HJBR Mar-Apr 2019

48 MAR / APR 2019 I  Healthcare Journal of Baton Rouge facility fee when telehealth is used. Twen- ty-three states limit the type of facility that can serve as an originating site, and 13 states reimburse service to the patient’s home, the CCHP reports. A recent Manatt analysis compared all 50 states’ Medicaid programs and ranked each in six telehealth categories: Practice Standards and Licensure; Medicaid Cov- erage and Reimbursement; Medicaid-El- igible Patient Settings; Medicaid-Eligible Provider Types; Medicaid-Eligible Tech- nologies; and Medicaid Service Limita- tions. States were scored as progressive, moderate, or restrictive in each category. Only 20 states were rated progressive across all six categories. A dozen received a restrictive rating, including neighbor- ing Texas and Arkansas. The remaining 18 states were classified as moderate. Where Louisiana Stands The Mannat analysis ranked Louisiana as progressive in all but two categories— column INSURANCE Progressive Innovations: The Rise of Telehealth in Louisiana The National Landscape for Medicaid & Telehealth The pursuit of the Triple Aim—better care quality, lower healthcare costs, and improved population health—has ignited a rapid evolution of state laws and policies related to Medicaid reimbursement for telehealth services. Currently, nearly all state Medicaid pro- grams provide reimbursement for some telehealth services, according to the Cen- ter for Connected Health Policy (CCHP). The CCHP’s 2018 State Telehealth Laws & Reimbursement Policies Report shows that Medicaid programs in 49 states and Washington, DC, provide reimbursement for live video telehealth, and 11 states of- fer reimbursement for store-and-forward. Four states have geographic restrictions in place, requiring a minimum distance be- tween the provider and the patient. Twenty state Medicaid programs pro- vide reimbursement for remote patient monitoring (RPM) services, and 34 offer a According to the American Telemedicine Association , more than half of U.S. hos- pitals are using telehealth technology, with most citing the opportunities to reduce the costs of care delivery, increase efficiency and revenue, and expand patient access to care as benefits. Here in Louisiana, the concept of telehealth continues to gain traction as healthcare policy-makers and providers recognize the tremendous value the technology can bring to the residents of a rural state with significant healthcare provider shortage areas. In fact, according to a recent Manatt analysis, Louisiana is considered progressive in all but two categories of telehealth—a clear indicator that our state is raising the telehealth bar to new heights. Medicaid-Eligible Technologies and Med- icaid Service Limitations—and in those two categories, the state was still consid- ered moderate. Overall, Manatt identified Louisiana as a moderate state, where state law and Medicaid policy are mixed and/or moderately support the broad use of tele- health. Currently, Louisiana’s Medicaid pro- gram covers live video telemedicine for Medicaid-enrolled distant site providers, though there is no reimbursement at this time for the originating site. Also covered are certain forms of RPM, including activ- ity and sensor monitoring, health status monitoring and medication dispensing and monitoring. Store-and-forward tele- health services are currently excluded from reimbursement. Recognizing the value of telehealth in Louisiana, the state’s Medicaid program has made clear its support for telehealth technology. In a March 2018 white paper, “Paving the Way to a Healthier Louisiana: Advancing Medicaid Managed Care,” the Louisiana Department of Health (LDH) indicated that innovative investments in primary care, timely access to care, tele- health, and medical homes are key pri- orities for Louisiana’s Medicaid managed care program. Telehealth Innovators in Louisiana With the support of Louisiana’s health- care policy-makers behind them, tele-