ALASKA

MASTER MEDICAID TELEHEALTH LAWS
WITH THE HELP FROM GD

Summary

Alaska reimburses for Live Video, Store-and-Forward & Remote Patient Monitoring, although some
restrictions apply.

 

Definitions

“Alaska Medicaid will pay for telemedicine services delivered in the following manner:
• Interactive method: Provider and patient interact in ‘real-time’ using video/camera and/or dedicated audio conference equipment.
• Store-and-forward method: The provider sends digital images, sounds, or previously
recorded video to a consulting provider at a different location. The consulting provider reviews the information and reports back his or her analysis.
• Self-monitoring method: The patient is monitored in his or her home via a telemedicine application, with the provider indirectly involved from another location.”

 

Source: State of AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manuals for Community Behavioral Health Services, Early and Periodic Screening, Diagnosis, and Treatment, Hospice Care, Inpatient Psychiatric Services, Independent Laboratory Services, Appendices. (Accessed Mar. 2019).

“Telemedicine means the practice of health care delivery, evaluation, diagnosis, consultation, or treatment, using the transfer of medical data through audio, video, or data communications that are engaged in over two or more locations between providers who are physically separated from the
patient or from each other.”

Source: AK Admin. Code, Title 7, 12.449 (2012). (Accessed Mar. 2019)

Live Video

Policy

Alaska’s Medicaid program will reimburse for services “provided through the use of camera, video, or dedicated audio conference equipment on a real-time basis.”

 

Source: AK Admin. Code, Title 7, 110.625(a)(1) (Accessed Mar. 2019).

Alaska Medicaid will pay for a covered medical service furnished through telemedicine application if the service is:
• Covered under traditional, non-telemedicine methods;
• Provided by a treating, consulting, presenting or referring provider;
• Appropriate for provision via telemedicine.

Source: AK Dept of Health and Social Svcs., AK Alaska Medical Assistance Provider Billing Manuals, Section1: Physician, Advance Nurse Practitioner, MHPC, Therapies, Audiology, School Based Services, Physician Assistant, RBRS, SBS, Tribal, Vision: Services, Policies and Procedures. & AK Admin. Code, Title 7, 110.630 (Accessed Mar. 2019)
Eligible Services / Specialties

“Medically necessary office consultations provided via telemedicine may be covered only when used as a second opinion and the provider is of a different specialty than the requesting provider. Documentation requirements apply.

Eligible services:
• Initial or one follow-up office visit;
• Consultation made to confirm diagnosis;
• A diagnostic, therapeutic or interpretive service;
• Psychiatric or substance abuse assessments;
• Psychotherapy or pharmacological management services on an individual basis.

Source: AK Dept of Health and Social Svcs., AK Alaska Medical Assistance Provider Billing Manuals, Section1: Physician, Advance Nurse Practitioner, MHPC, Therapies, Audiology, School Based Services, Physician Assistant, RBRS, SBS, Tribal,
Vision: Services, Policies and Procedures. & AK Admin. Code, Title 7, 110.630. (Accessed Mar. 2019).

No reimbursement for:
• Home and community-based waiver services;
• Pharmacy;
• Durable medical equipment;
• Transportation;
• Accommodation services;
• End-stage renal disease;
• Direct-entry midwife;
• Private duty nursing;
• Personal care assistants;
• Visual care, dispensing or optician services;
• Technological equipment and systems associated with telemedicine application.

Source: AK Admin. Code, Title 7, 110.635 & AK Dept of Health and Social Svcs., AK Alaska Medical Assistance Provider Billing Manual, Section1: Physician, Advance Nurse Practitioner, Physician Assistant: Services, Policies and Procedures.
(Accessed Mar. 2019).
Eligible Providers

Office consultations performed by a provider of the same specialty within the same organization are not covered.

 

Source: Alaska Medicaid Policy Clarification: Office Consultations via Telemedicine Applications. March 30, 2017. (Accessed Mar. 2019).
Facility/Transmission Fee

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

 

Source: AK Admin. Code, Title 7, 110.635(b). (Accessed Mar. 2019)

Community Behavioral Health Services
The department will pay a community behavioral health services provider for facilitation of a
telemedicine session if:
• The Telemedicine communication equipment is supplied by the provider;
• The electronic connection used by the treating provider and the recipient are established and maintained by the provider;
• The provider remains available during the telemedicine session to reestablish failed
connection before the intended end of the telemedicine session; and
• The provider documents in the recipient’s clinical record a note summarizing the
facilitation of each telemedicine session (although the facilitating provider is not
required to document a clinical problem or treatment goal as these are to be documented by the treating provider).

Source: AK Admin. Code, Title 7, 135.290. (Accessed Mar. 2019).

Store-and-Forward

Policy

Alaska Medicaid will reimburse for Store-and-Forward telehealth as long as the service is provided through transferring digital images, sounds, or previously recorded video from one location to another

 

Source: AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manual, Section1: Physician,
Advance Nurse Practitioner, Physician Assistant: Services, Policies and Procedures. (Accessed Mar. 2019).
Eligible Services / Specialties

Eligible services:
• Initial or one follow-up office visit;
• Consultation made to confirm diagnosis;
• A diagnostic, therapeutic or interpretive service;
• Psychiatric or substance abuse assessments;
• Psychotherapy or pharmacological management services.

 

Source: AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manual, Section1: Physician, Advance Nurse Practitioner, Physician Assistant: Services, Policies and Procedures. & AK Admin. Code, Title 7, 110.630.
(Accessed Mar. 2019).
Transmission Fee

The department will pay only for professional services for a telemedicine application of service. The department will not pay for the use of technological equipment and systems associated with a telemedicine application to render the service.

 

Source: AK Admin. Code, Title 7, 110.635(b). (Accessed Mar. 2019)
Email / Phone / Fax

No reimbursement for telephone when not part of a dedicated audio conference system.
No reimbursement for FAX.

 

Source: AK Dept. of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manual, Section1: Physician, Advance
Nurse Practitioner, Physician Assistant: Services, Policies and Procedures. & AK Admin Code, Title 7, 110.625. (Accessed Mar. 2019).
Miscellaneous

Documentation requirements for telemedicine consultations include:
• Statement that the service was provided using telemedicine
• The address location of the patient
• The address location of the provider
• The method of telemedicine used
• The names of all persons participating in the telemedicine service and their role in the encounter
• The inquiry from the requesting provider
• The consulting provider’s report back to the requesting provider (see policy for more details).

 

Source: Alaska Medicaid Policy Clarification: Office Consultations via Telemedicine Applications. March 30, 2017. (Accessed Mar.
2019).

Payment to the presenting provider is limited to the rate established for brief evaluation and management of an established patient.
Providers delivering services via telemedicine will be reimbursed in the same manner as reimbursement is made for the same service provided through traditional modes of delivery, not to exceed 100
percent of the rate established in state law.

Source: AK Admin Code, Title 7, 145.270. (Accessed Mar. 2019).

Remote Patient Monitoring

Policy

Alaska Medicaid will reimburse for services delivered through self-monitoring, where the patient is monitored in their home via a telemedicine application, with the provider indirectly involved from another location.

 

Source: AK Dept of Health and Social Svcs., Alaska Medical Assistance Provider Billing Manual, Section1: Physician,
Advance Nurse Practitioner, Physician Assistant: Services, Policies and Procedures. (Accessed Mar. 2019).

To be eligible for payment under self-monitoring or testing, “the services must be provided
by a telemedicine application based in the recipient’s home, with the provider only indirectly
involved in the provision of the service.”

Source: AK Admin. Code, Title 7, 110.625(a). (Accessed Mar. 2019).

Professional Regulation /
Health & Safety

Online Prescribing

The guiding principles for telemedicine practice in the American Medical Association (AMA), Report 7 of the Council on Medical Service (A-14), Coverage of and Payment for Telemedicine, dated 2014, and the Federation of State Medical Boards (FSMB), Model Policy for the Appropriate Use of Telemedicine Technologies in the Practice of Medicine, dated April 2014, are adopted by reference as the standards of practice when providing treatment, rendering a diagnosis, prescribing, dispensing, or administering a prescription or controlled substance without first conducting an in-person physical examination

Source: AK 12 AAC 40.943 (Accessed Mar. 2019).

 

A physician is not subject to disciplinary sanctions for rendering a diagnosis, treatment or prescribing a prescription drug (except a controlled substance) without a physical examination if the physician or
another health care provider is available for follow up care and the physician requests that the person consent to sending a copy of all records of the encounter to the person’s primary care provider.

Source: AK Statute, Sec. 08.64.364. (Accessed Mar. 2019).

 

Physicians are prohibited from prescribing medications based solely on a patient-supplied history received by telephone, FAX, or electronic format.

Source: AK Admin. Code, Title 12, Sec. 40.967. (Accessed Mar. 2019).
Miscellaneous

The Department of Commerce, Community and Economic Development has adopted regulations for establishing and maintaining a registry of businesses performing telemedicine in the state.
See business registry regulations for more details.

Source: AK Admin Code. Sec. 600, Article 5. (Accessed Mar. 2019) & AK Dept. of Commerce, Community, and Economic Development, Occupational Licensing Centralized Regulations, Feb 2019. (Accessed Mar. 2019).

 

Professional Board Telehealth-Specific Regulations

Medical Board (Source: AK 12 AAC 40.943). (Accessed Mar. 2019)

Contact us to discuss your telehealth initiatives in Alaska


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