Kentucky Telehealth Laws & Reimbursement Policies

Kentucky Telehealth Laws

Medicaid Telehealth Reimbursement

Summary

Recently Adopted Legislation (Effective Jul. 1, 2019)
KY Medicaid is required to reimburse for covered services provided to a Medicaid recipient through telehealth. The Department must establish requirements for telehealth coverage and reimbursement which are equivalent to the coverage for the same service provided in-person unless the telehealth provider and the Medicaid program agree to a lower reimbursement rate for telehealth services, or the Department establishes a different reimbursement rate.

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Definitions

Telehealth means the delivery of health care-related services by Medicaid provider who is a health care provider licensed in Kentucky to a Medicaid recipient through a face-to-face encounter with access to real-time interactive audio and video technology or store-and-forward services that are provided via asynchronous technologies as the standard practice or care where images are sent to a specialist for evaluation.

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Live Video

Policy
Kentucky Medicaid will reimburse for a “telehealth consultation”, which includes live video.

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Eligible Services/Specialties
Click to see a list of covered services.

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Eligible Providers
Click for a list of eligible providers.

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Eligible Sites
Geographic Limits
Facility/Transmission Fee

Store-and-Forward

Policy
Beginning Jul. 1, 2019 KY Medicaid is required to reimburse telehealth consultations, which encompasses store-and-forward.

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Eligible Services/Specialties
Kentucky reimburses for tele-radiology but there is no other reference to reimbursing for other specialties.

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Geographic Limits
Transmission Fee

Remote Patient Monitoring

Policy
Not later than July 1, 2017 the department must establish a pilot project which creates coverage provisions and reimbursement criteria for telemonitoring services. CCHP has found no information regarding the commencement of this pilot.

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Conditions
Provider Limitations
Other Restrictions

Email/Phone/Fax

No reimbursement for email.
No reimbursement for telephone.
No reimbursement for FAX.

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Consent

The Cabinet must ensure informed consent.

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Out of State Providers

KY Medicaid program required to only allow providers licensed in Kentucky to receive reimbursement for telehealth services.

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Miscellaneous

Click for a list of miscellaneous Kentucky Medicaid requirements.

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Private Payer Laws

Definitions

Recently Adopted Legislation (Effective Jul. 1, 2019)
Telehealth means the delivery of health care-related services by a health care provider who is licensed in Kentucky to a patient or client through a face-to-face encounter with access to real-time interactive audio and video technology or store and forward services that are provided via asynchronous technologies as the standard practice of care where images are sent to a specialist for evaluation.

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Requirements

(Effective until Jul. 1, 2019)
Kentucky law states that insurers may not deny coverage because it is “provided through telehealth and not provided through face-to-face consultation” therefore requiring reimbursement for live video.
A health benefit plan may provide coverage for a consultation at a site not within the telehealth network at the discretion of the insurer.

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Parity

Payers shall not exclude services solely because the service is provided through telehealth. (Effective until July 1, 2019).

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Professional Regulation/Health & Safety

Definitions

Dietitians or Nutritionists & Jail Standards (Department of Corrections)
"Telehealth means the use of interactive audio, video, or other electronic media to deliver health care. It includes the use of electronic media for diagnosis, consultation, treatment, transfer of health or medical data, and continuing education.”

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Consent

The treating physician who delivers or facilitates the telehealth service shall obtain the informed consent of the patient before services are provided.

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Online Prescribing

Prior to prescribing in response to any communication transmitted or received by computer or other electronic means, physicians must establish a proper physician-patient relationship.

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Cross State Licensing

A provider must be licensed in Kentucky with the exception of persons who, being nonresidents of Kentucky and lawfully licensed to practice medicine or osteopathy in their states of actual residence, infrequently engage in the practice of medicine or osteopathy within this state, when called to see or attend particular patients in consultation and association with a Kentucky-licensed physician.

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Miscellaneous

Click for a list of professional board telehealth-specific regulations.

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Source: Center for Connected Health Policy
https://www.cchpca.org

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