b. Telehealth coverage policy

Telehealth coverage policy 2021, 1st Special Session HF33/SF37 Chapter 7, Article 6 HHS omnibus bill Effective: July 1, 2021, or upon federal approval, whichever is later

Short description The legislature established requirements for the coverage of telehealth by health carriers, consolidate statute, and define coverage by Medicaid.

Summary The lengthy telehealth provisions, which includes modifying and consolidating telehealth statute as well as addressing health carrier and Medicaid policy issues, demonstrate the further integration of telehealth into Minnesota’s health care system. Highlights include the following: • A rewrite the current telehealth coverage statute by changing the terminology from telemedicine to telehealth and by clarifying definitions and coverage requirements • When a practitioner prescribes a drug used for medication-assisted therapy for a substance use disorder, the required examination of the patient may be completed via telehealth • A clarification that a comprehensive assessment for substance use disorder may be delivered in person or via telehealth • A chemical use assessment may be conducted via telehealth • A chemical dependency services may be provided via telehealth, and that the use of telehealth must be medically appropriate and must meet the needs of the person being served • The medical assistance coverage of services delivered by telehealth is updated: o The current coverage limitation of three telemedicine services per enrollee per calendar week is removed o Allow the commissioner to establish criteria that a provider must attest to in order to demonstrate the safety and efficacy of delivering a particular service through telehealth o Authorizes telehealth visits provided through audio and visual communication to be used to satisfy the face-to-face requirement for reimbursement under methods that apply to FQHCs, rural health clinics, Indian health services, tribal clinics, and community behavioral health clinic if the service would have otherwise qualified for payment if performed in person o Permits a provider to document a client’s verbal approval or electronic written approval of the treatment plan or change to the treatment plan in

lieu of the client’s signature when mental health services or assessments are delivered through telehealth and are based on an individual treatment plan o The definition of telehealth by updating the definition of healthcare provider and adds several additional professionals who can deliver services by telehealth is modified; it also adds a cross-reference to the definition of originating site, distant site, and store and forward technology • Medical assistance to is required to cover telemonitoring services if o the service is medically appropriate based on the recipient’s medical condition or status; o the recipient’s provider has identified that telemonitoring services would likely prevent the recipient’s admission or readmission to a hospital, emergency room, or nursing facility; o the recipient is cognitively and physically capable of operating the device or equipment or has a caregiver who can operate the device or equipment; and o the recipient resides in a setting that is suitable for telemonitoring and not in a setting that has healthcare staff on site • The coverage of medication therapy management (MTM) services that are authorized to be delivered through telehealth is expanded • The definition of “long term care consultation services” is modified by removing language requiring long-term care consultation assessments to be face-to-face and permits the assessments to be conducted through telehealth • All long-term care consultation assessments must be conducted face-to-face unless the assessment is a reassessment meeting certain requirements; remote assessments may be conducted by interactive video or telephone to substitute for face-to-face reassessments if federal approval is received • The language requiring assessments to be face-to-face for home and communitybased service waivers for persons with disabilities is removed

Implications Telehealth is becoming more and more integral to long-term care. The big change made this year that providers will need to monitor is the use of interactive video and/or telephone to perform LTC consultation services that are reassessments!

Bill language https://www.revisor.mn.gov/laws/2021/1/Session+Law/Chapter/7/