Telehealth

Telehealth (formerly “Telemedicine”)

Telehealth

We help providers add telehealth (formerly called “telemedicine” in Minnesota law and currently cited as the “Minnesota Telehealth Act”) to their business so that providers can be legally reimbursed for telehealth visits with their patients while maintaining compliance with Minnesota law and Federal law. Minnesota’s telehealth parity law establishes that private insurance and state employee health plans must provide the same coverage (and reimbursement) for telehealth as in-person visits, so long as certain requirements are met. After the Minnesota law changed in 2021 following the COVID-19 pandemic, “telemedicine” was changed to “telehealth” throughout the law. Sometimes these terms are used interchangeably by healthcare professionals, payors and government entities. In addition, until July 1, 2023, telehealth also includes audio-only communication between a health care provider and a patient provided the communication is a scheduled appointment and the standard of care for that service can be met using audio only communication. Telehealth does not include communication between health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission.

 

Telehealth law in Minnesota is largely defined for the purposes of reimbursement by Medical Assistance. “Telehealth” is specifically defined as:

 

the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communication to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient’s health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Telehealth does not include communication between health care providers, or between a health care provider and a patient that consists solely of an audio-only communication, e-mail, or facsimile transmission or specified by law;

 

Distant Site and Originating Site

“Distant site” means a site at which a health care provider is located while providing health care services or consultations by means of telehealth.

“Originating site” means a site at which a patient is located at the time health care services are provided to the patient by means of telehealth. For purposes of store-and-forward technology, the originating site also means the location at which a health care provider transfers or transmits information to the distant site.

 
The big questions in these definitions are what do they mean by “originating site” and “distant site.”
 
 

The Originating Site is the location of an eligible patient at the time the service is being furnished via a telecommunication system. Authorized originating sites include:

  • Office of physician or practitioner
  • Hospital (inpatient or outpatient)
  • Critical access hospital (CAH)
  • Rural health clinic (RHC) and Federally Qualified Health Center (FQHC)
  • Hospital-based or CAH-based renal dialysis center (including satellites)
  • Skilled nursing facility (SNF)
  • End-stage renal disease (ESRD) facilities
  • Community mental health center
  • Dental clinic
  • Residential settings, such as a group home, assisted living, shelter or temporary lodging
  • Home (a licensed or certified health care provider may need to be present to facilitate the delivery of telemedicine services provided in a private home)
  • School
  • Correctional facility-based office
  • Mobile stroke unit

 

The Distant Site simply means a site at which a licensed health care provider is located while providing health care services or consultations by means of telemedicine. This is generally the provider’s office.
 
Finally, for mental health providers, it should be noted that the new telehealth law permits a provider to document a client’s verbal approval or electronic written approval of the treatment plan or change to the treatment plan in lieu of the client’s signature when mental health services or assessments are delivered through telehealth and are based on an individual treatment plan.
 

Telemonitoring

Telemonitoring is new to Minnesota. “Telemonitoring services” means the remote monitoring of clinical data related to the enrollee’s vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a health care provider for analysis. Telemonitoring is intended to collect an enrollee’s health-related data for the purpose of assisting a health care provider in assessing and monitoring the enrollee’s medical condition or status.

A health carrier must provide coverage for telemonitoring services if: (1) the telemonitoring service is medically appropriate based on the enrollee’s medical condition or status; (2) the enrollee is cognitively and physically capable of operating the monitoring device or equipment, or the enrollee has a caregiver who is willing and able to assist with the monitoring device or equipment; and (3) the enrollee resides in a setting that is suitable for telemonitoring and not in a setting that has health care staff on site.

 

Resources:

Minn section 62A.673

Minn. Stat. 256B.0625, Subd. 3b
 
https://www.senate.mn/departments/scr/billsumm/2021/HF33.pdf

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