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Coronavirus and Telehealth Forum Introduction

Posted by [email protected] on $$DATE$$  /   17

INAMFT Board Members have been getting requests for information regarding all aspects of telehealth during the Coronavirus.  The board is learning about this subject at the same rate members may be and we would like to this forum to be a place where we can all learn from each other.  Please post any question/answers you may have here regarding telehealth (platforms, costs, reviews, etc.), telehealth insurance reimbursement (specific to each insurance company), licensing issues and HIPPA concerns or anything else about this subject.  Please help others learn from your experiences and please remember, if you have a question, 10 others probably have the same one, so please ask!

Some may have questions about emergency orders and laws related to telehealth in other states, so here is a link to a website that is tracking each state's rules and regulations during this pandemic:

https://wearemotivo.com/online-clinical-supervision-rules/?utm_campaign=ACA%202020%20Conference%20Email%20Blast&utm_source=email

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17 Comments

  1. Kurt H. Gregory, MS

    May. 29, 2020

    The following email was sent to INAMFT members on May 29, 2020 Dear INAMFT Member, As we all know, on March 6, 2020, Governor Eric Holcomb issued Executive Orders that essentially cleared the way for medical and mental health practitioners to legally practice telehealth during the COVID-19 crisis. These orders are set to expire on June 4, 2020, which will mean a return to the restrictions in place prior to March 6. INAMFT, as well as many other associations, remain concerned for the health and well being of, not only those we serve who are in a high risk demographic, but our members who provide services who also may be at a higher risk, if the telehealth order is lifted. Therefore, we collaborated with the Physical Therapists, Occupational Therapists, Speech, Language, and Hearing Therapists, Social Workers, Mental Health Counselors, Mental Health America of Indiana, and Addiction Professionals to author the attached letter. This letter, which was delivered to the Governor on the morning of May 28, asks the Governor to extend his Executive Order through June 30, 2021to give us time to address all telehealth issues in the General Assembly when it convenes at the beginning of 2021. Hopefully, the Governor grant our request so we can continue to serve all the citizens of our state in the safest manner possible for both them and ourselves. Sincerely, Kurt H. Gregory, M.S., L.M.F.T. Legislative Chair and Past President The referenced letter may be viewed here: https://inamft.org/images/downloads/telemedicine_in_indiana.pdf

  2. Kurt H. Gregory, MS

    Mar. 27, 2020

    From AAMFT: Please leave specific comments on the AAMFT site at: https://blog.aamft.org/2020/03/aamft-sends-letter-to-congress-and-naic-about-telebehavioral-health-restrictions.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed%3A+TheAamftBlog+%28The+AAMFT+Blog%29 AAMFT Sends Letter to Congress and NAIC About Telebehavioral Health Restrictions AAMFT and many other national behavioral health organizations that are members of the Mental Health Liaison Group sent letters to Congress, the nation’s governors, and the National Association of Insurance Commissioners requesting that states lift restrictions on telebehavioral health for all individuals regardless of insurance and ensure payment parity with face-to-face therapy during this emergency period. Read our letter to Congress here: Download MHLG Telehealth State Coverage Letter 3.25.20 FINAL House and Senate Read our letter to NAIC here: Download MHLG Telehealth State Coverage Letter 3.25.20 FINAL NAIC

    1. Robert A. Atchison, PhD

      May. 1, 2020

      Greetings! I posted this link above, but just in case anyone has any interest in what other states are doing with telehealth during the pandemic here is a website that is tracking these updates: https://wearemotivo.com/online-clinical-supervision-rules/?utm_campaign=ACA%202020%20Conference%20Email%20Blast&utm_source=email

  3. Kurt H. Gregory, MS

    Mar. 27, 2020

    Mark Scherer, our Lobbyist, who is also an attorney, and I (Mark more than me) looked into why this insurance coverage and billing is such a mess. Here is Mark's take on it, which makes sense: "Kurt, as I previously mentioned IC 27-8-34-6 does require telehealth parity. And HB 1092 this year reinforces this point as parity language was added to the bill that requires a state plan amendment for the Medicaid authority we got last year. But upon further reflection considering some testimony this past session and input from some other folks, we believe that only 10-20% of insurance plans are covered by these provisions due to ERISA and self-funded plans. So that is why you correctly observed that it is a patchwork in the insurance world."

  4. Kurt H. Gregory, MS

    Mar. 27, 2020

    UMR: Summary of information: Conflicting information. Some reports indicate UMR wants their insured to use Teledoc or OC-24. Other reports state a provider needs to sign a waiver, while others appear to be getting information that a waiver is not needed. One person said they received the following, but we cannot confirm. “Telephonic care: For providers who do not have access to HIPAA-approved technology typically required to conduct a video-enabled virtual session, or video chat platforms as listed below, telephonic services can begin immediately. Providers do not need to attest through our virtual visits process to provide telephonic care. Please refer to reimbursement guidelines below for telehealth billing guidelines as this will allow properly submitted claims to process through auto-adjudication without creating manual work and support timely payment. Virtual visits: HIPAA-approved technology can continue to be used by providers to deliver telehealth care to members. For providers who do not have access to HIPAA-approved technology to conduct a virtual video-enabled session, providers can conduct these sessions immediately using any nonpublic-facing remote communications product that is available to communicate with members as listed below in accordance with OCR’s Notice. Although providers are encouraged to use HIPAA-compliant technologies, consistent with OCR’s Notice, as outlined below and follow Optum standard telehealth processes, during the nationwide public health emergency, providers do not need to attest through the Optum virtual visits process to provide telehealth or virtual visit care. (Please note: Providers will not be listed in the virtual visit provider directory until attestation is completed, including the use of HIPAA-compliant technologies.) Please refer to reimbursement guidelines below for telehealth billing guidelines as this will allow properly submitted claims to process through auto-adjudication without creating manual work and support timely payment. “

  5. Kurt H. Gregory, MS

    Mar. 27, 2020

    Beacon Health: Summary of information: Telehealth is not a covered service for GM employees. It appears GM needs to lift this restriction so Beacon can cover. Reports indicate Lutheran Hospital in Fort Wayne, also covered by Beacon, “has not made a decision yet”.

  6. Kurt H. Gregory, MS

    Mar. 27, 2020

    Signature Care, which is mostly in the Northeast part of the state: Summary of information: They will cover any Parkview employee for Telepsych. Billing will need to include location change and modifier. Non Parkview employees such as FWCS, will be case by case and will likely be covered, but not absolute. AGA signature care clients are a firm NO for telehealth. This includes city of Fort Wayne employees (who are being directed to the insurance company's version of “Teledoc”.

  7. Kurt H. Gregory, MS

    Mar. 27, 2020

    Shared from a Facebook Group: If you are billing Medicaid for Telehealth: Bulletin came out today. Use Modifier GT. Do not change place of service or your claim will be denied.

  8. Laura K. Snyder, MS

    Mar. 27, 2020

    I learned from a member of the Central Indiana Private Practice Facebook group that VA Community care clients are being covered with telehealth right now - the person posting this stated she received a call from the VA verifying this.

  9. Kurt H. Gregory, MS

    Mar. 26, 2020

    Free training from Pesi in telehealth: $439 training for FREE with code TELEFREE PESI IS OFFERING A 12 HOUR TELETHERAPY TRAINING FOR FREE WITH CODE TELEFREE LINK BELOW. THE CODE: It doesn’t go in the mail code spot or the gift card spot. It goes in the Discount spot at the end of the page on the last page of registration form https://catalog.pesi.com/item/52191/…

  10. Kurt H. Gregory, MS

    Mar. 26, 2020

    Information on Anthem We are getting spotty reports. Some say Anthem will pay. Some say Anthem will pay for some plans. One person reported they filed a claim and the eob stated it was to be applied to an already met deductible. One person reported they recieved the following from Anthem "Access to Virtual Care: For 90 days, Anthem’s affiliated health plans will waive any member cost share for telehealth visits, including visits for mental health, for our fully insured employer plans, Individual plans, Medicare plans and Medicaid plans, where permissible. Cost sharing will be waived for members using Anthem’s telemedicine service, LiveHealth Online, as well as care received from other telehealth providers delivering virtual care. Access to LiveHealth Online as well as virtual care via text is available to members through the Sydney Care app. Self-insured plan sponsors will have the choice to participate in this program. Anthem continues to recommend members use virtual care options when possible, as it can help prevent spread of coronavirus and improve access to care. Virtual care is a safe and effective way for members to see a doctor to receive health guidance related to COVID-19 from their homes via smart phone, tablet or computer." Please share any information or experiences you have with Anthem

    1. Laura K. Snyder, MS

      Mar. 27, 2020

      Shared from the Central Indiana Private Practice Facebook page: An Anthem rep stated that though most plans are “self funded” and have the option to “opt out” of tele-mental health, he has not seen any plans that HAVE opted out. The rep said that some plans have opted out of approving teletherapy for physical therapy, occupational therapy, and speech therapy, but he has seen ZERO plans opting out of Telehealth for mental health. The rep said that ALL Blue Access Plans and Blue Card Plans are “fully funded” and will cover telemental health services for 90 days beginning 3/19/2020. Plans with prefixes YRP and YZD are both “fully funded” and are not eligible to “opt out.” Other plans that the rep said had NOT opted out include plans beginning with the following prefixes: EYUAN (Eli Lilly), GMJ (General Motors, non-union), IUCAN (IU corporate), JINAN (State of Indiana), LJS (Livingston, International), RPWAN (Republic Airways), SJAAN (JoAnne Stores), UIK (University of Georgia), UPDAN (ABC Supply), UQKAN (United Technologies), XPA (NSCI Indiana), and R (federal plans). These prefixes are all associated with plans that my clients have. Obviously, there are many others. But if you have clients with these prefixes, it would seem that they are confirmed to have NOT opted out. I hope this helps you whittle down which plans are currently “opting in” to approve telemental health services for the 90 days following 3/19/2020. I cannot speak to other plans. Nor can I address the copay / co-insurance issue.

  11. Kurt H. Gregory, MS

    Mar. 26, 2020

    Information from Aetna https://www.aetna.com/content/dam/aetna/pdfs/health-care-professionals/bh-televideo-service-codes-covid-19.pdf?

    1. Laura K. Snyder, MS

      Mar. 27, 2020

      Shared from the Central Indiana Private Practice Facebook page: Until June 4, 2020, Aetna will waive member cost sharing for any covered telemedicine visits regardless of diagnosis - including mental health. For commercial plans, cost sharing will be waived for all virtual visits through the Aetna-covered Teladoc® offerings and in-network providers delivering telemedicine services. Aetna is allowing clinicians to deliver mental health counseling and consultative services through telemedicine to members who are hospitalized. We're reimbursing for Applied Behavioral Analysis delivered via televideo, allowing children with Autism to receive therapy services at home with required professional oversight. Aetna is reimbursing for Medication Assisted Treatment (MAT) services conducted through televideo or telephonically, when used with non-injectable medications, for the treatment of substance use disorders. Until further notice, Aetna is also expanding coverage of telemedicine visits to its Aetna Medicare members, so they can receive the care they need from you without leaving their homes. With this change and new flexibilities announced by the Centers for Medicare and Medicaid Services to help combat the virus, Aetna Medicare members can now see their providers virtually via telephone or video. Aetna Employee Assistance Program counseling sessions can be delivered via televideo or telephonically until June 4, 2020.

  12. Kurt H. Gregory, MS

    Mar. 26, 2020

    Information from United Healthcare. https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-telehealth-services.html#2-mar20

  13. Kurt H. Gregory, MS

    Mar. 26, 2020

    Link to Gov. Holcomb's Executive Order 20-05 addressing Medicaid telehealth and telehealth for Mental Health practitioners. https://www.in.gov/gov/files/EO_20-05.pdf

  14. Kurt H. Gregory, MS

    Mar. 26, 2020

    Link to the HHS press release regarding the federal use of telehealth in medicare and the suspension of certain good faith HIPPA rules. https://www.hhs.gov/about/news/2020/03/17/secretary-azar-announces-historic-expansion-of-telehealth-access-to-combat-covid-19.html