TBHI Summarizes Epstein Becker & Green 2018 Telehealth Report
Telehealth services became notably more popular among clients/patients, practitioners, employers, and legislators according to a 2018 telehealth report from the law firm, Epstein Becker & Green. Their 3rd annual telebehavioral healthcare report focused on laws, regulations, and policies. They also noted that adoption amongst insurance companies continues to lag.
Three trends fueled the 2018 expansion, according to the 2018 telehealth report:
1. Bipartisan support. Legislative action in the form of the Bipartisan Budget Act of 2018 expanded Medicare coverage for specific telehealth services delivered by practitioners participating in ACOs. Medicare’s trial funding will establish data to be used for future decision-making related not only to Medicare but to third-party carriers seeking detailed analysis and comparison with in-person costs and outcomes related to key issues such as service to the home.
2. Advocacy from Medicare and Medicaid. The Centers for Medicare and Medicaid Services Administration (CMS) encouraged states to use telehealth and telepsychiatry services to coordinate care for Medicaid recipients. An example is the Medicare’s Telehealth Expansion Waiver.
3. Opioid epidemic. Landmark legislation was passed by several states to expand the prescribing of controlled substances via telehealth for the treatment of substance use disorders (SUDs).
The Epstein, Becker Green 2018 telehealth report also identified these two barriers to telehealth expansion in 2019:
1. Lack of federal guidance on coverage and reimbursement. Although Medicaid relaxed restrictions on telehealth coverage, current implementation guidance is still vague for state Medicaid programs.
2. Limited coverage from third-party payers. Although the majority of states have passed telehealth parity laws of one form or another, the majority of public and private payers don’t yet offer meaningful telehealth reimbursement.
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Want to Maximize Telehealth Reimbursement?
For more information about other telebehavioral health and telemental health reimbursement, see the Telebehavioral Health Institute’s “Telehealth Reimbursement Strategies: Increasing Authorization & Payment.” This professional online training with 3 CME/CE Hours will review relevant telehealth, telemedicine, telemental health, and telebehavioral health reimbursement law and proper procedures for practitioners and consultants.
Recommended Reimbursement Articles
- CMS Congressional Report: 85.4% of all Telehealth Users Had Mental Health Diagnosis
- Telehealth Reimbursement: Legally and Ethically Practicing Over State Lines Using a Consultative Model
- Interstate Licensing Compact and Telehealth Reimbursement: Recommendations of the U.S. Departments of Health and Human Services, Treasury, and Labor to the U.S. President
- Telehealth Reimbursement for Home-Based Care