May 30, 2019 – Every state now offers Medicaid reimbursement for some real-time virtual visits, according to the latest analysis of state telehealth and telemedicine laws and reimbursement policies by the Center for Connected Health Policy.
The challenge, as always, lies in finding out what state covers what services, as well as when, where, how and why.
CCHP’s Spring 2019 report on connected care guidelines and coverage highlight the advances that are being made in telehealth and telemedicine adoption at the state level, while also pointing out that each state follows its own path. So while Massachusetts might be commended for allowing some Medicaid coverage for telemental health services – becoming the last state to cross the virtual visit threshold – the commonwealth is also far down on the list for telehealth-friendly policies.
“No two states are alike in how telehealth is defined and regulated,” the report, overseen by Executive Director Mei Wa Kwong, JD, notes. “While there are some similarities in language, perhaps indicating states may have utilized existing verbiage from other states, noticeable differences exist. These differences are to be expected, given that each state defines its Medicaid policy parameters, but it also creates a confusing environment for telehealth participants to navigate, particularly when a health system or practitioner provides health care services in multiple states.”
“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 to no restrictions<’ it adds.
According to the CCHP, the most common action taken by states since the last report was issued in fall 2018 is to join the Interstate Medical Licensure Compact. The IMLC, which saw its membership jump from 15 to 29 states and the District of Columbia, creates a streamlined process for applying for a medical license in multiple states, thus enabling doctors to expand their reach through telemedicine and telehealth.
Aside from the expansion of video-based telemedicine coverage, the CCHP identified three other significant trends in its 420-page report:
Among other notable trends, according to the CCHP, are the inclusion of the home and schools as eligible originating sites for telehealth programs, and the identification of teledentistry and substance abuse disorder (SUD) services as specialty care services qualifying for Medicaid and/or private payer reimbursement.