Page 78 50 State Telemedicine Gaps Analysis Coverage and Reimbursement
P. 78
50 State Telemedicine Gaps Analysis: Coverage & Reimbursement
Telemedicine in
West Virginia
PARITY:
Private Insurance F WV is bordered by 2 states with
Medicaid F private insurance parity laws:
237
State Employee Health Plan F Kentucky and Virginia. No parity
MEDICAID SERVICE legislation introduced in 2015.
COVERAGE & CONDITIONS
OF PAYMENT: Medicaid
Patient Setting C Coverage is limited to originating
Eligible Technologies F sites located in non-metropolitan
Distance or Geography C professional shortage areas for
Restrictions services listed under the physician
Eligible Providers C benefit. This restriction does not
Physician-provided B apply to telemedicine services
provided under the mental and
Services behavioral health benefit. In fact WV
Mental/behavioral Health A Medicaid encourages providers to use
Services 238-239 telemedicine to enhance access to
Rehabilitation F mental and behavioral health
Home Health F services.
Informed Consent B Coverage for interactive audio-video
Telepresenter B only.
INNOVATIVE PAYMENT Managed care plan covers weight
OR SERVICE DELIVERY management services including
MODELS: preventative medicine counseling and
State-wide Network individual and group exercise classes
240
Medicaid Managed Care ✔ with nutritional counseling. Only
Medicare-Medicaid Dual state to allow exercise physiologists
Eligibles and certified trainers as eligible
Health Home ✔ distant site providers.
HCBS Waiver Requires telepresenter on patient site
Corrections premises and unspecified form of
Other consent only for behavioral health
services.
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American Telemedicine Association
2015
