Vermont Telehealth State Laws & Reimbursement Policies

Medicaid Telehealth Reimbursement

Summary

Vermont Medicaid reimburses for live video under certain circumstances. Home health monitoring is considered a Medicaid benefit and is available under certain conditions.

Vermont Telehealth Summary

Definitions

Telemedicine is defined in Act 64 as “…the delivery of health care services…through the use of live interactive audio and video over a secure connection that complies with the requirements of the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191.

Vermont Telehealth Definitions

Live Video

Policy
Health insurance plans must provide coverage for health care service delivered through telemedicine by a health care provider at a distant site to a patient at an originating site to the same extent that the plan would cover the services if they were provided through in-person consultation.

Vermont Telehealth Live Video Policy

Eligible Services/Specialties
No reference found.
Eligible Providers
Eligible Sites
An originating site is the location of the patient, whether or not accompanied by a health care provider, at the time services are provided by a health care provider through telemedicine, including a health care provider’s office, a hospital, or a health care facility, or the patient’s home or another nonmedical environment such as a school-based health center, a university-based health center or patient’s workplace.

Vermont Telehealth Eligible Sites

Geographic Limits
No reference found.
Facility/Transmission Fee

Store-and-Forward

Policy
Statute permits health plans (including Medicaid) the option to reimburse for teleophthalmology and teledermatology services provided by store-and-forward. In the Medicaid Provider Manual dated Feb. 1, 2019, VT Medicaid states it does not reimburse for these services.

Vermont Telehealth Store-and-Forward Policy

Eligible Services/Specialties
No reimbursement for tele-ophthalmology or tele-dermatology by store-and-forward stated in the Provider Manual dated Feb 1, 2019. However, as noted above, The Administrative Rules for the VT Agency of Human Services (dated Jan. 1, 2019), states that store-and-forward teledermatology and teleopthalmology is covered. The two policies are close enough in date as to make it uncertain which may be the actual policy in place.

Vermont Eligible Telehealth Services and Specialities

Geographic Limits

No reference found.
Transmission Fee
No reference found.

Remote Patient Monitoring

Policy
Conditions
Provider Limitations
Other Restrictions
View additional criteria for remote patient monitoring.

Email/Phone/Fax

Consent

Written or oral informed consent for telemedicine services shall be provided in accordance with Vermont and national policies and guidelines on the appropriate use of telemedicine within the provider's profession prior to the use of telemedicine.

Vermont Telehealth Consent

Out of State Providers

No reference found.

Miscellaneous

No reference found.

Private Payer Laws

Definitions

"Telemedicine means the delivery of health care services such as diagnosis, consultation, or treatment through the use of live interactive audio and video over a secure connection that meets Health Insurance Portability and Accountability Act (HIPAA) requirements."

Vermont Telehealth Private Payer Definitions

Requirements

Health insurance plans must provide coverage for health care service delivered through telemedicine by a health care provider at a distant site to a patient at an originating site to the same extent that the plan would cover the services if they were provided through in-person consultation.

Vermont Telehealth Private Payer Requirements

Parity

For live video, plans are required to cover services provided through telemedicine to the same extent the plan covers services provided in-person. For store-and-forward, plans are allowed but not required to reimburse for tele-ophthalmology and tele-dermatology.

Vermont Telehealth Private Payer Parity

Professional Regulation/Health & Safety

Definitions

"Telemedicine means the delivery of health care services such as diagnosis, consultation, or treatment through the use of live interactive audio and video over a secure connection that meets Health Insurance Portability and Accountability Act (HIPAA) requirements. Telemedicine does not include the use of audio-only telephone, e-mail, or facsimile.”

Vermont Telehealth Health and Safety Definitions

Consent

A health care provider delivering health care services through telemedicine must obtain and document a patient’s oral or written informed consent.

Vermont Teleheath Consent

Online Prescribing

Providers may prescribe, dispense, or administer drugs or medical supplies, or otherwise provide treatment recommendations if they first examine the patient in-person or by the use of instrumentation and diagnostic equipment through which images and medical records may be transmitted electronically.

Vermont Telehealth Online Prescribing

Cross State Licensing

Miscellaneous

No reference found.

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