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Proposed Telehealth Regulations Carry Forward COVID-19 PHE Flexibilities

On March 23rd, the Department of Health (DOH) issued proposed telehealth regulations intended to ensure continuity of care provided to Medicaid enrollees during the transition from telehealth services provided during the public health emergency (PHE) and after the PHE ends.

During the PHE, all Medicaid providers were authorized to utilize telehealth, including audio-only telephone or other audio-only technology, pursuant to executive orders (EOs) and, subsequently, pursuant to emergency regulations. The proposed telehealth regulations are required to authorize Medicaid providers to continuously provide services pursuant to these flexibilities to ensure continuity of care. Specifically, the proposed telehealth regulations provide:

  1. Expansion in the types of providers who can deliver care via telehealth, as long as such telehealth services are appropriate to meet a patient’s needs and are within a provider’s scope of practice.
  2. Addition of Audio-only, eConsult, Virtual Check-in, and Virtual Patient Education as telehealth modalities, as well as parameters for appropriately using those modalities and standards for reimbursement.

The proposed regulations also include revisions that allow for the provision of teleradiology, as well as remove outdated reimbursement processes.

New definitions are introduced to regulation for audio-only visits, eConsults, virtual check-ins, and virtual patient education. Also, additional telehealth providers are added to the laundry list: voluntary foster care providers, radiologists, and providers licensed or certified to provide Applied Behavioral Analysis therapy.

A broader definition of telehealth provider is added to the list as well to authorize all Medicaid providers and providers employed by Medicaid facilities or provider agencies who are authorized to provide in-person services to provide such services via telehealth as long as such telehealth services are appropriate to meet a patient’s needs and are within a provider’s scope of practice.

Payment for telehealth services shall be made if the provision of such services appropriately reduces the need for on-site or in-office visits and certain standards are met for services and care delivered. Further, as required by Social Services Law § 367-u, and except for services paid by State-only funds, reimbursement rates are to be made by the Commissioner based on and benchmarked to in-person fees for equivalent or similar services.

LeadingAge NY will be commenting on the proposed regulations and expressing our interest in carrying forward the telehealth care and services that were afforded during the pandemic, especially in light of current and future workforce staffing challenges and the possibility of increased infection rates. Members should reach out to us with questions or feedback on the regulations so that we may incorporate your concerns in our comments, which are due in mid-May. We welcome your input.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871