Telehealth Reimbursement during Coronavirus

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Nori Gordon
Nori Gordon 159 Comments
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We urge Governor Lamont to immediately require all insurers to provide the same fee schedules for telehealth as for in-person care. Governor Lamont’s Executive Order on March 20th regarding telehealth in the state of Connecticut has put unnecessary burdens on the providers in our state by allowing insurers to set lowered rates for telehealth.

Some insurers in Connecticut have announced that they will reimburse telehealth at the same rate as in-person services, and other insurers, some with very large customer bases, are paying greatly reduced rates for the provision of telehealth services. Connecticut’s response is not in line with that of other states. For example,

  • Governor Baker of Massachusetts issued an executive order on March 15th including the following:

‘The GIC and all Carriers shall ensure that rates of payment to in-network providers for services delivered via telehealth are not lower than the rates of payment established by the Carrier for services delivered via traditional (i.e., in-person) methods, and shall notify providers of any instructions necessary to facilitate billing for such telehealth services’.

Connecticut’s response is also not in line with Medicaid’s acknowledgment of the added burden to providers in time and overhead costs associated with telehealth. Medicaid recently published guidelines on the Medicaid.gov website (“Medicaid State Plan Fee-for-Service Payments for Services Delivered Via Telehealth”) to assist states in understanding policy options for paying providers. It gives examples of how a state might supplement a provider’s reimbursement with add on fees, and provides the following guidance:

‘States may also pay for appropriate ancillary costs, such as technical support, transmission charges, and equipment necessary for the delivery of telehealth services. …’

‘Ancillary costs associated with the originating site for telehealth may be incorporated into the fee-for-service rates or separately reimbursed as an administrative cost by the state when a Medicaid service is delivered. …’

We urge the governor to take immediate action to help Connecticut providers and their patients use telehealth without penalty when compared to going into the office. Community medical and mental health providers are on the front lines of the COVID-19 emergency. They are responding to unprecedented fears and exacerbated mental health problems across our state, and deserve to serve their patients without unnecessary risk. We ask the Governor to immediately require all insurers to provide the same fee schedules for telehealth as for in-person care.


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