KANSAS

MASTER MEDICAID TELEHEALTH LAWS
WITH THE HELP FROM GD

Summary

Kansas Medicaid covers live video telemedicine for certain services. Additionally, they also cover remote patient monitoring that is in real-time through home health agencies and with prior authorization.
All insurers (including Medicaid) must cover medically necessary services, subject to the terms and conditions of the contract. Medicaid specifically must provide reimbursement for speech language pathology services and audiology services.

 

Definitions

“Telemedicine is the use of communication equipment to link health care practitioners and patients in different locations. This technology is used by health care providers for many reasons, including increased cost efficiency, reduced transportation expenses, improved patient access to specialists
and mental health providers, improved quality of care, and better communication among providers.”

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Feb
2019). (Accessed Mar. 2019).

 

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:
(A) Healthcare providers that consist solely of a telephone voice-only conversation, email or
facsimile transmission; or
(B) a physician and a patient that consists solely of an email or facsimile transmission.

Source: KS Statute Ann. § 40-2,211(5) (2018). & KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 (Feb. 2019). (Accessed Mar. 2019).

Live Video

Policy

Insurers (including Medicaid) cannot exclude from coverage a service solely because the service is provided through telemedicine, rather than in-person contact or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider

Source: KS Statute Ann. § 40-2,213(b) (2018). (Accessed Mar. 2019).

 

Kansas Medicaid will reimburse for live video for certain medically necessary services.
Payment or reimbursement of covered services delivered through telemedicine is the same
as for covered services delivered through personal contact.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 & 2-30 (Feb 2019). (Accessed Mar. 2019).
Eligible Services / Specialties

Eligible services:
• Office visits;
• Individual psychotherapy;
• Pharmacological management services.
The consulting expert must bill with the 02 place of service code. The GT modifier is not required except for services provided on or before December 31, 2017.
See manual for list of acceptable CPT codes. Telemedicine will be reimbursed at the same rate as face-to-face services.
KMAP does not recognize CPT Codes 99241-99245 and 99251-99255.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.2-29 (Feb 2019). (Accessed Mar. 2019).

 

Mental health assessment can be delivered either face-to-face or through telemedicine.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.
8-8 (Dec. 2019). (Accessed Mar. 2019).

 

Speech-language pathology and audiology services may be delivered face-to-face or through telemedicine. See manual for specific codes for eligible telemedicine services.
Codes not appearing on the list are not covered via telemedicine.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.2-28 (Feb. 2019). (Accessed Mar. 2019).

 

Kansas Medicaid does not authorize the use of telemedicine in the delivery of any abortion procedure.

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-29 (Feb. 2019). (Accessed Mar. 2019)

 

Telemedicine and telehealth services may be delivered by a healthcare provider, which
includes:
• Physicians
• Licensed Physician Assistants
• Licensed Advanced Practice Registered Nurses
• Other persons licensed, registered, certified, or otherwise authorized to practice by
the behavioral sciences regulatory board

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.2-31 (Feb. 2019). (Accessed Mar. 2019).
Eligible Providers

All physicians with an Alabama license, enrolled as a provider with the Alabama Medicaid
Agency, regardless of location, are eligible to participate in the Telemedicine Program to
provide medically necessary telemedicine services to Alabama Medicaid eligible recipients. In
order to participate in the telemedicine program:
• Physicians must be enrolled with Alabama Medicaid with a specialty type of 931
(Telemedicine Service).
• Physician must submit the telemedicine Service Agreement/Certification form.
• Physician must obtain prior consent from the recipient before services are rendered.
This will count as part of each recipient’s benefit limit of 14 annual physician office
visits currently allowed.

 

Source: AL Medicaid Management Information System Provider Manual, (28-17) (Accessed Mar. 2019).

For Nursing Assessment and Care services the following providers are eligible:
• Licensed Registered Nurse
• Licensed Practical Nurse
• Certified Nursing Assistant
• MAC Worker

Source: AL Medicaid Management Information System Provider Manual, (105-60) (Accessed Mar. 2019).
Facility/Transmission Fee

The originating site, with the beneficiary present, may bill code Q3014 for the originating site fee with the appropriate POS code.

 

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p.2-29 (Feb. 2019). (Accessed Mar. 2019).

Store-and-Forward

Policy

Kansas Medicaid requires the patient to be present at the originating site indicating storeand-forward will not be reimbursed.

 

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-31 (Feb. 2019). (Accessed Mar. 2019)
Email / Phone / Fax

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.

 

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, General Benefits, p. 2-30 (Feb.2019). (Accessed March 2019).
Consent

Written consent for telehealth home services is required.

 

Source: KS Dept. of Health and Environment, Kansas Medical Assistance Program, Provider Manual, Home Health Agency, p. AIII-19 (Dec 2018) (Accessed Mar. 2019).
Miscellaneous

The Department of Health and Environment is required to prepare an impact report that assesses the financial and social effects of Kansas Medicaid’s coverage of speech-language pathology and audiology services via telemedicine on or before January 13, 2020.

 

Source: KS HB 2028 (2018). (Accessed Mar. 2019).

Private Payer Laws

Requirements

Insurers cannot exclude from coverage a service solely because the service is provided through telemedicine, rather than in-person contact or based upon the lack of a commercial office for the practice of medicine, when such service is delivered by a healthcare provider.
No additional documentation for telemedicine is required.

 

Source: KS Statute Ann. § 40-2,213(2018). (Accessed Mar. 2019).
Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual
communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:
(A) Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or (B) a physician and a patient that consists solely of an email or facsimile transmission.

 

Source: KS Statute Ann. § 40-2,211(5) (2018). (Accessed Mar. 2019).

Parity

Payment Parity

Payment for covered services delivered through telemedicine may be established by an insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation or health maintenance organization in the same manner as payment or reimbursement for covered services that are delivered via in-person contact are established.

 

Source: KS Statute Ann. § 40-2,213 (2018). (Accessed Mar. 2019).
Service Parity

Payment can be limited to only services that are medically necessary, subject to the terms and conditions of the covered individual’s health benefits plan.

 

Source: KS Statute Ann. § 40-2,213 (2018). (Accessed Mar. 2019).

Professional Regulation /
Health & Safety

Definitions

‘‘Telemedicine,’’ including ‘‘telehealth,’’ means the delivery of healthcare services or consultations while the patient is at an originating site and the healthcare provider is at a distant site. Telemedicine shall be provided by means of real-time two-way interactive audio, visual, or audio-visual
communications, including the application of secure video conferencing or store-and-forward technology to provide or support healthcare delivery, that facilitate the assessment, diagnosis, consultation, treatment, education and care management of a patient’s healthcare. ‘‘Telemedicine’’ does not include communication between:
(A) Healthcare providers that consist solely of a telephone voice-only conversation, email or facsimile transmission; or (B) a physician and a patient that consists solely of an email or facsimile transmission.

 

Source: KS Statute Ann. § 40-2,211(5) (2018). (Accessed Mar. 2019)
Online Prescribing

The same laws and regulations that apply to the prescribing of drugs by means of in-person contact shall apply to the prescribing of drugs by means of telemedicine.

Source: KS Admin. Regs., Sec. 100-77-3. (Accessed Mar. 2019).

 

Physicians must have a pre-existing patient-prescriber relationship. Physicians are prohibited from prescribing drugs on the basis of an internet-based questionnaire or consult, or telephone consult.

Source: KS Admin. Regs., Sec. 68-2-20(2). (Accessed Mar. 2019).

 

Telemedicine may be used to establish a valid provider-patient relationship.

Source: KS Statute Ann. § 40-2,212(b) (2018). (Accessed Mar. 2019).
Cross-State Licensing

Member of the interstate medical licensure compact.

Source: Interstate Medical Licensure Compact. The IMLC. (Accessed Mar. 2019).

 

Member of Nurses Licensure Compact.

Source: Current NLC States and Status. NCSBN. (Accessed Mar. 2019).

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