Written by Duncan West
Governor Inslee signed into law a measure that moves telehealth visits closer to parity with traditional, face to face patient care. We posted earlier in the year about the bills being considered. Bottom line is that all payers except CMS will be required to support professional fees for telehealth services delivered to patients in rural AND urban care settings. Key points of the law signed are:
- On the next renewal, private insurance company and Medicaid health plans must pay for telehealth professional services as if they were delivered directly. Medical need and eligibility rules will apply.
- Like CMS rules, the patient must be in a care setting such as a hospital, clinic, SNF, or community mental health center.
There will be no payment for telehealth services delivered to the patient’s home or school.
- Unlike current CMS, there is no requirement that the originating site (where the patient is) be rural. It can be urban.
- Also unlike CMS, telehealth originating sites (the care settings hosting the patient) must negotiate with payers for payment of hosting their end of the telehealth visit.
- Store and forward consults are permitted, however they must be in conjunction with an office visit.
What does this mean in our region? Before this new law, telehealth solutions could only be billed for remote consultations of Medicare enrollees in Concrete, Lopez or Camano. Now telehealth programs and investments can earn returns for remote visits with privately insured patients in Sedro Woolley, Stanwood, Mount Vernon and Arlington.
Specialists and sub-specialists in Seattle can be scheduled into patient visits with assurance of payment for their time, without any concern for the ‘ruralness’ of the patient care setting.
MIN-NS will continue to work to provide securely shared medical records, secure email and secure, HIPAA compliant telehealth solutions to rural and urban providers. We are currently working with specialists in cardiology and behavioral health to support remote follow-up visits. In one implementation under discussion there would be remote feeds of ECG results, ultrasound images, and stethoscope sounds on the same secure channel as the streamed voice and participant images.