District of Columbia
STATE LAW/REGULATIONS MEDICAID PROGRAM store-and-forward technology
• The term does not include the use of audio-only telephone, e-mail, or facsimile transmissions.
Source: MT Code Sec. 33-22-138.
Live Video Reimbursement
Private payers are required to provide coverage for services delivered through live video, equivalent to in-person coverage.
Eligible providers under this law include:
• Physicians
• Registered professional nurse
• Advanced practice registered nurse
• Genetic counselor certified by the American board of genetic counseling
• Diabetes educator certified by the national certification board for diabetes
Eligible facilities under this law include:
• Critical access hospital
• Hospice
• Hospital
• Long-term care facility
• Mental health center
• Outpatient center for primary care
• Outpatient center for surgical services Source: MT Code Sec. 33-22-138.
Montana Medicaid will reimburse for live video services when the consulting provider is enrolled in Medicaid.
The requesting provider need not be enrolled in
Medicaid nor be present during the telemedicine consult.
Source: MT Dept. of Public Health and Human Svcs., Medicaid and Medical Assistance Programs Manual, Physician Related Svcs., p 27 (Mar 2012).
Store and Forward Reimbursement
Private payers are required to provide coverage for services delivered through store and forward technology, equivalent to in-person coverage.
Eligible providers under this law include:
• Physicians
• Registered professional nurse
• Advanced practice registered nurse
• Genetic counselor certified by the American board of genetic counseling
• Diabetes educator certified by the national certification board for diabetes
Eligible facilities under this law include:
• Critical access hospital
• Hospice
• Hospital
No reference found.
STATE LAW/REGULATIONS MEDICAID PROGRAM
• Long-term care facility
• Mental health center
• Outpatient center for primary care
• Outpatient center for surgical services
Source: MT Code Sec. 33-22-138.
Remote Patient Monitoring Reimbursement
No reference found. No reference found.
Email/Phone/FAX No Email
No Phone No Fax
Source: MT Code Sec. 33-22-138.
No reference found.
Online Prescribing
No reference found. No reference found.
Consent
No reference found. No reference found.
Location
No reference found. No reference found.
Cross-State Licensing
Montana issues telemedicine licenses to out-of-state physicians that only allows the physician to practice telemedicine in the specialty the physician is board certified or meets the current requriements to take the examination to become board certified.
This license does not authorize the physician to practice medicine while physically present within the state.
Source: MT Code Annotated, 37-3-343.
No reference found.
Private Payers
Private payers are required to provide coverage for services delivered through telemedicine, equivalent to in-person coverage.
Source: MT Code Sec. 33-22-138.
No reference found.
Site/Transmission Fee
No reference found. No reimbursement for network use charges.
Source: MT Dept. of Public Health and Human Svcs., Medicaid and Medical Assistance Programs Manual, Physician Related Svcs., p 27 (Mar 2012).
Miscellaneous
STATE LAW/REGULATIONS MEDICAID PROGRAM
Nebraska
Medicaid Program: Nebraska Medicaid
Program Administrator: NE Dept. of Health and Human Services
Regional Telehealth Resource Center:
Great Plains Telehealth Resource and Assistance Center University of Minnesota/Institute for Health Informatics 330 Diehl Hall
505 Essex Street S.E.
Minneapolis, MN 55455 (888) 239-7092
www.gptrac.org
STATE LAW/REGULATIONS MEDICAID PROGRAM
Definition of telemedicine/telehealth
No reference found. “Telehealth means the use of telecommunications
technology by a health care practitioner to deliver health care services within his or her scope of practice to a patient located at a site other than the site where the patient is located.
Telehealth service means any contact between a patient and a health care practitioner relating to the health care diagnosis or treatment of such patient through
telehealth, but does not include a telephone conversation, electronic mail message, or facsimile transmission between a health care practitioner and a patient or a consultation between two health care practitioners.”
Source: NE Admin. Code Title 471, Ch. 1 & Manual Letter #64-2000.
Live Video Reimbursement
(see Medicaid column) Nebraska Medicaid stipulates in-person contact is not required for reimbursable services under the Medicaid program, subject to reimbursement policies developed.
This policy also applies to managed care plans who contract with the Department only to the extent that:
• Services delivered via telehealth are covered and reimbursed under the fee-for-service program and
• Managed care contracts are amended to add coverage of services delivered via telehealth Telehealth services are not covered if the patient has access to a comparable service within 30 miles of his/her place of residence.
Exceptions to this requirement:
STATE LAW/REGULATIONS MEDICAID PROGRAM
• Emergency or urgent medical situations;
• When accessing in-person services at less than 30 miles poses a significant hardship on the patient, due to a medical condition or disability;
• Nursing facility patients who require transportation via ambulance.
• Recently Passed Legislation: Children receiving behavioral health services.
Reimbursement shall, at a minimum, be set at the same rate as a comparable in-person consult.
Source (authorization and reimbursement): NE Revised Statutes Sec. 71-8506 (2012).
Source (exceptions to 30-mile rule): NE Admin. Code Title 471, Ch. 1.
Source: & Manual Letter #64-2000.
Source (Children’s behavioral health): LB 556 (Recently passed, effective Aug. 30, 2013).
NB Medicaid requires providers to be specifically enrolled as a telehealth site with Medicaid to bill for a telehealth services.
Source: NB Medicaid Telehealth FAQ: “Can any Medicaid enrolled provider do a service via telehealth?”
Children’s Behavioral Health
A trained staff member must be immediately available to a child receiving telehealth behavioral health service.
This requirement may be waived by a legal guardian.
Source: Revised Statutes of NE. Sec. 71-8506.
Store and Forward Reimbursement
(see Medicaid column) Nebraska Medicaid will reimburse for tele-radiology when it meets the American College of Radiology standards for tele-radiology. There is no other reference to reimbursing for other specialties.
Source: NE Admin. Code Title 471, Ch. 1.
Remote Patient Monitoring Reimbursement
No reference found. No reference found.
Email/Phone/FAX
(see Medicaid column) No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.
Source: NE Admin. Code Title 471, Ch. 1.
Online Prescribing
Prescribing drugs to individuals the physician has never met, based solely on answers to questions provided by
Prescriptions over the Internet: Neither the prescribing health care practitioner service nor the pharmacy
STATE LAW/REGULATIONS MEDICAID PROGRAM