State Telehealth Laws and Reimbursement Program Policies
The updated Spring 2019 version of “State Telehealth Laws and Reimbursement Policies” from PHI's Center for Connected Health Policy (CCHP) offers policymakers, health advocates, and other interested health care professionals the most current summary guide of telehealth-related policies, laws, and regulations for all 50 states and the District of Columbia.
This round of updates to CCHP’s “State Telehealth Laws and Reimbursement Policies ” report revealed some movement in terms of the number of states reimbursing in Medicaid for live video, store-and-forward and remote patient monitoring (RPM). As of January 2019, all fifty states and the District of Columbia are reimbursing for some service via live video in their Medicaid program when Massachusetts released Medicaid telehealth reimbursement policy on mental and behavioral health. Other states revised details within their existing telehealth reimbursement policies such as expanding reimbursement to additional provider types and/or originating sites and eliminating barriers. For example, Kansas clarified some of their policy on reimbursement for remote patient monitoring. Expanding eligible originating site lists is also a frequent policy change with 15 states and D.C. specifically stating they are allowing schools to be eligible originating sites, and 14 states allowing the home to be an eligible originating site, although certain special conditions often apply. Some states (i.e. D.C., NY, NJ and HI) have passed wide ranging laws requiring telehealth reimbursement in their Medicaid program in recent years, but the programs have yet to respond with official regulation or documentation in their Medicaid provider manuals or regulations indicating they are actively reimbursing services via telehealth.
Additionally, CCHP took note that the most common policy change since Fall 2018 was the number of states who have joined the Interstate Medical Licensure Compact, doubling from 15 to 29 states and D.C. This number does not include states who have joined other licensure compacts, which are noted within the report.
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• Fifty states and Washington, D.C. provide reimbursement for some form of live video in Medicaid fee-for-service.
• Eleven state Medicaid programs reimburse for store-and-forward. However, five additional jurisdictions (D.C., HI, MS, NJ and NY) have laws requiring Medicaid reimburse for store-and-forward but as of the creation of this edition, yet to have any official Medicaid policy indicating this is occurring.
• Twenty-one state Medicaid programs provide reimbursement for RPM. As is the case for store-and-forward, four Medicaid programs (D.C., HI, NY and NJ) have laws requiring Medicaid reimburse for RPM but at the time this report was written, did not have any official Medicaid policy. Kentucky Medicaid is also required to create an RPM pilot, but CCHP has not seen any evidence that the pilot has been established. Iowa will begin an RPM program for Medicaid managed care plans on July 1, 2019.
• Six state Medicaid programs (Alaska, Arizona, Maryland, Minnesota, Virginia and Washington) reimburse for all three, although certain limitations apply.