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Telemedicine and the issue of reimbursement, P.1

We have previously written about the issues of telemedicine and interstate licensing on this blog, noting that with the increasing demand for telemedicine, there is a corresponding push to make it easier for doctors to become licensed in other states. The Interstate Medical Licensure Compact, which is being adopted by an increasing amount of states, is part of the solution to the growing demand.

Another issue with telemedicine, though, is coverage and reimbursement. If insurance companies are not covering telemedicine services, this form of health care is not likely to be as widely used. Fortunately, Minnesota is among the states that have passed legislation addressing coverage for telemedicine services. In 2015, Minnesota enacted a law ensuring parity for private insurers and state employee health plans, which include dental and joint self insured plans. 

With respect to Medicaid, parity is not as extensive or as easy to obtain compared to private insurance and state-sponsored plans. Among these limitations are: attestation requirements must be met before payment can be made; distant site providers are limited to a menu set of OT, PT speech therapist and audiologist providers; there are frequency limits on all covered telemedicine services; and telepresenters are required to be on the premises in order to be reimbursed.

On the positive side of Medicaid coverage, health care providers are only required to be on the premises rather than physically with the patient during the provision of services, telemedicine is covered when provided by a licensed professional counselor or a licensed social worker, and coverage is available for services using synchronous technology and store-and-forward and remote patient monitoring in some capacity

In our next post, we’ll look a bit more at some of these points.

Source: mobihealthnews.com, “In past year, telemedicine reimbursement has gotten better, licensure worse,” Jonah Comstock, Feb. 1, 2016. 

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