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                                                                                 Center for Connected Health Policy

           Michigan


           Medicaid Program: Michigan Medicaid

           Program Administrator: Michigan Dept. of Community Health

           Regional Telehealth Resource Center:
           Upper Midwest Telehealth Resource Center
           2901 Ohio Boulevard, Ste. 110
           Terre Haute, IN 47803
           (855) 283-3734 ext. 232
           www.umtrc.org

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM
            Definition of telemedicine/telehealth

            ”Telemedicine means the use of an electronic media to   “Telemedicine is the use of telecommunication
            link patients with health care professionals in different   technology to connect a patient with a health care
            locations. To be considered telemedicine, the health   professional in a different location.”
            care professional must be able to examine the patient
            via a real-time, interactive audio or video, or both,   Source: MI Dept. of Community Health, Medicaid Provider
            telecommunications system, and the patient must be   Manual, p. 1466 (Jan. 1, 2015) & MI Department of Community
            able to interact with the off-site health care professional   Health Bulletin Telemedicine. Aug. 30, 2013.
            at the time the services are provided.”

            Source: MI Compiled Law Svcs. Sec. 500.3476 (2012).
            Live Video Reimbursement
            Michigan law states that “contracts shall not require   Michigan Medicaid reimburses for the following services
            face-to-face contact between a health care professional  categories via live video:
            and a patient for services appropriately provided through
            telemedicine”, which includes live video.              •   Inpatient Consults;
                                                                   •   Office or other outpatient consults
            Source: MI Compiled Law Services Sec. 500.3476 (2012).   •   Office or other outpatient services

            (See “Private Payers” section).                        •   Psychiatric diagnostic procedures
                                                                   •   Subsequent hospital care
                                                                   •   Telehealth
                                                                   •   Training services, diabetes
                                                                   •   Pharmacological management;
                                                                   •   End stage renal disease (ESRD) related
                                                                       services. However, there must be at least one
                                                                       in-person visit per month, by a physician, nurse
                                                                       practitioner, or physician’s assistant, to examine
                                                                       the vascular site for ESRD services.
                                                                   •   Behavior change intervention, individual
                                                                   •   Behavior health and/or substance abuse
                                                                       treatment services
                                                                   •   Education service, telehealth
                                                                   •   Nursing facility subsequent care

                                                               The initial visit for nursing facility services must be face-
                                                               to-face.

                                                               Where face-to-face visits are required, telemedicine
                                                               services may be used in addition to the required face-to-


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                                                               face visit, but cannot be used as a substitute.

                                                               The following health professionals may provide
                                                               telemedicine services:
                                                                   •   Physician;
                                                                   •   Osteopath;
                                                                   •   Podiatrist;
                                                                   •   Nurse practitioner;
                                                                   •   Nurse midwife;
                                                                   •   Physician’s assistant;
                                                                   •   Clinical Psychologist;
                                                                   •   Clinical Social Worker;
                                                                   •   Clinical nurse specialist

                                                               Source: Dept. of Community Health, Medicaid Provider Manual, p.
                                                               1466-68 (Jan. 1, 2015) & MI Department of Community Health
                                                               Bulletin Telemedicine. Aug. 30, 2013.
            Store and Forward Reimbursement

            No reimbursement based upon definition of          Michigan Medicaid does not reimburse for store and
            “telemedicine” which describes telemedicine as     forward based upon the definition of telemedicine which
            occurring in “real time.                           describes telemedicine as occurring in “real time” and
                                                               the patient’s ability to see and interact with the “off-site”
            Source: MI Compiled Law Svcs. Sec. 500.3476 (2012).   practitioner at the time services are being provided.

                                                               Source: Dept. of Community Health, Medicaid Provider Manual, p.
                                                               1466 (Jan. 1, 2015).
            Remote Patient Monitoring Reimbursement

            No reference found.                                No reference found.
            Email/Phone/FAX Restrictions

            No reference found.                                No reference found.
            Online Prescribing
            Providers must have an existing physician-patient   No reference found.
            relationship.

            Source: MI Compiled Laws Sec. 333.17751 (2012).
            Consent
            No reference found.                                No reference found.

            Location
            No reference found.                                Eligible originating sites:

                                                                   •   County mental health clinics or publicly funded
                                                                       mental health facilities;
                                                                   •   Federally Qualified Health Centers;
                                                                   •   Hospitals (inpatient, outpatient, or Critical
                                                                       Access Hospitals);
                                                                   •   Physician or other providers’ offices, including
                                                                       medical clinics;
                                                                   •   Hospital-based or CAH-based Renal Dialysis


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

                                                                       Centers;
                                                                   •   Rural Health Clinics;
                                                                   •   Skilled nursing facilities;
                                                                   •   Tribal Health Centers.

                                                               Source: MI Dept. of Community Health, Medicaid Provider
                                                               Manual, p. 1467 (Jan. 1, 2015) & MI Department of Community
                                                               Health Bulletin Telemedicine. Aug. 30, 2013.
            Cross-State Licensing
            No reference found.                                No reference found.
            Private Payers

            Contracts shall not require face-to-face contact between  No reference found.
            a health care professional and a patient for services
            appropriately provided through telemedicine, as
            determined by the insurer or health maintenance
            organization. Telemedicine services shall be provided by
            a health care professional who is licensed, registered, or
            otherwise authorized to engage in his or her health care
            profession in the state where the patient is located.
            Telemedicine services are subject to all terms and
            conditions of the contract.

            Source: MI Compiled Law Services Sec. 500.3476 (2012).
            Site/Transmission Fee
            No reference found.                                Originating site may bill for a facility fee.

                                                               Source: Dept. of Community Health, Medicaid Provider Manual, p.
                                                               1467 (Jan. 1, 2015).
            Miscellaneous

                                                               No reimbursement for remote access for surgical
                                                               procedures, and use of robotics.

                                                               Source: Dept. of Community Health, Medicaid Provider Manual, p.
                                                               1466 (Jan. 1, 2015).


























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