1 / 18

The Latest on Telehealth Coverage & Reimbursement (and It’s Good News)

The Latest on Telehealth Coverage & Reimbursement (and It’s Good News). Nancy S. Rowe Associate Director, Outreach & Public Policy Arizona Telemedicine Program. Arizona’s Telehealth Private Payer Coverage Law. Private Payer Coverage Parity Nationwide. Spring 2019: CCHP Report

paul
Télécharger la présentation

The Latest on Telehealth Coverage & Reimbursement (and It’s Good News)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Latest on Telehealth Coverage & Reimbursement(and It’s Good News) Nancy S. Rowe Associate Director, Outreach & Public Policy Arizona Telemedicine Program

  2. Arizona’s Telehealth Private Payer Coverage Law

  3. Private Payer Coverage Parity Nationwide • Spring 2019: CCHP Report • 39 states + DC have some form of coverage parity From Center for Connected Health Policy (CCHP) Spring 2019 State Telehealth Laws and Reimbursement Policies Infographic

  4. Small Steps: AZ Telehealth Parity Progression • Limited private payer coverage parity • SB 1353: Signed into law 2013; effective 1/1/15 • 7 specialties only (trauma, burn, cardiology, ID, mental health, neurologic diseases, dermatology) • Rural AZ only

  5. Small Steps: AZ Telehealth Parity Progression • “Body part by body part” … • SB 1363, signed 2016: Removes rurality & adds pulmonology effective 1/1/18 • HB 2042, signed 2018: Adds substance abuse & pain medicine effective 1/1/19; adds urology effective 1/1/20

  6. Giant Leap Forward: SB 1089 Signed into Law! • Extends mandated private payer coverage to all services that would be covered in person • Adds asynchronous & RPM • Signed April 2019 • Effective 12/31/2020 Bill sponsor Sen. Heather Carter

  7. Payment Parity: Arizona’s Next Frontier? • Only 10 states have some form of payment parity • Lack of payment parity = disincentive for providers

  8. Prelim AZ Telemedicine Uses & Barriers Survey • Sent to 20 NAZ sites; 15 responses, 11 users, 9 providers 44% 22%

  9. Medicare’s ExpandingCoverage

  10. Medicare Telehealth Restrictions • On pt. geographic location • On pt. facility type • On provider type • On covered services • On type of interaction • On FQHCs

  11. Medicare Telehealth Good News • Payment parity • Facility fee • 2 new codes added • Restrictions lifted for certainservices…

  12. CMS: Expanding Medicare Coverage • Not “telehealth”: • Always: Traditional S&F • New: RPM codes • New: 3 “Communication technology-based services”

  13. CONGRESS: Expanding Medicare Coverage • Removed geographic restriction & allowed pt. home for SUD starting 7/1/19 • Removed geographic restriction & expanded allowed facilities for telestroke & ESRD starting 1/1/19 • MA Plans can offer expanded coverage not subject to geographic restriction starting 2020

  14. CONGRESS: New Telehealth Bills, May 2019 • HR 2508: pilot program to include respiratory therapists as telehealth practitioners under Medicare for COPD • S 1618: grants & TA to support ECHO models, distance ed.

  15. Medicaid Updates

  16. Medicaid Overview • 50 states + DC reimburse for live video telemedicine • 11 states reimburse for S&F services • 21 states reimburse for RPM • 34 states pay a transmission or facility fee • 14 states explicitly allow the pt. home to be an eligible originating site under certain circumstances Stats from CCHP 50 State Telehealth Laws & Reimbursement Policies Report Spring 2019 Edition, S&F map from CCHP Key Findings Infographic Spring 2019

  17. AHCCCS ? • Limited services covered • Limited S&F, limited RPM • Limited provider types • Consent required • Telehealth policies not consistent • Being updated!!

  18. Thank you!Questions?Arizona Telemedicine Program: https://telemedicine.Arizona.edunrowe@telemedicine.arizona.edu

More Related