Expanding State Telehealth MedicaidIn response to the pandemic, state Medicaid programs enrolled temporary emergency measures to expand telehealth coverage. The longevity of these reforms isn’t clear. States are tasked with evaluating which policies should remain permanent in a post-COVID-19 world.

Suggested Route for Expanding State Telehealth Medicaid

Jacqueline Marks, Manager with the Manatt Health division of Manatt, Phelps & Philips, offers suggestions for policy changes. The suggestions include changes for certain reimbursement modalities, sites of care, and services of interest to children. She stated, “States, providers, advocates and families recognize the important role that telehealth has played in maintaining access to care during the pandemic and are now turning to the difficult work of evaluating which components of a state’s temporary telehealth policies can be made permanent beyond the public health emergency.” The suggested policy actions lay the groundwork for a proposed route to prolonging this level of telehealth coverage even after the pandemic.

As for video visits, Marks suggests making permanent a policy that covers all medically necessary and clinically appropriate services delivered via video visits and equally reimburses for these services. Audio-only (telephone) visits are a convenient option for low-income and rural patients with limited actions to the internet. However, few telehealth Medicaid programs provided coverage and reimbursement prior to the pandemic. Marks suggests enabling coverage and reimbursements for audio-only visits for select services that can be delivered via telephone, all in a “clinically appropriate matter.” She also suggests providing codes for telephonic management and evaluation for brief check-ins over the phone.

Prior to the pandemic, some states required patients to physically travel to a clinic to receive remote care. However, this changed only after the pandemic, which is why Marks suggests making permanent a policy that allows patients to receive care via telehealth wherever they are. Many state telehealth Medicaid programs have temporarily allowed providers to deliver care from their homes or wherever they might be located. However, before the pandemic, policies that prevented providers from providing care from their homes were a major inconvenience. “As telehealth becomes a more commonly utilized form of care delivery, it will be important to give providers the flexibility to deliver care from locations outside of their clinic or facility,” says Marks. This is why she proposes making permanent a policy that eliminates this issue. She also suggests a policy that reimburses for specialized therapy services delivered via telehealth, as well as encouraging a telehealth option for annual well-child services for the duration of a public health emergency or states of emergencies.

Expanding State Medicaid for Behavioral Health

Behavioral health services were also included in the list of suggested policy changes. Marks suggested making permanent a policy that covers and reimburses for behavioral health services, including research-based autism spectrum disorder services, delivered via telehealth. “COVID-19 has highlighted the critical role that telehealth can play in making behavioral health services more accessible to patients.” Mark concluded, “Going forward, it is likely that states will continue offering these services via telehealth modalities such as video and audio-only visits.”