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                                                                                 Center for Connected Health Policy

           Mississippi


           Medicaid Program: Mississippi Medicaid

           Program Administrator: Mississippi Division of Medicaid

           Regional Telehealth Resource Center:
           South Central Telehealth Resource Center
           4301 W. Markham St. #519
           Little Rock, AR 72205
           (855) 664-3450
           learntelehealth.org


            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Definition of telemedicine/telehealth
            “Telemedicine is the practice of medicine using    No reference found.
            electronic communication, information technology or
            other means between a physician in one location and a
            patient in another location with or without an intervening
            health care provider. This definition does not include the
            practice of medicine through postal or courier services.”

            Source: Code of MS Rules 50-013-2635 (2012).

            Telemedicine means the delivery of health care services
            such as diagnosis, consultation, or treatment through
            the use of interactive audio, video or other electronic
            media.  Telemedicine must be “real-time” consultation,
            and it does not include the use of audio-only telephone,
            e-mail or facsimile.

            Source: MS Code Sec. 83-9-351.
            Live Video Reimbursement

            Mississippi Medicaid and private payers are required to   There is live video reimbursement for Medicaid mental
            provide coverage for live video consultations.     health medication evaluation and management.

            Source: MS Code Sec. 83-9-351.                     Source: Code of MS Rules 23-206, Rule. 1.9, pg. 28.

            (also see Medicaid column)
            Store and Forward Reimbursement
            Private payers, MS Medicaid and employee benefit   There is reimbursement for tele-radiology services,
            plans are required to provide coverage at the same level  however there is no reference to reimbursing for other
            as in-person consultation for store-and-forward    specialties.
            telemedicine services.
                                                               Source: MS Code Ann. 23-220, Rule 1.4, pg. 6 & Mississippi
            A health insurance or employee benefit plan can limit   Division of Medicaid. Radiology Services Provider Reference
            coverage to health care providers in a telemedicine   Guide, pg. 4-5. March 2013.

            network approved by the plan.                      MS Medicaid is required to cover store and forward
                                                               services to the same level as in-person services.
            Patients receiving medical care through store and
            forward must be notified of their right to receive   Source: MS Code Sec. 83-9-353.
            interactive communication with the distant site provider.


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM

            Telemedicine networks unable to offer this will not be   (see State law/regulation column)
            reimbursed for store and forward telemedicine services.

            Source: MS Code Sec. 83-9-353.                     Source: MS Senate Bill 2646.

            Remote Patient Monitoring Reimbursement

            Private payers, MS Medicaid and employee benefit   MS Medicaid is required to cover remote patient
            plans are required to provide coverage for remote   monitoring services. (see State law/regulation column)
            patient monitoring services for Mississippi-based
            telehealth programs affiliated with a Mississippi health   Source: MS Code Sec. 83-9-353.
            care facility.

            A onetime telehealth installation/training fee is also
            reimbursed.

            A health insurance or employee benefit plan can limit
            coverage to health care providers in a telemedicine
            network approved by the plan.

            To qualify for reimbursement patients must meet all of
            the following criteria:
                 •   Be diagnosed in the last 18 months with one
                     or more chronic condition, as defined by CMS.
                 •   Have a recent history of costly services; and
                 •   The patient’s healthcare provider recommends
                     disease management services via remote
                     patient monitoring.

            Remote patient monitoring prior authorization request
            form must be submitted to request telemonitoring
            services.

            The law lists specific technology requirements.

            Source: MS Code Sec. 83-9-353.

            Email/Phone/FAX
            No Email                                           No reference found.
            No Phone
            No Fax

            Source: MS Code Sec. 83-9-351.
            Online Prescribing
             A prescription for a controlled substance based solely   An e-prescribed, telephoned or faxed prescription from
             on a consumer's completion of an online medical    the prescriber may be accepted when it is not in conflict
             questionnaire is not a valid prescription.         with federal and state laws and regulations.

             Source: MS Code Annotated Sec. 41-29-137 (2012).   Source:  MS. Code Ann.23-214, Rule 1.7 & Mississippi Medicaid
                                                                Provider Reference Guide, Pharmacy Services, Jul. 2014, pg. 29.
             A health care practitioner may prescribe medication
             after an appropriate examination through the use of
             instrumentation and diagnostic equipment through
             which images and medical records may be transmitted
             electronically.


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM


             Source: MS Code Sec. 83-9-351.
            Consent

            The physician should obtain the patient's informed   No reference found.
            consent before providing care.

            Source: Code of MS Rules 50-013-2635 (2012).
            Location

            No reference found.                                No reference found.
            Cross-State Licensing
            Physicians practicing telemedicine must have a     No reference found.
            Mississippi medical license.

            However, a valid Mississippi license is not required
            where the evaluation, treatment and/or medicine given
            by a physician outside of Mississippi is requested by a
            physician duly licensed to practice medicine in
            Mississippi, and the physician who has requested such
            evaluation, treatment and/or medical opinion has
            already established a doctor/patient relationship with the
            patient to be evaluated and/or treated.

            In order to practice telemedicine a valid "physician
            patient relationship" must be established. The elements
            of this valid relationship are:

               1.  verify that the person requesting the medical
                   treatment is in fact who they claim to be;
               2.  conducting an appropriate examination of the
                   patient that meets the applicable standard of
                   care;
               3.  establishing a diagnosis through the use of
                   accepted medical practices, i.e., a patient
                   history, mental status exam, physical exam and
                   appropriate diagnostic and laboratory testing;
               4.  discussing with the patient the diagnosis, risks
                   and benefits of various treatment options to
                   obtain informed consent;
               5.  insuring the availability of appropriate follow-up
                   care; and
               6.  maintaining a complete medical record available
                   to patient and other treating health care
                   providers.

            Source: Code of MS Rules 50-013-2635 (2012).
            Private Payers

            Health insurance plans must provide coverage for   No reference found.
            telemedicine services to the same extent as in-person
            consultations.

            Source: MS Code Sec. 83-9-351.


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                                                                                 Center for Connected Health Policy

            STATE LAW/REGULATIONS                              MEDICAID PROGRAM


            Health insurance plans are also required to provide
            coverage for store-and-forward and remote patient
            monitoring services, in accordance with certain
            requirements (see above store and forward & remote
            patient monitoring sections).

            Source: MS Source: MS Code Sec. 83-9-353.

            Site/Transmission Fee
            The originating site is eligible to receive a facility fee.   No reference found.

            Source: MS Code Sec. 83-9-351 MS Source: MS Code Sec. 83-9-

            353.
            Miscellaneous

            To practice telemedicine, physicians must establish a
            valid physician-patient relationship by the following:

               •   Verifying the identity of the patient;
               •   Conducting an appropriate exam that meets the
                   applicable standard of care. This exam need not
                   be in person if the technology is sufficient to
                   provide the same information to the physician as
                   if the exam had been performed face to face;
               •   Establishing a diagnosis;
               •   Discussing with the patient the diagnosis, and
                   the risks and benefits of various treatment
                   options, to obtain informed consent;
               •   Insuring the availability of appropriate follow-up
                   care;
               •   Maintaining a complete medical record.

            Source: Code of MS Rules 50-013-2635 (2012).

            A health insurance plan may limit coverage to health
            care providers in a telemedicine network approved by
            the plan.

            Source: MS Code Sec. 83-9-351.
























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