Bills to Help Telehealth & Telemedicine

Legislation (S4023-2013) was recently introduced in the New York Senate to develop and provide telehealth and telemedicine services in the state and also establish telehealth and telemedicine development research grants.

The purpose of this bill is to expand and improve telehealth and telemedicine programs in communities across the state and develop an integrated telecommunications system. Congress has recognized the benefits to providing essential services but the issues related to telehealth and telemedicine are more complex at the state level because each state has the authority to set its own requirements for licensure and credentialing, as well as different rules for insurance and Medicaid programs.

The legislation would enact the “New York State Telehealth/Telemedicine Development Act” to coordinate and focus state policy and program planning directly for telehealth and telemedicine. Section 2799-u would establish a telehealth/telemedicine development program to coordinate state administrative responsibilities and planning efforts relative to telehealth and telemedicine.

The legislation would require that an annual plan be submitted to the governor and legislature that would include recommendations for legislation, information on budgetary support, identify barriers to providing telehealth/telemedicine, and an overview on relevant research being conducted.

Section 2799-v would authorize funding  and grants to go to eligible providers to develop telehealth/telemedicine services in underserved geographic areas in the state where it is determined that the  telehealth and telemedicine services would improve patient access and the quality of care for New York residents.

In other state actions, Utah has put in place rule (R414-42) governing the provision for providing telehealth home health services in the state. The rule has been in effect as of February 1, 2013. The rule outlines eligibility, access requirements, coverage, limitations, and reimbursement for telehealth home health services.

To qualify for telehealth home health services, the recipient must be eligible for Medicaid coverage, require medical monitoring for diabetes, and be willing and able to use the technology required to deliver the service.

A home health agency is able to provide telehealth services if the service is delivered through secure transmission lines at the home health agency along with audiovisual computer equipment installed in the patient’s home, and if the home health agency has sent a registered nurse to the patient’s home to do a physical health assessment and evaluation of the patient’s condition.

The home health agency must have determined that the patient is unable to leave the home, formulated a nursing care plan, and the home health agency must determine that at least two skilled nursing home visits are required per week.

The home health agency that provides telehealth services may use telehealth services only as a supplement to the in-person visits. Patients receiving telehealth home health services must reside in underserved rural areas where the patient would be required to travel more than 50 miles to obtain medical services.

Reimbursement for telehealth home health services will be reimbursed in accordance with the Utah Medicaid State Plan. The Department pays the lesser of the amount billed or the rate on the fee schedule.  A provider is not to charge the Department a fee that exceeds the provider’s usual and customary charges for the provider’s private pay patients.

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