CAST Two

2 States Decide to Reimburse for Telemedicine

by Published On: Jul 19, 2012

Health consumers in Delaware and Michigan will get some help in paying for telemedicine visits thanks to recent legislation in both states.

Telemedicine in Delaware

As of July 1, the Delaware Medical Assistance Program will reimburse for telemedicine-delivered services provided to Delaware Medicaid clients. 

The new reimbursement plan will improve beneficiary access to behavioral health services and general health care services, including medical subspecialties not widely available in the state. Reimbursable services will include:

  • Consultations.
  • Office or outpatient visits.
  • Psychotherapy.
  • Medication management.
  • Psychiatric interview or examination.
  • Substance abuse screening and brief interventions.
  • Neurobehavioral examination.
  • End-stage renal disease services.
  • Medical nutrition therapy. 

Facilities where patients receive telemedicine services from distant care providers will receive a facility fee for the telemedicine space and equipment, according to a news release from the state government. 

These “originating sites” could be:

  • Hospitals.
  • Federally qualified health centers.
  • Skilled nursing facilities.
  • Mental health and substance abuse centers.
  • Public health clinics.
  • Programs of All-Inclusive Care for the Elderly (PACE). 

Consulting physicians will be reimbursed as if their services had been delivered face-to-face. For services to be covered, both the distant provider and the originating site must be enrolled in the Delaware Medical Assistance Program or in one of the program’s managed care organizations.

Michigan and Telemedicine

Michigan’s telemedicine bill requires private health insurance providers to recognize claims for health services delivered by telemedicine.

The telemedicine legislation was a combination of 2 House bills that passed with unanimous support in both chambers of the state Legislature. The legislation also earned the support of Blue Cross Blue Shield of Michigan, the Michigan Association of Health Plans, Priority Health and other organizations.

The new law is designed to encourage insurers to use telemedicine more often as a less costly alternative to physician visits, according to Healthcare Informatics. Basically, the law prevents insurers from requiring face-to-face contact between health care providers and patients for treatment coverage.

Michigan’s new law brings to 13 the number of states that require private-sector insurance companies to pay for telemedicine services, according to Crain’s Detroit Business. The other states are: 

  • California
  • Colorado
  • Georgia
  • Hawaii
  • Kentucky
  • Louisiana
  • Maine
  • New Hampshire
  • Oklahoma
  • Oregon
  • Texas
  • Virginia

 



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