By Carol Hoppe, CPC, CCS-P, CPC-I
MedLucid Solutions, LLC
Payers are continuing to release additional information to explain their changes to various telehealth policies. Most recently, on July 1, Indiana Medicaid issued BT202152 regarding telehealth policy changes.
In response to Gov. Holcomb’s executive order EO 21-17, which extends the public health emergency (PHE) in Indiana through the end of July 2021, the Indiana Health Coverage Program (IHCP) has rescinded temporary telehealth policies previously issued in response to the PHE. The temporary policies listed here
will no longer be effective after July 31, 2021. Most of these changes were related to more lenient prior authorization requirements; one included relaxed signature requirements. For dates of service on or after Aug. 1, 2021, providers are required to follow the previously existing IHCP telemedicine and telehealth guidelines, available here
Some important things to note regarding the state’s position on telehealth are found in Senate Enrolled Act (SEA) 3, which expands telehealth services in Indiana as it does the following:
- Prohibits the Medicaid program from specifying originating sites and distant sites for purposes of Medicaid reimbursement.
- Prohibits the use of telehealth to provide any abortion, including the writing or filling of a prescription for any purpose that is intended to result in an abortion.
- Changes the use of the term "telemedicine" to "telehealth.”
- Specifies certain activities that are considered to be health care services for purposes of the telehealth laws, including the use of telecommunications and information technology to provide access to health assessment, diagnosis, intervention, consultation, supervision and information across a distance.
- Expands the application of the telehealth statute to additional licensed practitioners instead of applying only to prescribers.
- Amends the definitions of "prescriber" and "telehealth."
- Provides that a practitioner who directs an employee to perform a specified health service is held to the same standards of appropriate practice as those standards for health care services provided at an in-person setting.
- Requires that the telehealth medical records be created and maintained under the same standards of appropriate practice as medical records for patients in an in-person setting.
- Specifies that a patient waives confidentiality of medical information concerning individuals in the vicinity when the patient is using telehealth.
- Provides that an applicable employment contract, agreement, or policy to provide telehealth services must explicitly provide that a practitioner may refuse at any time to provide health care services if, in the practitioner's sole discretion, the practitioner believes: (1) that health quality may be negatively impacted; or (2) the practitioner would be unable to provide the same standards of appropriate practice as those provided in an in-person setting.
- Prohibits certain insurance policies and individual and group contracts from mandating the use of certain technology applications in the provision of telehealth services.
With these guidelines, the state has addressed many concerns that previously limited physicians in offering telehealth services. The future of telehealth in Indiana appears to be moving in a positive direction.
For information on other recent changes to payers’ telehealth policies, see the June 24 ISMA Reports article