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* Telemedicine Facts, 2nd Edition
TELEMEDICINE FACTS, 2ND EDITION
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eBook $199.00
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Telemedicine Facts provides an in-depth look at the administrative and
regulatory requirements for telemedicine operations in government health
insurance programs (Medicare/Medicaid) and private health insurance plans. Due
to the onset of the COVID-19 pandemic, healthcare providers rapidly shifted to
adoption of telemedicine options. Even with some lessening of the pandemic,
telemedicine remains an important part of American health coverage and likely
will remain so well into the future.
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Details
Key topics include:
* How telemedicine works
* Advantages of telemedicine vs in-person healthcare
* Different types of telemedicine (store-and-forward, remote patient
monitoring, etc.)
* Covid-19's effect on telemedicine
* Telemedicine's relationship with Medicare and Medicaid
* State-by-state analysis of telehealth services available, restrictions on
each service, and billing codes by state
New in this 2nd edition:
* Live Video Medicaid Reimbursement – 50 states and District of Columbia
Live video is the most common type of telehealth and the most predominantly
reimbursed. Every state offers some type of live video reimbursement in their
Medicaid program. The reimbursement varies with some Medicaid programs,
limiting the types of reimbursable services and placing additional
requirements and restrictions such as provider type and originating site
stipulations.
* Store-and-Forward Medicaid Reimbursement – 22 states
Store-and-forward services are covered for reimbursement by twenty-two
Medicaid Programs. Some states cover only teleradiology, and they are not
included in this count. Of those covering "store-and-forward," many limit
what is considered reimbursable. Some states allow store-and-forward
reimbursement because of communication technology-based services (CBTS), some
of which include the store-and-forward modality in its description.
* Remote Patient Monitoring Medicaid Reimbursement – 27 states
Twenty-seven states offer some type of reimbursement for RPM in their
Medicaid programs. The states that offer RPM reimbursement generally include
several restrictions for using RPM. Often seen are restrictions offering
reimbursement to home health agencies, restricting the clinical conditions
for which symptoms can be monitored, and imposing limits on the type of
monitoring device and information that can be collected. Ohio allows
reimbursement only for specific remote physiologic monitoring codes modeled
after CMS reimbursement.
* Transmission & Facility Fees
Thirty-four states will reimburse for either a transmission, facility fee, or
both.
* Telephone Medicaid Reimbursement – 22 states
Telephone use reimbursement is allowed in twenty-two states for some Medicaid
treatments. While it varies between states, generally they reimburse specific
specialties such as mental health treatment or case management. Three states
allow Medicare reimbursement for audio-only interaction.
* Facility Originating Site Restrictions -16 states
Sixteen states restrict the "site of origin" that is covered, with several of
them not allowing the home as a reimbursable site. Jurisdictions have a
formal list of sites that can serve as the originating site for a telehealth
encounter.
* Home Services – 30 states and District of Columbia
Thirty states and the District of Columbia allow reimbursement of services
from the home. Twenty-nine states allow reimbursement from school-based
settings.
* Private Payer Laws – 43 states and the District of Columbia
Forty-three states and DC have laws that govern private payer telehealth
reimbursement policies. This area has experienced incredible growth over the
past few years.
* Consent Requirements – 45 states and the District of Columbia
Forty-five jurisdictions require a type of informed consent requirement to
allow telemedicine services. What is covered often varies by state with some
regulating all Medicaid service, all telehealth in general, or designated
areas of treatment.
Additional Information
Additional Information SKU 3180022B Publication Date May 6, 2022 ISBN
978-1-954096-47-9 Page Count 0 Author Michael D. Thomas, J.D. Edition 2nd
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Table Of Contents
Author Info
Michael D. Thomas, J.D.
Michael D. Thomas, is an author and consultant and has served as the Manager of
Online Product Development and as a Senior Editor with the National Underwriter
Company, a division of ALM Media. In addition, Mike has served as a consultant
to the State of Ohio Department of Medicaid and as a writer for “The Digital
Broker Podcast”, which focuses on insurance technology and operations. Mike
currently works with a major commercial healthcare insurance company and
provider of Medicare and Medicaid services. In addition to authoring 2021
Healthcare Reform Facts, Mike has also authored 2021 Social Security & Medicare
Facts, and has been responsible for the editorial process and development of
other healthcare and insurance publications including Advisor’s Guide to Long
Term Care 2nd Edition, Social Security & Medicare Facts, ERISA Facts, and Health
Savings Accounts Facts for The National Underwriter Company as well as
designing, implementing, and managing the NUPro Healthcare Reform online
service. Mike has also authored numerous articles on healthcare reform, Social
Security, Medicare and Insurance issues. He has developed, hosted, and taught
webinars on Healthcare Reform and Social Security, including “The Affordable
Care Act and the Employer Mandate”, “The Affordable Care Act and the Cadillac
Tax – Use the Delay for Your Advantage!”, “How to Successfully Navigate the
Latest Changes to the Affordable Care Act”, and “The Impact of Social Security
on Retirement Plans”.
Prior to joining National Underwriter, Mike spent over twenty-five years with
LexisNexis®, where he was responsible for the editorial content and new product
development of new online and traditional legal products, including Health Law,
Insurance Law, Social Security Law, Labor & Employment Law, Family Law, as well
as other legal research tools. In addition, he worked as a Field Agent for
Knights of Columbus Insurance specializing in life, health, disability income,
long-term care insurance as well as annuity sales.
Mike has a Bachelor of Arts from Tufts University and a Juris Doctorate from the
University of Dayton.
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