LinkedIn Newsletter: Telehealth and Virtual Care Updates by State

As the year begins to wind down, states are embracing new ways to expand access to care. From creating new reimbursement options in schools to streamlining licensure processes to optometry going virtual, there is a lot to unpack this week.

On another note: Carrie Nixon and Kaitlyn O'Connor will be attending ATA EDGE from December 11-13th. Will we see you there?

Now, let's get on with the updates!

Oregon

Allows for Reimbursement for School-Based Health Services (SBHS) delivered via Telehealth

TLDR: Effective September 6, 2024, the Oregon Health Authority implemented a new rule that will allow it to reimburse school medical providers for providing covered School-Based Health Services (SBHS) via telehealth under the state’s Medicaid program. Such services will be reimbursed at the same rate as if they were provided in person.? To qualify, the service provided via telehealth must be equivalent to the same extent as if it were provided in person; consent for telehealth delivery of care must be obtained and documented from the child, young adult, and their parent/legal guardian; and the provider must determine that the child or young adult can access and participate in telehealth. HIPAA and relevant privacy and confidentiality terms apply. The Oregon Health Authority may waive encryption requirements for telehealth SBHS in the event of a national or state declaration of emergency.

Key Takeaways

• ?As of September 6, 2024, Oregon will now reimburse medical providers for telehealth delivery of School-Based Health Services under the state’s Medicaid program at the same rate as if the SBHS was provided in person..
• For more details about conditions for the delivery of telehealth SBHS in Oregon, click here.

Kansas

Adopts Interstate Social Work Licensure Compact

TLDR: As of July 1, 2024, Kansas has adopted the interstate Social Work Licensure Compact.? When fully implemented, this will enable licensed social workers in Kansas who apply for a multi-state license under the Compact to practice in other Compact states. It will also allow licensed social workers in other Compact states to practice in Kansas without needing to apply for a state-specific license. The Compact explicitly encourages the use of telehealth to improve access to social work services.?

Key Takeaways

• Under the Compact, licensed social workers who apply for a multi-state compact license are authorized to practice in any other compact member state without any additional licensing requirements via telehealth under a privilege to practice.?
• Check out the provisions of the legislation adopting the Compact here.

Oklahoma

Adopts Telemedicine for Optometry Care

TLDR: Effective July 25, 2024, OK implemented a rule that allows for the practice of optometry via telemedicine only after a doctor-patient relationship has been formed via a comprehensive in-person visual examination. The doctor-patient relationship cannot be formed via telehealth alone. All optometrists treating patients in OK via telemedicine must be fully licensed to practice in OK, and patients must provide informed consent.

Key Takeaways

• OK allows for the practice of optometry via telemedicine, but views telemedicine as only a tool and requires that the same standards of care apply to both in-person and telemedicine care.
• Check out the full provisions here.

CMS

Allows Home Health Agencies to Submit Claims for Telehealth Services that Overlap with an Inpatient Stay

TLDR: On October 10, 2024, CMS issued a Change Request (CR 13812) and Medicare Learning Network Article (MLN 13812) announcing that effective April 1, 2025, home health agencies will be able to submit claims for telehealth G Codes (G0320, G0321, and G0322) when they overlap with inpatient, skilled nursing, or swing bed claims. Currently, CMS automatically rejects any home health claims that are billed during dates that overlap with an inpatient stay, including telehealth G codes. However, CMS has recognized that home health agencies often utilize telehealth services to maintain contact and continuity of care with caregivers even while a beneficiary is an inpatient to meet home health agency CMS reporting requirements. The submission of telehealth G Codes therefore should not be rejected outright, and are non-payable reporting items, so there is no risk of duplicative payments. As such, CMS will accept such claims and allow for the resubmission of revised claims that were previously rejected.?

Key Takeaways

• ?CMS will not automatically reject telehealth claims from home health agencies that overlap with an inpatient stay.
• This is in line with CMS’s greater interest in expanding billing flexibility to better understand home health agency use of telehealth.

?Click here to check out the CMS MLN 13812.