Telemedicine: Clinical & Legal Perspectives

State of Connecticut Bill No. 6001: AN ACT CONCERNING TELEHEALTH

Overview (Newly Updated: 10.16.20)

  • The bill expands the list of authorized telehealth providers, in addition to allowing for telehealth services to be provided via audio only.
  • The bill prohibits health carriers (e.g., insurers and HMOs), until March 15, 2021, from reducing the amount of reimbursement they pay to telehealth providers for covered services appropriately provided through telehealth instead of in person.
    • This also means that health insurance policies cannot exclude coverage solely because a service is provided through telehealth, as long as telehealth is appropriate
    • Reimbursement must be equal to in-person rates
  • The bill applies to individual and group health insurance policies in effect any time from the bill’s passage until March 15, 2021.
    • This means that self-funded plans are excluded from this requirement
  • The bill requires that the provider also determine whether 1) the patient has health coverage that is fully insured, not fully insured, or provided through CMAP, and 2) the coverage includes telehealth services.
  • Payment for Uninsured and Underinsured Patients – the bill requires we accept either:
    • for patients who do not have health insurance coverage for telehealth services, an amount equal to the Medicare reimbursement rate for telehealth services or
    • for patients with health insurance coverage, the amount the carrier reimburses for telehealth services and any cost sharing (e.g., copay, coinsurance, deductible) or other out-of-pocket expense imposed by the health plan.
  • Enhanced documentation requirements, as well as regulations related to out-of-state telehealth providers (which for SOHO, as a regional organization, is an everyday reality of business)
  • To view/read the full bill, click here.

COVID-19 has dramatically increased the number of healthcare providers looking to telemedicine to respond to symptomatic at-risk patients and for treating non-COVID-19 illnesses.  While telemedicine offers many benefits this method of healthcare can expose the provider to liability. Healthcare providers and organizations must consider the risks associated with telemedicine. It is important to develop and implement a telemedicine program that provides quality care, while minimizing risk to the patient.

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