WSR 15-17-088 EMERGENCY RULES HEALTH CARE AUTHORITY (Washington Apple Health) [Filed August 18, 2015, 9:51 a.m., effective August 18, 2015, 9:51 a.m.] Effective Date of Rule: Immediately upon filing.
Purpose: Adding a new section (WAC 182-531-1730) for coverage of telemedicine.
Statutory Authority for Adoption: RCW 41.05.021.
Under RCW 34.05.350 the agency for good cause finds that immediate adoption, amendment, or repeal of a rule is necessary for the preservation of the public health, safety, or general welfare, and that observing the time requirements of notice and opportunity to comment upon adoption of a permanent rule would be contrary to the public interest; and that state or federal law or federal rule or a federal deadline for state receipt of federal funds requires immediate adoption of a rule.
Reasons for this Finding: This emergency rule is necessary to continue the current emergency rule adopted under WSR 15-09-113 to allow for the coverage of telemedicine services while the agency continues to finalize the permanent rule-making process. The agency has completed the internal and external review processes and is filing the CR-102 Proposed rule making for public hearing in early October.
Number of Sections Adopted in Order to Comply with Federal Statute: New 0, Amended 0, Repealed 0; Federal Rules or Standards: New 0, Amended 0, Repealed 0; or Recently Enacted State Statutes: New 0, Amended 0, Repealed 0.
Number of Sections Adopted at Request of a Nongovernmental Entity: New 0, Amended 0, Repealed 0.
Number of Sections Adopted on the Agency's Own Initiative: New 0, Amended 0, Repealed 0.
Number of Sections Adopted in Order to Clarify, Streamline, or Reform Agency Procedures: New 1, Amended 0, Repealed 0.
Number of Sections Adopted Using Negotiated Rule Making: New 0, Amended 0, Repealed 0; Pilot Rule Making: New 0, Amended 0, Repealed 0; or Other Alternative Rule Making: New 1, Amended 0, Repealed 0.
Date Adopted: August 18, 2015.
Wendy Barcus
Rules Coordinator
NEW SECTION
WAC 182-531-1730 Telemedicine.
(1) Telemedicine is when a health care practitioner uses HIPAA-compliant, interactive, real-time audio and video telecommunications (including web-based applications) to deliver covered services that are within his or her scope of practice to a client at a site other than the site where the provider is located. Using telemedicine enables health care practitioners and the client to interact in real-time communication as if they were having a face-to-face session. Telemedicine allows clients, particularly those in medically underserved areas of the state, improved access to health care services that may not otherwise be available without traveling long distances.
(2) The medicaid agency does not cover the following services as telemedicine:
(a) E-mail, audio only telephone, and facsimile transmissions;
(b) Installation or maintenance of any telecommunication devices or systems; and
(c) Purchase, rental, or repair of telemedicine equipment.
(3) Originating site. An originating site is the physical location of the client at the time the health care service is provided. Approved originating sites are:
(a) Clinics;
(b) Community mental health/chemical dependency settings;
(c) Dental offices;
(d) Federally qualified health centers;
(e) Home or natural setting, for applied behavior analysis benefit only;
(f) Hospitals - Inpatient and outpatient;
(g) Offices;
(h) Rural health clinics;
(i) Schools; and
(j) Skilled nursing facilities.
(4) Distant site. A distant site is the physical location of the health care professional providing the health care service.
(5) The agency pays a technical administration fee to either the originating site or the distant site, as specified in the agency's program-specific billing instructions.
(6) If a health care professional performs a separately identifiable service for the client on the same day as the telemedicine service, documentation for both services must be clearly and separately identified in the client's medical record.
(7) Billing procedures for telemedicine can be found in the agency's program-specific billing instructions.
|