Oklahoma State Telehealth Laws and Reimbursement Policies

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Information Provided ByCenter for Connected Health Policy

© Public Health Institute/ Center for
Connected Health Policy 2019: http://cchpca.org

Oklahoma SoonerCare

Oklahoma

Medicaid Program: SoonerCare

Medicaid Program Administrator: Oklahoma Health Care Authority

Regional Telehealth Resource Center:

Heartland Telehealth Resource Center
3901 Rainbow Blvd MS 1048
Kansas City, KS 66160

(877) 643-4872
heartlandtrc.org

STATE LAW/REGULATIONS MEDICAID PROGRAM

Definition of telemedicine/telehealth

“Telemedicine means the practice of health care delivery, diagnosis, consultation, treatment, including but not limited to, the treatment and prevention of strokes, transfer of medical data, or exchange of medical education information by means of audio, video, or data communications. Telemedicine is not a consultation provided by telephone or facsimile machine.”

Source: OK Statutes, Title 36, Sec. 6802.

Telemedicine means the practice of health care delivery, diagnosis, consultation, evaluation and treatment, transfer of medical data or exchange of medical education information by means of a two-way, real-time interactive communication, not to exclude store and forward technologies, between a patient and a physician with access to and reviewing the patient’s relevant clinical information prior to the telemedicine visit.

Source: Title 59, Sec. 478.

“Telemedicine means the practice of health care delivery, diagnosis, consultation, treatment, including but not limited to, the treatment and prevention of strokes, transfer of medical data, or exchange of medical education information by means of audio, video, or data communications. Telemedicine is not a consultation provided by telephone, facsimile machine nor does it include administrative applications such as billing, contracted services, security systems, etc.”

This definition excludes phone or Internet contact or prescribing and other forms of communication, such as web-based video, that might occur between parties that does not meet the equipment requirements as specified in OAC 435:10-7-13 and therefore requires an actual face-to-face encounter.

Source: OK Admin Code Title 435:10-1-4

For purposes of SoonerCare reimbursement telemedicine is the use of interactive audio, video or other electronic media for the purpose of diagnosis, consultation or treatment that occur in real-time and when the member is actively participating during the transmission.

Source: OK Admin. Code Sec. 317:30-3-27 (a) & Health Care Authority, Providers, Telehealth. (accessed Oct. 2017)

Telehealth means the mode of delivering healthcare services via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management and self-management of patients, at a distance from health care providers.

OK Admin. Code Sec. 317:30-3-27 (a)

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STATE LAW/REGULATIONS MEDICAID PROGRAM

Telemedicine uses audio and video multimedia

telecommunication equipment which permits two-way
real-time communication between a health care
practitioner and a patient who are not in the same
physical location.

Source: OK Statute, Title 22, Sec. 1161.1.

Telepractice means the use of audio, video or data

communication to provide speech-language pathology
and audiology services to clients who are not present at
the same site as the licensee when the service is
provided.

Source: OK Admin Code, 690:10-3-9.

Live Video Reimbursement

Oklahoma statute requires coverage of telemedicine services, which includes live video, by health care service plans, disability insurer programs, workers’ compensation programs, and state Medicaid managed care program contracts.

Source: OK Statute, Title 36 Sec. 6803.

(see Medicaid column & “Private Payers” section)

SoonerCare (Oklahoma’s Medicaid program)

reimburses for live video when:

The GT modifier is billed

Proper documentation to include services rendered, location and services provided via telemedicine is maintained

OHCA has discretion and final authority to approve or deny telehealth services based on agency and/or SoonerCare members’ needs.

See Medicaid Telehealth webpage for full list of eligible CPT Codes for Medical and Behavioral Health Services.

Source: OK Admin. Code Sec. 317:30-3-27 & Health Care Authority, Providers, Telehealth (accessed Oct. 2017).

Office and outpatient visits count toward benefit limits.

Source: OK Statute, Title 36 Sec. 6803.

Store and Forward Reimbursement

(see Medicaid column) Health care services delivered by telehealth such as
remote patient monitoring, store and forward, or any
other telehealth technology must be compensable by
OHCA in order to be reimbursed.
Source: OK Admin. Code Sec. 317:30-3-27.

Remote Patient Monitoring Reimbursement

No reference found. Health care services delivered by telehealth such as
remote patient monitoring, store and forward, or any
other telehealth technology must be compensable by
OHCA in order to be reimbursed.
Source: OK Admin. Code Sec. 317:30-3-27.

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

Email/Phone/FAX

No reference found for email. No reimbursement for email.
No reimbursement for telephone. No reimbursement for telephone.
No reimbursement for FAX. No reimbursement for FAX.
Source: OK Statute, Title 36 St. Sec. 6802. Source: OK Admin. Code Sec. 317:30-3-27(a).

Online Prescribing

Recently Passed Legislation (Now Effective) No reference found.
A physician-patient relationship can be established,
provided that a physician:
Holds a license to practice medicine in this
state;
Confirms the patient’s identity; and
Provides the patient with the treating
physician’s identity and professional
credentials.
Telemedicine encounters involving store and forward
technology shall not be used to establish a valid
physician-patient relationship for purpose of prescribing
opiates, synthetic opiates, semisynthetic opiates,
benzodiazepine or carisprodol, but may be used to
prescribe opioid antagonists or partial agonists.
The relationship shall not be based solely on the receipt
of patient health information by a physician.
Source: Title 59, Sec. 478.
Telemedicine physicians who meet certain criteria are
not subject to the face-to-face requirement to establish
a physician-patient relationship.
Source: OK Admin. Code Sec. 435:10-7-12.
Prescribing or administering a drug or treatment without
sufficient examination and the establishment of a valid
physician-patient relationship is prohibited.
Source: OK Statute, Title 59, Sec. 509.
A physician-patient relationship includes an in-person
patient exam.
Source: OK Admin. Code Sec. 435:10-1-4.

Consent

(See Medicaid column) No reference found.

Location

No reference found. A patient may receive telehealth services outside of
Oklahoma when medically necessary. Out of state
providers must comply with all laws and regulations of
the provider’s location, including health care and

© 2017 Public Health Institute Center for Connected Health Policy

STATE LAW/REGULATIONS MEDICAID PROGRAM

telemedicine requirements.
Source: Health Care Authority, Providers, Telehealth & OK
Admin. Code Sec. 317:30-3-27. (Accessed Oct. 2017).

Cross-State Licensing

Physician treating patients in OK through telemedicine No reference found.
must be fully licensed in OK.
Source: OK Admin Code Title 435:10-1-4.
The State Board of Osteopathic Examiners has the
authority to issue a telemedicine license.
Source: OK Statute, Title 59, Sec. 633

Private Payers

Requires coverage of telemedicine services by health No reference found.
care service plans, disability insurer programs, workers’
compensation programs, and state Medicaid managed
care program contracts, subject to contract terms and
conditions.
Source: OK Statute, Title 36 Sec. 6803.

Site/Transmission Fee

No reference found. No reference found.

Miscellaneous

OK provides, at no cost, one telecommunications line or
wireless connection for telemedicine services to the
following:
Not-for-profit hospitals;
County health departments;
City-county health departments;
Federally Qualified Health Centers.
Source: OK Statutes, Title 17 Sec. 139.109.

Comments: The OK Dept. of Health has begun to develop a statewide telemedicine network.

Oklahoma Statutes, Title 63 Sec. 1-2702.

Professional Board Telehealth-Specific Regulations

State Board of Medical Licensure and Supervision (OAC 435:10-11-13)

State Board of Examiners for Speech-Language Pathology and Audiology (OAC 690:10-3-9)

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