensing, Reimbursement and Credentialing Issues Across State Lines
Telehealth Billing, Licensing, Reimbursement and Credentialing Issues Across State Lines Live tweet - #telehealth2015 Introduction and Session Notes Agenda Introduction and panel presentations: ~55 minutes
More informationComparison of the Health Provisions in HR 1 American Recovery and Reinvestment Act
APPROPRIATIONS Comparative Effectiveness Research $1.1B for comparative effectiveness programs, including $300 M for AHRQ, $400 M for NIH, and $400 M for HHS. Establishes a Federal Coordinating Council.
More informationACCESS TO MENTAL HEALTH CARE IN RURAL AMERICA: A CRISIS IN THE MAKING FOR SENIORS AND PEOPLE WITH DISABILITIES
ACCESS TO MENTAL HEALTH CARE IN RURAL AMERICA: A CRISIS IN THE MAKING FOR SENIORS AND PEOPLE WITH DISABILITIES A Capitol Hill Briefing Sponsored by the: AMERICAN MENTAL HEALTH COUNSELORS ASSOCIATION (AMHCA)
More informationLOUISIANA MEDICAID PROGRAM ISSUED: 06/09/17 REPLACED: CHAPTER 2: BEHAVIORAL HEALTH SERVICES SECTION 2.2: OUTPATIENT SERVICES PAGE(S) 8
Licensed Practitioner Outpatient Therapy includes: Individual; Family; Group; Outpatient psychotherapy; Mental health assessment; Evaluation; Testing; Medication management; Psychiatric evaluation; Medication
More informationChapter 7 Section 22.1
Medicine Chapter 7 Section 22.1 Issue Date: April 17, 2003 Authority: 32 CFR 199.4 and 32 CFR 199.14 Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationOklahoma Health Care Authority. Telemedicine
Oklahoma Health Care Authority Telemedicine Telemedicine Policy: OAC 317:30-3-27 Billing Technology 2 Telemedicine Applicability & Scope The purpose of the SoonerCare telemedicine is to improve access
More informationTELEHEALTH IN FLORIDA
TELEHEALTH IN FLORIDA Nikole Helvey, Bureau Chief Florida Center for Health Information and Transparency May 2017 1 TELEHEALTH HB 7087 (2016) / 2016-240 L.O.F. 1. Telehealth Advisory Council: 15 members
More informationPREVENTIVE MEDICINE AND SCREENING POLICY
UnitedHealthcare Oxford Reimbursement Policy PREVENTIVE MEDICINE AND SCREENING POLICY Policy Number: ADMINISTRATIVE 238.19 T0 Effective Date: July 1, 2018 Table of Contents Page INSTRUCTIONS FOR USE...
More informationCalifornia community health centers:
California community health centers: Financial analysis of telehealth programs Date: Prepared for: Center for Connected Health Policy Prepared by: Susan Philip, MPP Healthcare Management Consultant Susan.Philip@milliman.com
More informationBenefits are effective January 01, 2018 through December 31, 2018 PLAN DESIGN AND BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY
PLAN FEATURES Annual Deductible The maximum out-of-pocket limit applies to all covered Medicare Part A and B benefits including deductible. Hearing aid reimbursement does not apply to the out-of-pocket
More information11/10/2015. Workforce Shortages and Maldistribution. Health Care Workforce Shortages/Maldistribution: Why? Access to Health Care Services
Workforce Shortages and Maldistribution DEVELOPING NEW STATE LEGISLATIVE HEALTH LEADERS Access to Health Care Services Health Professional Shortage Areas (HPSAs) are geographic areas, or populations within
More informationChapter 7 Section 22.1
Medicine Chapter 7 Section 22.1 Issue Date: April 17, 2003 Authority: 32 CFR 199.4 and 32 CFR 199.14 Copyright: CPT only 2006 American Medical Association (or such other date of publication of CPT). All
More informationAges Ages 3 through 64.
Medicaid: Follow-Up After Discharge from Community Hospitals, State Psychiatric Hospitals, and Facility Based Crisis Services for Mental Health Treatment The percentage of discharges for individuals ages
More information