Reimbursement for Telehealth Services and Telemedicine Services for Certain Providers; Implementation; Rules

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     Note: This version of section effective 7-1-2021. See also preceding version of this section, effective until 7-1-2021.

Sec. 11. (a) As used in this section, "telehealth activities" means the use of telecommunications and information technology to provide access to:

(1) health assessment;

(2) diagnosis;

(3) intervention;

(4) consultation;

(5) supervision; and

(6) information;

across a distance.

(b) As used in this section, "telehealth services" has the meaning set forth for "telehealth" in IC 25-1-9.5-6.

(c) The office shall reimburse a Medicaid provider who is licensed as a home health agency under IC 16-27-1 for telehealth activities.

(d) The office shall reimburse the following Medicaid providers for medically necessary telehealth services:

(1) A federally qualified health center (as defined in 42 U.S.C. 1396d(l)(2)(B)).

(2) A rural health clinic (as defined in 42 U.S.C. 1396d(l)(1)).

(3) A community mental health center certified under IC 12-21-2-3(5)(C).

(4) A critical access hospital that meets the criteria under 42 CFR 485.601 et seq.

(5) A provider, as determined by the office to be eligible, providing a covered telehealth service.

(e) The office may not impose any distance restrictions on providers of telehealth activities or telehealth services. Before December 31, 2017, the office shall do the following:

(1) Submit a Medicaid state plan amendment with the United States Department of Health and Human Services that eliminates distance restrictions for telehealth activities or telehealth services in the state Medicaid plan.

(2) Issue a notice of intent to adopt a rule to amend any administrative rules that include distance restrictions for the provision of telehealth activities or telehealth services.

(f) Subject to federal law, the office may not impose any location requirements concerning the originating site or distant site in which a telehealth service is provided to a Medicaid recipient.

(g) A Medicaid recipient waives confidentiality of any medical information discussed with the health care provider that is:

(1) provided during a telehealth visit; and

(2) heard by another individual in the vicinity of the Medicaid recipient during a health care service or consultation.

(h) For purposes of a community mental health center, telehealth services satisfy any face to face meeting requirement between a clinician and consumer.

(i) The office shall implement any part of this section that is approved by the United States Department of Health and Human Services.

(j) The office may adopt rules under IC 4-22-2 necessary to implement and administer this section.

As added by P.L.204-2013, SEC.3. Amended by P.L.150-2017, SEC.1; P.L.85-2021, SEC.3; P.L.207-2021, SEC.8.


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