Page 27 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Scale – Medicaid:
Telepresenter
A 3 points
B 2 points
C 1 point
F 0 points

Figure 16

Alabama, Georgia, Iowa, Maryland, Minnesota, Missouri, New Jersey, North Carolina, and West
Virginia only require a health care provider to be on the premises and not physically with the
patient during a telemedicine encounter (Figure 16). Nevada and Utah improved their grade to
an ‘A’ by removing this arbitrary requirement. Although Connecticut and Rhode Island have no
telemedicine coverage under Medicaid, their Medical Boards do not require a telepresenter for
telemedicine related services.

Innovative Payment or Service Delivery Models

This report also includes a category to capture innovative payment and service delivery models
implemented in each state. In addition to state supported networks in specialty care and
correctional health, the report identifies a few federally subsidized programs and waivers that
states have leveraged to enhance access to health care services using telemedicine.

Over the years, states have increasingly used managed care organizations (MCOs) to create
payment and delivery models involving capitated payments to provide better access to care and
follow-up for patients, and also to control costs. The variety of payment methods and other
operational details among Medicaid managed care arrangements is a useful laboratory for

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American Telemedicine Association
2015