2014 Kentucky Revised Statutes CHAPTER 205 - PUBLIC ASSISTANCE AND MEDICAL ASSISTANCE 205.559 Requirements for Medicaid reimbursement to participating providers for telehealth consultations -- Report of impact on health care delivery system required -- Administrative regulations.
Download as PDF
205.559 Requirements for Medicaid reimbursement to participating providers
for telehealth consultations -- Report of impact on health care delivery
system required -- Administrative regulations.
(1)
(2)
(3)
(4)
(5)
(6)
(7)
The Cabinet for Health and Family Services and any regional managed care
partnership or other entity under contract with the cabinet for the administration
or provision of the Medicaid program shall provide Medicaid reimbursement for
a telehealth consultation that is provided by a Medicaid-participating
practitioner who is licensed in Kentucky and that is provided in the telehealth
network established in KRS 194A.125(3)(b).
(a) The cabinet shall establish reimbursement rates for telehealth
consultations. A request for reimbursement shall not be denied solely
because an in-person consultation between a Medicaid-participating
practitioner and a patient did not occur.
(b) A telehealth consultation shall not be reimbursable under this section if it
is provided through the use of an audio-only telephone, facsimile
machine, or electronic mail.
A health-care facility that receives reimbursement under this section for
consultations provided by a Medicaid-participating provider who practices in
that facility and a health professional who obtains a consultation under this
section shall establish quality-of-care protocols and patient confidentiality
guidelines to ensure that telehealth consultations meet all requirements and
patient care standards as required by law.
The cabinet shall not require a telehealth consultation if an in-person
consultation with a Medicaid-participating provider is reasonably available
where the patient resides, works, or attends school or if the patient prefers an
in-person consultation.
The cabinet shall request any waivers of federal laws or regulations that may
be necessary to implement this section.
(a) The cabinet and any regional managed care partnership or other entity
under contract with the cabinet for the administration or provision of the
Medicaid program shall study the impact of this section on the health care
delivery system in Kentucky and shall, upon implementation, issue a
quarterly report to the Legislative Research Commission. This report shall
include an analysis of:
1.
The economic impact of this section on the Medicaid budget,
including any costs or savings as a result of decreased
transportation expenditures and office or emergency room visits;
2.
The quality of care as a result of telehealth consultations rendered
under this section; and
3.
Any other issues deemed relevant by the cabinet.
(b) In addition to the analysis required under paragraph (a) of this
subsection, the cabinet report shall compare telehealth reimbursement
and delivery among all regional managed care partnerships or other
entities under contract with the cabinet for the administration or provision
of the Medicaid program.
The cabinet shall promulgate an administrative regulation in accordance with
KRS Chapter 13A to designate the claim forms, records required, and
authorization procedures to be followed in conjunction with this section.
Effective:June 26, 2007
History: Amended 2007 Ky. Acts ch. 24, sec. 26, effective June 26, 2007. -Amended 2005 Ky. Acts ch. 99, sec. 233, effective June 20, 2005. -- Created
2000 Ky. Acts ch. 376, sec. 4, effective July 15, 2001.
Legislative Research Commission Note (7/15/2001). Under 2000 Ky. Acts ch.
376, sec. 24(1), this statute takes effect "on July 15, 2001, or upon approval of
any federal waivers, whichever first occurs." Because federal waivers were not
approved, the effective date is July 15, 2001.
Disclaimer: These codes may not be the most recent version. Kentucky may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.