| Mar 23, 2020

Telehealth/Telemedicine

If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS.

STATE HEALTH AND VALUE STRATEGIES RESOURCES

SHVS/Manatt Health.State Medicaid and CHIP Strategies to Respond to the COVID-19 Public Health Crisis  This expert perspective, written by experts at Manatt Health, discusses strategies state Medicaid and CHIP agencies can pursue as part of their response to COVID-19.

SHVS/Manatt Health Responding to COVID-19: State Strategies for Medicaid and Commercial Health Insurance Oversight  Webinar recording and slide deck from webinar hosted on March 18, 2020.

——————————————————-

OTHER RESOURCES

STATE TEMPLATES AND TOOLKITS

CMS.  Long-Term Care Nursing Homes Telehealth and Telemedicine Toolkit 

CMS.  1115 Application Process This page includes guidance and a template for COVID-19 1115 waiver demonstrations. 

CMS.  State Plan Flexibilities This page includes guidance and templates for the Medicaid State Plan Disaster Relief SPA and CHIP Disaster Relief SPA.

——————————————————-

FEDERAL STATUTE AND GUIDANCE

CMS/CMCS. COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies  These updated FAQs for state Medicaid and CHIP agencies address available resources for emergency preparedness and response efforts, and flexibilities related to eligibility and enrollment, benefits, cost-sharing, financing, and workforce.

CMS. Coverage and Benefits Related to COVID-19 Medicaid and CHIP 

CMS. Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth

CMS. COVID-19 Resources for States Compilation of resources for state on Medicare, Medicaid, and CHIP, including transcripts and recordings of all-state calls.

CMS. Coronavirus Waivers and Flexibilities  Resources on waivers and flexibilities available to states and providers.

CMS. The Center for Consumer Information & Insurance Oversight Fact Sheets & Frequently Asked Questions (FAQs) Compilation of COVID-19 FAQs on private insurance issues

CMS. FAQs on Availability and Usage of Telehealth Services through Private Health Insurance Coverage in Response to Coronavirus Disease 2019  CCIIO FAQs on telehealth coverage.

Drug Enforcement Administration (DEA). Exception to Regulations Emergency Oral CII Prescription  This guidance allows prescribers and practitoners to issue time limited prescriptions of schedule II drugs via oral communication (e.g., telephone) under limited circumstances.

Drug Enforcement Administration (DEA).  Exception to Separate Registration Requirements Across State Lines  This guidance allows practitioners to dispense schedule II-IV drugs (including methadone, buprenorphine and opioids) not only in their home states but also in states with which their home stateshave reciprocity. 

Drug Enforcement Administration (DEA).  Exemption Allowing Alternate Delivery Methods for OTPs  This guidance allows OTPs to make “door stop” deliveries for medications for opioid use disorder in a lock-box for patients under quarantine.

Substance Abuse and Mental health Services Administration (SAMHSA). FAQs: Provision of Methadone and Buprenorphine for the Treatment of Opioid Use Disorder in the COVID-19 Emergency  This FAQ clarifies that OTPs may initiate new patients on buprenorphine via telehealth and without an in-person visit, but maintains the face to face requirement for initiation with methadone.

——————————————————-

ANALYSIS

Manatt Health. Summary of Healthcare Provisions of COVID-19 Stimulus Package #3 (CARES Act)

American Medical Association (AMA).  Special Coding Advice During COVID-19 Public Health Emergency 

Foundation for Opioid Response Efforts (FORE), National Academy for State Health Policy (NASHP), Manatt Health Federal and State Policy Levers to Maintain Access to Medications for Opioid Use Disorder During the COVID-19 Pandemic

——————————————————-

STATE EXAMPLES AND MODELS

The Commonwealth Fund/Georgetown’s Center on Health Insurance Reforms (CHIR). State Action Related to COVID-19 Coverage of Critical Services by Private Insurers  Interactive 50-state map on state DOI actions re: COVID-19

Alaska.  Insurance Coverage for Telehealth AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March. 

California.  DHCS COVID‑19 Response  CA developed a robust, centralized COVID-19 resource page that provides guidance related to providers, HCBS, and federal requests/waivers.

Massachusetts.  MassHealth Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 MA developed a managed care plan bulletin that outlines requirement’s for coverage and billing related to COVID-19.  

Massachusetts.  March 15 2020 Telehealth Order  In MA, through executive order, Governor Baker expanded access to telehealth services in all commercial insurers and MassHealth programs, waived all cost-sharing for any medically necessary treatment delivered via telehealth related to COVID-19 at in-network providers, waived any prior authorization barriers needed to obtain medically necessary telehealth services, and established a 24-hour process to allow medical professionals to receive a license to practice in Massachusetts.

Minnesota. CHAPTER 70–S.F.No. 4334 AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March. 

Mississippi.  Reeves Administration announces temporary Medicaid changes in response to coronavirus outbreak MS Division of Medicaid is allowing beneficiaries to access telehealth services from home; promoting the use of personal cellular device, computer, tablet, or other web camera-enabled device to seek and receive medical care; and waiving limitation of the use of audio-only telephonic conversations until April 30, 2020.

Mississippi. Amended Proclamation MS Mississippi State Board of Medical Licensure has waived state licensure restrictions to allow out-of-state physicians who already have a pre-existing doctor-patient relationship to treat patients in Mississippi through telemedicine.

Mississippi. Public Notice MS submitted a Medicaid State Plan Amendment Telehealth Emergency Waiver to allow for telehealth service flexibilities during a state of emergency.

New Jersey. Governor Murphy Signs Legislation to Expand Telehealth Access and Expedite Licensure of Out-of-State Professionals AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March. 

New York. Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency NY established telehealth reimbursement parity in Medicaid programs during the state of emergency. 

New York. Department of Financial Services Adopts New Emergency Regulation Requiring Insurance Companies to Waive Cost Sharing for In-Network Telehealth Visits NY waived cost-sharing for telehealth visits with in-network providers.

New York.  Continuing Temporary Suspension and Modification of Laws Relating to the Disaster Emergency  NY allowed out-of-state providers and providers in New York that are not currently registered to provide telehealth services. 

North Carolina.  Telehealth Provisions – Outpatient Specialized Therapies and Dental Services  NC developed a Special Bulletin detailing the changes to its Telemedicine and Telepsychiatry Clinical Coverage Policy to better enable the delivery of remote care.

Vermont. Vermont House Passes Telehealth Bill Amid Coronavirus Concerns  AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March. 

West Virginia.  House Bill 4003 AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.