Payment for Telemedicine services Changes with New Year

[MMA News Now, Jan. 14, 2016] As of Jan. 1, Minnesota Health Care Programs (MHCP) now cover “medically necessary services and consultation” by licensed health care providers through telemedicine in the same manner as if the service or consultation was delivered in person. This is in accordance with the Minnesota Telemedicine Act, passed last legislative session. 

Beginning Jan. 1, 2017, Prepaid Medical Assistance Program (PMAP) plans will be required to cover telemedicine services. Until that time, PMAP plans can choose whether to cover these services. Payment is allowed for real-time interactive audio and video telecommunications as well as “store and forward,” or the transmission of medical information to be reviewed at a later time by a physician or practitioner at a distant site.  Also beginning Jan.1, 2017, commercial health insurance plans will also be required to cover telemedicine services. 
In order to be reimbursed physicians need to complete “Provider Assurance Payment Statement for Telemedicine.”
Last November, the MMA Board of Trustees approved the following recommendations brought forth by the MMA’s Telehealth Task Force, which met in 2015:

  • The MMA encourages and will participate in the creation of educational resources to support telehealth education for physicians at all stages of their career.
  • The MMA will advocate for the inclusion of more comprehensive and embedded telehealth education in medical school and residency curricula.
  • The MMA urges physicians to consider it an ongoing duty and opportunity to educate patients on the options, uses and possible benefits that telehealth may provide.  
  • The MMA encourages physicians to utilize specialty specific telehealth guidelines and to work with their specialty societies to encourage the development of guidelines where there are none. 
  • The MMA will work to establish a Telehealth Resource Site, which will include links to specialty specific telehealth practice guidelines as they are developed as well as links to general information regarding telehealth security and privacy. 
  • The MMA will explore, with MN Community Measurement, whether or not there is value in developing telehealth quality measures.
  • The MMA encourages physician practices that are utilizing telehealth to adopt internal quality measures.  
  • The MMA will continue to support and encourage improved health information exchange capabilities that fully consider and address evolving role of telehealth in health care.
  • The MMA will continue to advocate for legislation that would align Minnesota’s Health Record Act with HIPAA.  
  • The MMA will oppose the use of waivers of insurance network adequacy standards that seek to recognize telehealth services over existing and locally available in-person services.  
  • The MMA will support legislation to eliminate the telemedicine license from the Medical Practice Act, which is no longer relevant given Minnesota’s adoption of the interstate physician licensure compact. 
  • The MMA will work with the Minnesota Hospital Association (MHA) and other stakeholders to advocate for Medicare payment reform to expand coverage of telehealth services to include more services and broader eligible service sites.