Approved by the Vermont House and Senate, legislation aims to extend and regulate telemedicine reimbursement within the state. The telemedicine reimbursement bill involves new requirements for payers to reimburse telemedicine services, and enhances regulations regarded to how payers could charge beneficiaries.
If the legislation is signed by Governor Phil Scott (R), S.50 will come into effect on the day of October 1, 2017 and will apply to Medicaid and all other health insurance policies.
Under the telemedicine reimbursement bill, the Department of Vermont Health Access (VHA) must make sure that both the treating clinician and the hosting facility are reimbursed for the services rendered, unless the healthcare providers at both the host and service sites are employed by the similar organization.
In relation to guaranteeing clinician and facility reimbursement, payers will be needed to treat telemedicine as if it were an in-person visit between a beneficiary and a provider. For instance, payers can charge a deductible, co-pay, or coinsurance for telemedicine service, but charges might not exceed the amounts they would enforce for an in-person visit.
Plan of health insurance may reimburse for teleophthalmology or teledermatology given through store-and-forward technology. A distant site health care provider is also required by payers to document the reason the services are being given by store and forward means.
Payers also can’t set limits on telemedicine services, but are permitted to optionally need providers to describe why they are utilizing telemedicine.
S.50 revisions in the Senate also consist of new language that broadens telemedicine use by all kinds of certified health experts.
The bill reads, “A person, partnership or corporation, other than a facility or institution that is licensed, certified or otherwise authorized by law to give professional healthcare services in this state to an individual during the medical care, treatment or confinement of that individual.”
Vermont lawmakers have viewed this bill as a way to extend access to care through telemedicine, but permit care charges to remain stable.
“A primary factor behind the bill was offering people greater access to specialists in regions where they are scarce,” stated Sen. Debbie Ingram-D via the VT Digger. “I consider everybody thought it was a great way to give access without raising charges astronomically,” she claimed.