New York became the twenty-second state to require private insurance companies to cover telehealth services when New York Governor Andrew Cuomo signed the state’s telehealth parity law, which went into effect Jan. 1, 2016. This law also authorized the New York Medicaid agency to increase coverage and reimbursement of telemedicine.
New York Medicaid offers live video reimbursement and some reimbursement for store-and-forward and home health services. The New York State Department of Health released a Medicaid telehealth expansion in 2019 and the Office of Mental Health released telepsychiatry guidance in November 2019.
the New York State Department of Health issued a guidance document on the New York Medicaid program’s continued coverage of telehealth services for the duration of the federal Public Health Emergency (PHE). The guidance is designed to maintain the ability of Medicaid providers to use telemedicine and digital health to deliver health services for the remainder of the federal PHE. The guidance will remain in effect until the federal PHE expires or the Department of Health issues permanent Medicaid telehealth rules, whichever comes first. The guidance also may be a preview of additional guidance to be issued in the near future regarding telehealth in New York State beyond the Medicaid Program.
Additional guidance has been released since, however they currently appear to just be tied to the COVID-19 emergency.
Telehealth Definition: The term telehealth is broadly defined as “the use of electronic information and communication technologies to deliver health care to patients at a distance.” Medicaid-covered telehealth services include assessment, diagnosis, consultation, treatment, education, care management and/or self-management of a Medicaid patient. During the PHE, “telehealth” includes telephonic, telemedicine, store and forward, and remote patient monitoring. The guidance uses the term “telemedicine” to denote two-way audiovisual communication.
Originating Site Restrictions: An originating site is where the Medicaid patient is located at the time health care services are delivered to him/her by means of telehealth. Originating sites during the PHE can be anywhere the member is located including the member’s home.
Distant Site Restrictions: A distant site is the site where the telehealth provider is located while delivering health care services by means of telehealth. During the PHE, any site within the fifty United States or United States’ territories, is eligible to be a distant site for delivery and payment purposes. This includes Federally Qualified Health Centers and providers’ homes.