Telehealth update

Enactment of SB112 guarantees all Kentuckians will have access to healthcare services, no matter where they live.

By Rob Sprang

Kentucky has been a telehealth leader for many years despite outdated laws and regulations that restrict how telehealth may be used, preventing many Kentuckians from accessing healthcare services that are not available close to home.

Senate Bill 112, introduced by Senator Ralph Alvarado and signed into law by Governor Matt Bevin on April 26, 2018, will help make telehealth more accessible to the citizens of the Commonwealth by reducing the legal and regulatory restrictions that are currently in place.

As stipulated in SB 112, the Cabinet for Health and Family Services will be responsible for providing “oversight, guidance and direction” to Medicaid providers delivering care using telehealth and “shall maintain telehealth policies and guidelines to providing care that ensure that Medicaid-eligible citizens will have safe, adequate, and efficient medical care, and that prevent waste, fraud, and abuse of the Medicaid program.” The legislation also requires that telehealth-based care must be coordinated with the patient’s primary care provider to insure continuity of care.

SB112 defines telehealth as “the delivery of healthcare-related services by a Medicaid provider who is a healthcare provider licensed in Kentucky to a Medicaid recipient through a face-to-face encounter with access to real-time interactive audio and video technology or store and forward services that are provided via asynchronous technologies as the standard practice of care where images are sent to a specialist for evaluation.

The requirement for a face-to-face encounter shall be satisfied with the use of asynchronous telecommunications technologies in which the healthcare provider has access to the Medicaid recipient’s medical history prior to the telehealth encounter.”

SB 112 mandates Medicaid and Medicaid Managed Care programs must reimburse for services provided via telehealth. Payment for services will be equivalent to the coverage for the same service provided in a traditional in-person encounter unless the telehealth provider and the Medicaid/Medicaid MCO contractually agree to a lower reimbursement rate for telehealth or the Department of Medicaid Services establishes a different reimbursement rate. Similar language in the legislation applies to “health benefit plans,” insuring reimbursement parity for Kentuckians that have commercial health insurance.

Nate Lacktman, partner at Foley and Lardner and a nationally recognized telehealth attorney, noted that Kentucky has become one of approximately 36 states to mandate insurance plans cover telehealth services and one of nine states with payment parity language. Kentucky has performed over 150,000 telehealth encounters during the last 23 years.

Lives have been changed and lives have been saved because telehealth improves access to healthcare services. Bono, lead singer for U2 and a committed humanitarian said, “Where you live should not determine whether you live”. The enactment of SB112 on July 1, 2019 guarantees all Kentuckians will have access to healthcare services that help them live full and productive lives, no matter where they live.

-Rob Sprang is the director of Kentucky TeleCare at the University of Kentucky and the co-project manager of Kentucky TeleHealth Network.

 

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