Utah Sets Reimbursement Guidelines for Telehealth through Medicaid

Utah’s governor has signed legislation expanding Medicaid payment parity for telehealth and telemedicine services.

Gov. Gary Herbert’s signature on HB 392 mandates that the state’s Medicaid program reimburse providers to designated connected care services “at the same rate that the Medicaid program reimburses for other health care services.” It also requires the state’s public employee health plan to reimburse, at the provider’s request, “medically appropriate telemedicine services at a commercially reasonable rate.”

The state has, in the past, reimbursed providers through Medicaid for what was called “mental health therapy.” Under the new law, it redefines that as “telepsychiatric consultations” and includes it under the list of telemedicine services reimbursed by the state program.

With the bill’s signing, Utah joins a number of states moving to mandate that telehealth and telemedicine services by reimbursed at the same rate as if those services were delivered in person. Some states and payers have pushed back at that concept, saying reimbursement rates should be negotiated by payers and providers and not tied to in-person standards.

Included in a bill is a reminder that the Legislature’s Public Utilities, Energy, and Technology Interim Committee and Health Reform Task Force will be studying:

  • How the payment parity rules are used;
  • “Practices and efforts” by healthcare providers, payers, employers and HMOs to reimburse for telehealth and telemedicine services;
  • Existing telehealth programs and the potential for expansion;
  • Any reimbursement issues experienced by providers; and
  • Any new legislation or rules that may be needed in the future.

Source: Utah Sets Reimbursement Guidelines for Telehealth through Medicaid