How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?



How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?
QUESTION
• Week 3: Discussion Question – Analyzing Policy
Discussion Topic
Discussion Prompt
How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state? California
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Expectations
Initial Post:
• Due: Thursday, 11:59 pm PT
• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years

How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?

ANSWER

Week Discussion Question

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Week Discussion Question
The U.S government reimbursement policy for healthcare providers dictates that the standard of care delivered to the patients should be the same as it would have been in person. The California state law provides that private payers must reimburse for all services provided through live video, and Medi-Cal would reimburse for services provided through live video (“50 state telehealth policy report,” 2022). The law also states that in-person contact is not required for a service to be recognized as a complete health service. Store and forward are in California’s definition of telehealth. In addition, no healthcare insurer shall limit the setting for telehealth services.
These laws mean that all services delivered via video technologies, including diagnosis, treatment, education, remote patient monitoring, remote monitoring technologies, and care management while the healthcare provider is at a remote location and patient is at the originating site are regarded with the same respect as if the patient were physically present at the healthcare facility, and are thus reimbursed the same (CCHP, 2021. These services must be billed with either GT or 95 modifiers. Additionally, physical contact between the healthcare provider and patient is not mandatory for services the healthcare provider deems adequately provided via telehealth and would thus be reimbursed.
The inclusion of store and forward into California’s definition of telehealth means telehealth for dermatology, ophthalmology, and dentistry services gets reimbursed for individuals under Medicaid. In California, a home is an eligible transmission site, though there is no limit to the setting when healthcare providers provide patients with covered services (“Telemedicine regulations in California,” n.d.). For Medicaid, the originating facility fee and transmission fee get reimbursed when billed separately as the telehealth site facility fee and telehealth transmission per minute and professional services, respectively. 
References
50 state telehealth policy report. (2022, May 10). Center for Connected Health Policy. https://mailchi.mp/cchpca/its-finally-here-the-spring-2022-50-state-telehealth-laws-medicaid-program-policies-summary-report-from-cchp/
CCHP. (2021, April 16). National Telehealth resource center partners. https://www.cchpca.org/telehealth-resource-centers/
Telemedicine regulations in California. (n.d.). Chiron Health. https://chironhealth.com/telemedicine/regulations/california/

How does U.S. government reimbursement policies for healthcare providers impact the use of telemedicine in your state?


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