Louisiana State Telehealth Laws and Reimbursement Policies

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Information Provided ByCenter for Connected Health Policy

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Connected Health Policy 2019: http://cchpca.org

Louisiana Medicaid

Louisiana
Medicaid Program: Louisiana Medicaid

Program Administrator: LA Dept. of Health and Hospitals

Regional Telehealth Resource Center:

TexLa Telehealth Resource Center
3601 4th Street, Ste. 2B440

Lubbock, TX 79430
(806) 743-4440
http://www.texlatrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

“Telemedicine is the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data using interactive telecommunication technology that enables a health care practitioner and a patient at two locations separated by distance to interact via two-way video and audio transmissions simultaneously. Neither a telephone conversation nor an electronic mail message between a health care practitioner and patient, or a true consultation as may be defined by rules promulgated by the board pursuant to the Administrative Procedure Act, constitutes telemedicine.”

Source: LA Revised Statutes 37:1262.

Telemedicine – the practice of health care delivery, diagnosis, consultation, treatment, and transfer of medical data by a physician using interactive telecommunication technology that enables a physician and a patient at two locations separated by distance to interact via two- way video and audio transmissions simultaneously. Neither an electronic mail message between a physician and a patient, or a true consultation constitutes telemedicine for the purposes of this Part. A physician practicing by telemedicine may utilize interactive audio without the requirement of video if, after access and review of the patient’s medical records, the physician determines that he or she is able to meet the same standard of care as if the healthcare services were provided in person.

Source: LA Admin. Code 46:XLV.75.

Telehealth means a mode of delivering healthcare services that utilizes information and communication technologies to enable the diagnosis, consultation, treatment, education, care management and self-management of patients at a distance from healthcare providers. Telehealth allows services to be accessed

“Telemedicine is the use of medical information exchanges from one site to another via electronic communications to improve a recipient’s health. Electronic communication means the use of interactive telecommunications equipment that includes, at a minimum, audio and video equipment permitting two-way, real time interactive communication between the patient at the originating site, and the physician or practitioner at the distant site.”

Source: LA Dept. of Health and Hospitals, Professional Svcs.

Provider Manual, Chapter Five of the Medicaid Svcs. Manual, p.

168 (As revised on Apr. 21, 2017). (Accessed Oct. 2017).

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STATE LAW/REGULATIONS MEDICAID PROGRAM

when providers are in a distant site and patients are in

the originating site. Telehealth facilitates patient self-
management and caregiver support for patients and
includes synchronous interactions and asynchronous
store and forward transfers.

Source: LA Revised Statutes HB 1280 (2014) & Title 40 Sec.

1300.383 & Title 46, Part LXXV, Ch. 1, Sec. 103 (Speech Language
Pathology/Audiology).

Live Video Reimbursement

Louisiana law requires reimbursement to the originating Louisiana Medicaid reimburses for “services provided

site physician for a live video consultation if he/she is via an interactive audio and video telecommunications
physically present during the exam and interacts with system.”
the distant-site physician. (See “Private Payers” section
below) Source: LA Register, Volume 31, 2032 (2012).
Source: LA Revised Statutes 22:1821 (2012). Louisiana Medicaid only reimburses the distant site
provider.
Source: LA Dept. of Health and Hospitals, Professional Svcs.
Provider Manual, Chapter Five of the Medicaid Svcs. Manual, p.
168 (As revised on Apr. 21, 2017). (Accessed Oct. 2017).

Store and Forward Reimbursement

There is no reimbursement requirement based upon the Louisiana Medicaid will not provide reimbursement for
definition of “telemedicine” which describes telemedicine store and forward based upon the definition of
as an interaction “via two-way video and audio “telemedicine” which describes telemedicine as
transmission”. including “audio and video equipment permitting two-
way, real time interactive communication” therefore
Source: LA Revised Statutes 37:1262 (2012). excluding store and forward.
Source: LA Dept. of Health and Hospitals, Professional Svcs.
Provider Manual, Chapter Five of the Medicaid Svcs. Manual, p.
168 (As revised on Apr. 21, 2017). (Accessed Oct. 2017).

Remote Patient Monitoring Reimbursement

No reference found. Under the Community Choices Waiver, Louisiana
Medicaid will reimburse an installation fee and a monthly
maintenance fee for:
TeleCare Activity and Sensor Monitoring,
Health status monitoring, and
Medication dispensing and monitoring.
Activity and Sensor Monitoring
At a minimum the system must:
Monitor the home’s points of egress and
entrance;
Detect falls;
Detect movement or lack of movement;
Detect whether doors are opened or closed; and
Provide a push button emergency alert system.
Providers of assistive devices and medical equipment
must be a licensed home health agency.

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STATE LAW/REGULATIONS MEDICAID PROGRAM

Certain standards apply for the medical equipment and
supplies used.
Limitations
Services must be pre-approved
Services must be based on verified need.
Benefit must be determined by an independent
assessment on any item that costs over $500.
All items must reduce reliance on other
Medicaid state plan or waiver services
All items must meet applicable standards of
manufacture, design and installation
The items must be on the Plan of Care
developed by the support coordinator.
A recipient is not able to receive Telecare Activity and
Sensor Monitoring services and traditional PERS
services.
Where applicable, recipients must use Medicaid State
Plan, Medicare or other available payers first.
Source: LA Dept. of Health and Hospitals, Community Choices
Waiver Provider Manual, Chapter Seven of the Medicaid Svcs.
Manual, p. 29-30 (as revised on Jan. 11, 2017). (Accessed Oct.
2017).

Email/Phone/FAX

No reimbursement for email. No reference found.
No reimbursement for telephone.
No reference found for FAX.
Source: LA Revised Statutes 37:1262 (2012).
Practice of Medicine (does not apply to
reimbursement):
A physician may utilize interactive audio without video
after access and review of the patient’s medical records,
and the physician determines that he is able to meet the
same standard of care if the health care services were
provided in person.
Source: LA Revised Statutes Sec. 40:1223.3 (HB 570 – 2016).

Online Prescribing

Only physicians certificated by a specialty board of the Greater New Orleans Community Health Connection
American Board of Medical Specialties or the American Provider Manual
Osteopathic Association shall use telemedicine to The use of a telemedicine communications system may
prescribe amphetamines or narcotics. substitute for a face-to-face, “hands on” encounter for
consultation, office visits, individual psychotherapy and
Telemedicine, including the issuance of any prescription pharmacologic management.
via electronic means, shall be held to the same
prevailing and usually accepted standards of medical Source: LA Dept. of Health and Hospitals, Greater New Orleans
practice as those in traditional, face-to-face settings. Community Health Connection Provider Manual, Chapter Forty-
seven of the Medicaid Svcs. Manual, p. 65 (as revised Oct. 22,
An online, electronic or written mail message, or a 2015). (Accessed Oct. 2017).

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STATE LAW/REGULATIONS MEDICAID PROGRAM

telephonic evaluation by questionnaire or otherwise,

does not satisfy the standards of appropriate care.

To establish a physician-patient relationship an in-

person visit is not required if the technology is sufficient
to provide the physician the pertinent clinical
information.

No physician shall authorize or order the prescription,

dispensation or administration of any controlled
substance unless; a. the physician has had at least one
in-person visit with the patient within the past year;
provided, however, the requirement for an in-person visit
shall not apply to a physician who holds an unrestricted
license to practice medicine in LA and who practices
telemedicine upon any patient being treated at a
healthcare facility that is required to be licensed
pursuant to the laws of LA and which holds a current
registration with the U.S. Drug Enforcement
Administration.

Source: LA Admin. Code 46:XLV.408, Ch. 75.

For physicians practicing telemedicine and treating a

patient at a healthcare facility that is required to be
licensed according to the laws of LA and holds a current
registration with the US Drug Enforcement
Administration:

Physician must use the same standard of care

as in person.

Physician must be authorized to prescribe any

controlled dangerous substance without
necessity of conducting an appropriate in-

person patient history or physical examination.

Physician shall not be subject to any regulation

prohibition or restriction on the use of
telemedicine that is more restrictive than those
that are otherwise applicable to their entire
profession.

Source: LA Statute Sec. 1271.1 (HB 480 – 2016).

No physician practicing telemedicine can prescribe a

controlled dangerous substance prior to conducting an
appropriate in-person patient history or physical
examination of the patient.

Source: LA Revised Statutes Sec. 1300.381 & HB 1280 (2014).

Consent

Physicians must inform telemedicine patients of the No reference found.

relationship between the physician and patient, and the
role of any other health care provider with respect to
management of the patient. The patient may decline to
receive telemedicine services and withdraw from such
care at any time.

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STATE LAW/REGULATIONS MEDICAID PROGRAM

Source: LA Admin. Code 46:XLV.7511 (2012).

Location

No reference found. No reference found.

Cross-State Licensing

A telemedicine license may be issued to out-of-state No reference found.
physicians, as long as they hold a full and unrestricted
license in another state or U.S. territory.
Out-of-state telemedicine providers cannot open an
office, meet with patients or receive calls from patients
within Louisiana.
A licensed health care provider must be in the
examination room with the patient during telemedicine
services.
Source: LA Revised Statutes 37:1276.1 (2012).
LA state agencies and professional boards can regulate
the use of telehealth including licensing of out-of-state
healthcare providers.
Source: LA Revised Statutes Sec. 1300.381 & HB 1280 (2014).
A physician may practice in the state with a full license,
or hold a telemedicine permit.
Source: LA Admin. Code 46:XLV.75.
Telemedicine Permit application available on LA Medical
Board’s website.

Private Payers

Reimbursement must be made to the originating site No reference found.
physician if he/she is physically present during the exam
and interact with the distant-site physician.
Originating-site physician fees shall be at least 75
percent of the normal fee for an intermediate office visit.
No reference found for distant-site physician
reimbursement.
Source: LA Revised Statutes 22:1821 (2012).

Site/Transmission Fee

No reference found. No reference found.

Miscellaneous

Louisiana law requires that a physician who uses
telemedicine establish a proper physician-patient
relationship. Physicians must:

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STATE LAW/REGULATIONS MEDICAID PROGRAM

Verify the identity of the patient;

Conduct an appropriate exam;

Establish a proper diagnosis;

Establish a treatment plan;

Create a written plan for follow up care.

Source: LA Admin. Code 46:XLV.7509 (2012).

Comments:

Professional Board Telehealth-Specific Regulations

Louisiana Medical Board (Title 46, Part XLV, Subpart 1, Subchapter C, Ch. 75)

Speech Language Pathology and Audiology (Title 46, Part LXXV, Ch. 1).

Louisiana has specific standards for its telemedicine physicians.

Source: LA Statute Sec. 1300.381 & House Bill 1280 (2014).

Louisiana created a Task Force on Telehealth access to advise the legislature and the Department of Health and Hospitals on policies and practices that expand access to telehealth services.

Source: LA House Concurrent Resolution 88 (2014).

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