Page 77 50 State Telemedicine Gaps Analysis Coverage and Reimbursement

50 State Telemedicine Gaps Analysis: Coverage & Reimbursement

Telemedicine in

Washington

PARITY:
Private Insurance C  Washington’s parity law was enacted in
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Medicaid B 2015 and provides coverage for all
State Employee Health Plan C essential health benefits offered by

MEDICAID SERVICE private insurance, state employee health
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COVERAGE & CONDITIONS plans, and Medicaid managed care.
OF PAYMENT:
Patient Setting C Medicaid
 The new parity law which goes into
Eligible Technologies C effect 2017 will impact Medicaid
Distance or Geography A managed care and not FFS plan
Restrictions offerings.
Eligible Providers C  New SPA approved by CMS adds the
Physician-provided B home and school to list of eligible
Services originating sites. It also expands the list
Mental/behavioral Health B of providers who may render services
Services including dentists and a number of
Rehabilitation F mental and behavioral health providers.
Home Health C The Medicaid program manual has not
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Informed Consent F been updated to reflect this emergency
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rulemaking.
Telepresenter A  Medicaid restrictions on covered
INNOVATIVE PAYMENT services and designates eligible distant
OR SERVICE DELIVERY site providers as a condition of payment.
MODELS: However Washington is 1 of 3 states
State-wide Network that covers services provided by
Medicaid Managed Care ✔ behavioral analysts which are critical to
Medicare-Medicaid Dual the treatment of autism spectrum
Eligibles disorders. The regulations were
Health Home amended earlier this year to allow this
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expansion.

HCBS Waiver  Coverage for interactive audio-video as
Corrections and RPM under the home health
Other benefit. 234

 Written informed consent required.

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American Telemedicine Association
2015