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New Medicaid Rules Support Telemedicine

Written by S.O.

Posted on November 23, 2015 at 7:30 am


The Centers for Medicare & Medicaid Services have issued a decisive rule that collates the policies related to the responsibilities of the state Medicaid agency in practicing and supervising access to innovative methods of healthcare.

According to the rule, states are required to come up with an access-monitoring plan, so that proper access to particular health care services can be ensured. The rule further corroborates that the plan must comprise numerous points the states use to examine access to healthcare, including needs of patients, time, distance and accessibility of telemedicine.

The CMS has now made it mandatory for states to craft a complete access-monitoring plan by July 1, 2016. The rule clearly states that the plan must elaborate the method states will use to oversee adequate access of patients to a primary set of telemedicine services as a starting point. It also requires states to evaluate performance of these services after every three years. The plan would also be left open for public opinions and suggestions before submitting it for approval.

According to CMS, telemedicine is comparatively an affordable option for the provision of healthcare services that states must bring under Medicaid. It is worth mentioning here that the federal Medicaid statute does not deem telemedicine as a separate service.

So, after this rule is executed, patients would be able to access health care across state lines. This would not only improve healthcare services, but also provide patients easy access to highly talented specialists across state lines, and then get reimbursed for it. Likewise, physicians can get benefit of the plan by being reimbursed for remote patient services.

The Medicaid rule has made it obligatory for all service providers to operate telemedicine under the range of their State Practice Act. It is pertinent to note that some states require telemedicine service providers to get a license in the state where the patient is located before providing telemedicine services there.

In order to get reimbursed for Medicaid covered services, providers are also required to meet federal requirements of proficiency, affordability and excellence of healthcare. Moreover, states are supported to come up with groundbreaking payment gateways for telemedicine services. For instance, a state can reimburse the doctor or service provider at the remote location and reimburse the facility the patient used to access telemedicine.

States can also repay extra expenditures like the technical support and equipment used during the service in addition to the communication fees. These additional charges can be integrated into the service charges or billed and repaid as administrative fees. When they are billed and reimbursed independently, the cost would fall under the covered Medicaid services.

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