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                                                                                 Center for Connected Health Policy

           Alaska


           Medicaid Program:  Alaska Medicaid

           Program Administrator:  Alaska Dept. of Health and Social Services, Division of Public Assistance

           Regional Telehealth Resource Center:
           Northwest Regional Telehealth Resource Center
                  th
           2900 12  Ave. N., Ste. 30W
           Billings, MT 59101
           (888) 662-5601
           www.nrtrc.org


            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Definition of telemedicine/telehealth
            “Telemedicine means the practice of health care    “Alaska Medicaid will pay for telemedicine services
            delivery, evaluation, diagnosis, consultation, or   delivered in the following manner:
            treatment, using the transfer of medical data through   •   Interactive method: Provider and patient interact
            audio, video, or data communications that are engaged      in ‘real time’ using video/camera and/or
            in over two or more locations between providers who        dedicated audio conference equipment.
            are physically separated from the patient or from each   •   Store-and-forward method: The provider sends
            other.”                                                    digital images, sounds, or previously recorded
                                                                       video to a consulting provider at a different
            Source: AK Admin. Code, Title 7, 12.449 (2012).            location. The consulting provider reviews the
                                                                       information and reports back his or her analysis.
                                                                   •   Self-monitoring method: The patient is
                                                                       monitored in his or her home via a telemedicine
                                                                       application, with the provider indirectly involved
                                                                       from another location.”

                                                               Source: State of AK Dept. of Health and Social Svcs., Alaska
                                                               Medical Assistance Provider Billing Manuals for Community
                                                               Behavioral Health Services, Early and Periodic Screening,
                                                               Diagnosis, and Treatment, Hospice Care, Inpatient Psychiatric
                                                               Services, Independent Laboratory Services, Appendices.
                                                               (Accessed Jan. 2014).
            Live Video Reimbursement
            (See Medicaid column)                               Alaska’s Medicaid program will reimburse for services
                                                                “provided through the use of camera, video, or
                                                                dedicated audio conference equipment on a real-time
                                                                basis”

                                                               Source: AK Admin. Code, Title 7, 110.625(a) (2012).

                                                               Alaska Medicaid will pay for a covered medical service
                                                               furnished through telemedicine application if the service
                                                               is:
                                                                   •   Covered under traditional, non-telemedicine
                                                                       methods;
                                                                   •   Provided by a treating, consulting, presenting or
                                                                       referring provider;
                                                                   •   Appropriate for provision via telemedicine

                                                               Eligible services:

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM


                                                                   •   Initial or one follow-up office visit;
                                                                   •   Consultation made to confirm diagnosis
                                                                   •   A diagnostic, therapeutic or interpretive service
                                                                   •   Psychiatric or substance abuse assessments;
                                                                   •   Individual psychotherapy or pharmacological
                                                                       management services.

                                                               Source: AK Dept of Health and Social Svcs., AK Alaska Medical
                                                               Assistance Provider Billing Manuals, Section1: Physician,
                                                               Advance Nurse Practitioner, Physician Assistant: Services,
                                                               Policies and Procedures, (Accessed Jan. 2014) & AK Admin.
                                                               Code, Title 7, 110.630 (2012).

                                                               No reimbursement for:

                                                                   •   Home and community-based waiver services;
                                                                   •   Pharmacy;
                                                                   •   Durable medical equipment;
                                                                   •   Transportation;
                                                                   •   Accommodation services;
                                                                   •   End-stage renal disease;
                                                                   •   Direct-entry midwife;
                                                                   •   Private duty nursing;
                                                                   •   Personal care assistants;
                                                                   •   Visual care, dispensing or optician services;
                                                                   •   Technological equipment and systems
                                                                       associated with telemedicine application.

                                                               Source: AK Admin. Code, Title 7, 110.635 (2012) & AK Dept of
                                                               Health and Social Svcs., AK Alaska Medical Assistance Provider
                                                               Billing Manual, Section1: Physician, Advance Nurse Practitioner,
                                                               Physician Assistant: Services, Policies and Procedures,
                                                               (Accessed Jan. 2014)

            Store and Forward Reimbursement
            (See Medicaid column)                               Alaska Medicaid will reimburse for services delivered
                                                                through store-and-forward.

                                                               Source: AK Dept. of Health and Social Svcs., Alaska Medical
                                                               Assistance Provider Billing Manual, Section1: Physician,
                                                               Advance Nurse Practitioner, Physician Assistant: Services,
                                                               Policies and Procedures, (Accessed Jan. 2014)

                                                               To be eligible for payment under store-and-forward the
                                                               service must be “provided through the transference of
                                                               digital images, sounds, or previously recorded video
                                                               from one location to another to allow a consulting
                                                               provider to obtain information, analyze it, and report
                                                               back to the referring provider.”

                                                               Source: AK Admin. Code, Title 7, 110.625(a) (2012).
            Remote Patient Monitoring Reimbursement

            (See Medicaid column)                              Alaska Medicaid will reimburse for services delivered
                                                               through self-monitoring.

                                                               Source: AK Dept of Health and Social Svcs., Alaska Medical

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                                                               Assistance Provider Billing Manual, Section1: Physician,
                                                               Advance Nurse Practitioner, Physician Assistant: Services,
                                                               Policies and Procedures, (Accessed Jan. 2014)

                                                               To be eligible for payment under self monitoring or
                                                               testing, “the services must be provided by a
                                                               telemedicine application based in the recipient’s home,
                                                               with the provider only indirectly involved in the provision
                                                               of the service.”

                                                               Source: AK Admin. Code, Title 7, 110.625(a) (2012).
            Email/Phone/FAX

            (see Medicaid column)                              No reimbursement for telephone.
                                                               No reimbursement for FAX.

                                                               Source: AK Dept. of Health and Social Svcs., Alaska Medical
                                                               Assistance Provider Billing Manual, Section1: Physician,
                                                               Advance Nurse Practitioner, Physician Assistant: Services,
                                                               Policies and Procedures,  (accessed Jan. 2014)

                                                                Reimbursement for phone, only if part of a dedicated
                                                                audio conference system.
                                                                No reimbursement for FAX.

                                                               Source: AK Admin Code, Title 7, 110.625 (2012).

            Online Prescribing
            Physicians are prohibited from prescribing medications   No reference found.
            based solely on a patient-supplied history received by
            telephone, FAX, or electronic format.

            Source: AK Admin. Code, Title 12, Sec. 40.967.

            Recently Passed Legislation (Now Effective)
            A physical examination is not necessary to prescribe
            drugs if:
               •   The prescription drug is not a controlled
                   substance or a controlled substance is
                   prescribed by a physician when an appropriate
                   licensed health care provider is present;
               •   The physician is located within the state and a
                   physician or provider is available for follow up
                   care; and
               •   The person consents to sending a copy of all
                   records.

            Source: AK Statute, Sec. 08.64.364.
            Consent
            No reference found.                                No reference found.

            Location
            No reference found.                                No reference found.
            Cross-State Licensing

            No reference found.                                No reference found.

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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Private Payers
            No reference found.                                No reference found.

            Site/Transmission Fee
            No reference found.                                The department will pay only for professional services
                                                               for a telemedicine application of service. The
                                                               department will not pay for the use of technological
                                                               equipment and systems associated with a telemedicine
                                                               application to render the service.

                                                               Source: AK Admin. Code, Title 7, 110.635(b) (2012).

                                                               Community Behavioral Health Services
                                                               The department will pay a community behavioral health
                                                               services provider for facilitation of a telemedicine
                                                               session if:
                                                                   •   The Telemedicine communication equipment is
                                                                       supplied by the provider;
                                                                   •   The electronic connection used by the treating
                                                                       provider and the recipient are established and
                                                                       maintained by the provider;
                                                                   •   The provider remains available during the
                                                                       telemedicine session to reestablish failed
                                                                       connection before the intended end of the
                                                                       telemedicine session; and
                                                                   •   The provider documents in the recipient’s
                                                                       clinical record a note summarizing the
                                                                       facilitation of each telemedicine session
                                                                       (although the facilitating provider is not required
                                                                       to document a clinical problem or treatment goal
                                                                       as these are to be documented by the treating
                                                                       provider).

                                                               This service may be rendered to the following eligible
                                                               recipients:
                                                                   •   Child or adult experiencing a substance use
                                                                       disorder or emotional disturbance
                                                                   •   Adult experiencing a serious mental illness

                                                               Source: AK Admin. Code, Title 7, 135.290.
            Miscellaneous



           Comments:    Alaska and Hawaii are the only two states with Medicare coverage of store and forward services.















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