New Report Shows Only Half of US States Reimburse for Four Key Types of Virtual Healthcare

“Though all 50 states and Washington, D.C., provide reimbursement for some form of live video-based telehealth within their Medicaid programs, only 25 provide Medicaid reimbursement for live video as well as store-and-forward telehealth, remote patient monitoring (RPM), and audio-only telehealth, a new report reveals.

Released by the Center for Connected Health Policy (CCHP), the Fall 2023 report details updates to telehealth policy since the Spring 2023 report. The report’s findings are based on information from CCHP’s online Policy Finder. State laws, state administrative codes, and Medicaid provider manuals are the primary resources for the Policy Finder.

While all states offer reimbursement for live video-based telehealth services, certain limitations exist. These include limitations related to the eligible services for reimbursement, the types of healthcare providers, and the patient’s location.

Thirty-three state Medicaid programs reimburse for store-and-forward telehealth, which refers to sharing medical information with a healthcare practitioner via technology for evaluation or management. Since spring, Florida, Montana, North Dakota, South Carolina, and Utah have added reimbursement for store-and-forward telehealth.

However, several states have restrictions in place for Medicaid reimbursement of RPM, including only offering reimbursement to home health agencies and restricting the clinical conditions that can be monitored.

Audio-only telehealth services have experienced a rapid reimbursement shift “from being often ineligible for reimbursement to becoming the second most commonly utilized telehealth modality eligible for Medicaid reimbursement in recent years, closely following live video services,” the report states.

Telehealth-based prescribing is another issue states are focused on, with several state bills addressing the remote prescribing of controlled substances. One example is a bill in Oklahoma that provides an exception for virtually prescribing controlled substances if they are Schedule III, IV, or V medications approved by the US Food and Drug Administration (FDA) for treating substance use disorder.

Remote prescribing of controlled substances via telehealth has also been an ongoing policy issue at the federal level.”

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Originally published by mHealthIntelligence