Federal Regulatory News

The Centers for Medicare and Medicaid Services (CMS) released the 2022 Medicare Part B Physician Fee Schedule. Some telehealth highlights of note:

The Consolidated Appropriate Act (CAA), that passed in December 2020 included a statue requiring an in-person mental health visit prior to qualifying for telehealth services. CMS did not have authority to modify this requirement so it must stand but CMS did have authority on subsequent in-person requirements. CMS will require an in-person with the provider or a provider in the same practice every 12 months thereafter. CMS’ original proposal was every 6 months.
Allows for audio-only behavioral health visits:
Must be an established patient
Provider must have the capability for audio/video but the patient declines video or does not have the technology needed – a modifier will be required and the document must support the medical necessity of audio-only
Allows the home as an originating site – updated definition of “home” to include temporary housing (hotel, homeless shelter)
Will allow Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHC) to serve as distant site providers for behavioral health and will reimburse for the services, including audio-only visits. These sites are subject to the same in-person requirements and technology capabilities as fee-for-service providers.
Added cardiac rehabilitation CPT codes 93797-98 and G0422-23 to the Category 3 list and allows providers to bill all Category 3 CPT codes through 2023.

State Regulatory News

Florida Senate Bill 312 – Passed the Health Committee (1st Committee)
This bill seeks to amend the ban on prescribing certain controlled substance by allowing providers to renew prescriptions for Schedule III, IV, or V substances via telehealth, including audio-only.

Maine Board of Licensure – Draft Rule for Telehealth Issued
In response to 2021 state legislative changes, the board of medicine, osteopathic licensure, and state board of nursing have released a joint draft of rules that include definition changes, an expanded list of eligible providers, and updates to practice language. The updates are proposed to be placed in Chapter 11: Joint Rule Regarding Telehealth Standards of Practice. The comment period is open until December 10, 2021.

New Jersey Senate Bill 309 – Conditionally Vetoed
This is a bill we have been watch for months as it addresses telehealth payment parity and standards of practice allowing greater flexibilities for telehealth provision. The passed the senate and has been sitting on Governor Murphy’s desk for months. As anticipated, he conditionally vetoed the comprehensive bill. The governor has extended parity until the end of 2023 while a commission studies the impact of parity on providers and health insurance plans.

Wisconsin Senate Bill 309 – ENACTED!
The state has updated the definition of “telehealth” to one that is technology neutral. The bill also limits professional boards from narrowing the definition.

440.01 (1) (hm)
“Telehealth means a practice of health care delivery, diagnosis, consultation, treatment, or transfer of medically relevant data by means of audio, video, or data communication that are used either during a patient visit or a consultation or are used to transfer medically relevant data about a patient. Telehealth includes asynchronous telehealth services, interactive telehealth, and remote patient monitoring.”

440.17 Telehealth
“If the department, an examining board, or an affiliated credentialing board promulgates rules related to telehealth, the department, the examining board, or the affiliated credentialing board shall define “telehealth” to have the meaning given in s. 440.01 (1) (hm).”