Medicaid: Updated COVID-19 Vaccine Counseling Coverage. If you intend to provide telepractice services to a resident of New York State, you must hold a New York State license and be in compliance with the relevant law, rules and regulations. For purposes of billing for Medicaid reimbursement, both the practitioner and/or facility employing the practitioner, and the designated program must be Medicaid enrolled and in good standing. of Health, Medicaid Update, Vol. SOURCE: NY Code of Rules and Regs. The designated program is the primary billing entity; reimbursement for practitioners at a distant/hub site must be pursuant to a contract or MOU. SOURCE: NY Office of Alcoholism and Substance Abuse Services. New York's Vaccine Equity Task Force was established to break down barriers to vaccination and ensure there is equitable distribution of the vaccine across the state, leaving no community behind. SOURCE: NY Insurance Law Article 32 Section 3217-h & Article 43 Section 4306-g. (Accessed Aug. 2022). SOURCE: NY Public Health Law Article 36 Section 3614(3-c). (Accessed Aug. 2022). 35, Number 2, February 2019, p. 4 & 11-12. Office of Mental Health: Clinic Treatment Program, Office of Mental Health: RTF Treatment and Documentation Standards, Visitation, Telemental Health Utilization, and Restraint Response during COVID-19 Emergency Period, Office of Mental Health: COVID-19 Disaster Emergency FAQ, Medicaid 1915(c) Waiver: Appendix K Childrens Waiver, STATUS: Active expires six months after the end of the federal PHE, Medicaid 1915(c) Waiver: Appendix K OPWDD/Home and Community Based Services Waiver. SOURCE: NY Dept. (Accessed Aug. 2022). See guidance for patients rights policy. This toolkit provides COVID-19 support and guidance for New Mexico communities and 7-9. NY Public Health Law Article 29 G Section 2999-dd. SOURCE: NY Office of Mental Health, Telemental Health Services Guidance, 2019, pg. Profession-Specific Telepractice Guidance is available for: SOURCE: NY Office of the Professions, Applied Behavioral Analysis, Practice Alerts Telepractice; Audiology, Practice Alerts Telepractice; Mental Health Practitioner, Practice Alerts Telepractice; Physical Therapy, Practice Alerts Telepractice; Psychology Practice Alerts Telepractice; Social Work Practice Alerts Telepractice; Speech Language Pathology Practice Alerts Telepractice, (Accessed Aug. 2022). 35, Number 2, February 2019 (Special Edition), p. 8-10. Such services do not include a telephone conversation, electronic mail message, or facsimile transmission between a provider and a recipient or a consultation between two physicians or nurse practitioners, or other staff, although these activities may support Telemental Health Services. Mask Mandates Medicaid: Comprehensive Guidance Regarding the Use of Telehealth including Telephonic Services During COVID-19. 35, Number 2, February 2019, p. 3 & 6. WebNew York administered the vaccine first to health-care workers, and then to nursing-home residents starting December 21. Licensed behavior analysts (LBAs) and certified behavior analyst assistants (CBAAs)/Mental Health Practitioners/Psychologists/Social Workers should develop procedures for and obtain informed consent prior to providing remote services and ensure that informed consent includes both benefits and risks. Such technology may include, but is not limited to: telephone, telefax, email, internet, or videoconference. SOURCE: NY Codes, Rules, & Regs. Store-and-forward technology involves the asynchronous, electronic transmission of a members health information in the form of patient-specific pre-recorded videos and/or digital images from a provider at an originating site to a telehealth provider at a distant site. Cover your cough or sneeze with a tissue. NY Dept. Title 11, Sec. Telepractice is providing service that is not in person and is facilitated through the use of technology. Telepractice is providing service that is not in person and is delivered through the use of technology. NY Code of Rules and Regs. SOURCE: NY Code of Rules and Regs. Medicaid 1915(c) Waiver: Appendix K Nursing Home Transition and Diversion (NHTD) and Traumatic Brain Injury (TBI). NY Office of Mental Health, Telemental Health Guidance, 2019, pg. of Health, Medicaid Update, Vol. Delivery of services via telepractice are covered when medically necessary and under the following circumstances: If the person receiving services is not present during the telepractice service, the service is not eligible for third party reimbursement and any incurred costs may remain the responsibility of the designated provider.Telepractice services may only be delivered via technological means approved by the Federal Center for Medicaid and Medicare Services (CMS), provided such means are compliant with Federal confidentiality requirements. (Accessed Aug. 2022). 35, Number 2, February 2019 (Special Edition), p. 11. The Scanner app is also able to validate SMART Health Cards issued by other U.S. states. Also includes billing gudiance, managed care reimbursement, technology and telecommunications guidance, and guidance for contracting with telemedicine companies. NY Public Health Law Article 29 G Section 2999-dd. Title 11, Sec. NY Dept. An insurer or corporation that provides comprehensive coverage for hospital,medical, or surgical care with a network of health care providers shallensure that such network is adequate to meet the telehealth needs ofinsured individuals for services covered under the policy when medicallyappropriate. Should maintain appropriate documentation, including informed consent (risks and benefits) for use of telepractice which includes a client agreement to use a private environment with a secure connection, and documentation of the telepractice encounter. Article 43 Section 4306-g. (Accessed Aug. 2022). Related to Credentialing and Privileging health care practitioners providing telemedicine, Telemedicine means the delivery of clinical health care services by means of real time two-way electronic audio-visual communications which facilitate the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patients health care, while such patient is at the originating site and the health care provider is at a distant site.. Provided, however, that an insurer or corporation may exclude from coverage a service by a health care provider where the provider is not otherwise covered under the policy or contract. Recently Effective Legislation until April 1, 2024: An insurer or corporation that provides comprehensive coverage for hospital,medical or surgical care shall reimburse covered services delivered bymeans of telehealth on the same basis, at the same rate, and to the sameextent that such services are reimbursed when delivered in person;provided that reimbursement of covered services delivered via telehealthshall not require reimbursement of costs not actually incurred in theprovision of the telehealth services, including charges related to theuse of a clinic or other facility when neither the originating site nordistant site occur within the clinic or other facility. All students registering for a fully in-person or hybrid class for the Spring 2023 semester and thereafter, must be fully vaccinated unless they have been granted a religious exception or medical SOURCE: Dental Procedure Manual. Generally, NY Medicaid covers audio-only services, but there is no explicit mention for FQHCs. STATUS:Based onWaiverbelieved to still be in effect (Most recent waiver reissued June 6, 2022 for 120 days). Procedure code Q3014 may be used by the provider at the originating site. Social Services Law Article 367-u. SOURCE: NY Code of Rules and Regs. Originating site means a site at which a patient is located at the time health care services are delivered to him or her by means of telehealth. Title 18, Sec. 8-9. of Health, Medicaid Update, Vol. Free and available in more than 12 languages. For serviceslicensed, certified or otherwise authorized, suchservices provided by telehealth, as deemed appropriate by the relevantcommissioner, shall be reimbursed at the applicable in person rates orfees established by law, or otherwise established or certified by theoffice for people with developmental disabilities, office of mentalhealth, or the office of addiction services and supports. New York State law permits a person from another state to perform speech-language pathology or audiology services in this State, as long as such services are performed for no more than thirty (30) days in any calendar year and NY Public Health Law Article 29 G Section 2999-cc, NY Code of Rules and Regs. (Accessed Aug. 2022). Members must be seen in-person by their practitioner, as needed, for follow-up care. Remote consultations between practitioners, without a Medicaid member present, including for the purposes of teaching or skill building, are not considered telehealth and are not reimbursable. The consulting provider must provide the requesting originating-site practitioner with a written report of the consultation and use the GQ modifier in order for payment to be made. The totality of the communication of information exchanged between the physician or other qualified health care practitioner and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via face-to-face interaction. FQHCs that have opted out of APGs are unable to bill for RPM services. of Health, Medicaid Update, Vol. NY Code of Rules and Regs. 35, Number 2, February 2019 (Special Edition), p. 4. Medicaid: Telehealth and Telephonic Services for Adult Day Health Care Program, Medicaid: Guidance for Home and Community-Based Services, Medicaid: Guidance for Children and Family Treatment and Support Service Providers, Medicaid: Factsheet for Consumers during COVID-19, Office of Mental Health: Telemental Health and Program Guidance. Title 18, Sec. (Accessed Aug. 2022). NY Code of Rules and Regs. More , The Family Health Center at NYMC provides same-day or walk-in appointments for outpatient care. 35, Number 2, February 2019, p. 6. NY Office of Mental Health, Telemental Health Services Guidance, 2019, pg. P. 87; NY Dept. (Dec. 2019), p 2, (Accessed Aug. 2022). SOM's humanistic and experiential approach to medical education prepares doctors to be as compassionate as they are clinically skilled. See guidance for details. Telehealth means the use ofelectronic information and communication technologies by a health careprovider to deliver health care services to an enrollee while suchenrollee is located at a site that is different from the site where thehealth care provider is located. NY Office of Alcoholism and Substance Abuse Services. CDC is the nations leading science-based, data-driven, service organization that protects the publics health. Follow-up is included in the monthly time component. SOURCE: NY Statute, Social Services Law SOS 367-u. (Accessed Aug. 2022). Telehealth should not be used by a provider if it may result in any reduction to the quality of care required to be provided to a Medicaid member or if such service could adversely impact the member. In such cases, only the originating site should bill Medicaid for the telemedicine encounter. The originating site must be located within the fifty United States or United States territories. SOURCE: NY Dental Policy and Procedure Code Manual January 1, 2022, page 86 (Accessed Aug. 2022). SOURCE: NY Public Health Law Article 29 G Section 2999- cc, (Accessed Aug. 2022). NY Public Health Law Article 29 G Section 2999-cc, (Accessed Aug. 2022). Telehealth is defined as the use of electronic information and communication technologies to deliver health care to patients at a distance, which shall include the assessment, diagnosis, consultation, treatment, education, care management and/or self-management of a patient (Medicaid member). Medical conditions that may be treated/monitored by means of RPM include, but are not limited to: SOURCE: NY Public Health Law Article 29 G Section 2999-cc. NY Code of Rules and Regs. CCHP encourages you to check with the appropriate state agency for further information and direction. NY Office of the Professions, Speech Language Pathology and Audiology, Practice Guidelines, (Accessed Aug. 2022). (Accessed Aug. 2022). See regulation for details. Title 11, Sec. WebEvery day, the City's 325,000 employees serve millions of residents and visitors. Reimbursement shall be made for telehealth services provided by use of telephone and other audio-only technologies. This page is available in other languages. 35, Number 2, February 2019 (Special Edition), p. 11. NY Codes, Rules, & Regs. Such policy shall include health care providers who legally prescribe abortion medication to out-of-state patients by means of telehealth. Every insurer which issues or renews medical malpractice insurance covering a health care provider licensed to practice in this state shall be prohibited from taking any adverse action against a health care provider solely on the basis that the health care provider performs an abortion or provides reproductive health care that is legal in the state of New York on someone who is from out of the state. 35, Number 2, February 2019, p. 5-6. RPM included within definition of telehealth in statute requiring Medicaid Reimburse telehealth delivery of services. NY Medicaid does not reimburse for telehealth used solely for the convenience of the practitioner when a face-to-face visit is more appropriate and/or preferred by the member. For example, the completion of clinical laboratory test, blood draws or X-rays that are scheduled subsequent to the initial clinic visit do not qualify for reimbursement unless the patient is also seen for purposes of discussing the findings and for definitive treatment planning. 52.16 (q). SOURCE: NY Office of Mental Health, Telemental Health Guidance, 2019, pg. SOURCE: NY Office of Mental Health, Telemental Health Guidance, 2019, pg. NY Insurance Law Article 43 Section 4306-g. NY Codes, Rules, & Regs. NY State Office of Mental Health Telemental Guidance (Nov. 2019), p. 3. This includes all public, private, and religious schools. Under the Medicaid program, Telemental Health Services are covered when medically necessary and under the following circumstances: SOURCE: NY Code of Rules and Regs. (Aug. 2022). 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