*Effective July 1, 2022* Telehealth visits provided through audio and real time video communication may be used to satisfy the face-to-face requirement for reimbursement under the payment methods that apply to federally qualified health centers, rural health centers, Indian Health Service and 638 Tribal clinics, and certified community behavioral health centers. This change extends the current telehealth reimbursement policy for these provider types beyond the federal public health emergency.

*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below. Significant changes for MEDICAID include:

• Audio-only telehealth services are covered at parity until July 1, 2023

• Medical Assistance clients may consent verbally to treatment plans for mental health and substance use disorder services

• Mental health case management & targeted case management services can be delivered via telehealth in most situations

• Coverage for telehealth is expanded to include the services of peer and family specialists, mental health rehabilitation workers, behavioral health aides, treatment coordinators, alcohol and drug counselors, and recovery peer specialists.

• The previous limit of three telehealth visits per enrollee per week for Medical Assistance enrollees has been removed.

• Pilot studies and reports on the use of audio-only telehealth in Medical Assistance programs were initiated.

• For mental health centers: Many home and community based services (case management, disability services, home-based services, etc) were extended by waivers under the state peacetime emergency. DHS is evaluating the extent to which they can keep many of these waivers in place between state and federal authority.

Summary and text of HF 33

TELEHEALTH DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site.”

SERVICE PARITY: “A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.”

PAYMENT PARITY: “A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider.” Payment parity for audio-only telehealth services is required until July 1, 2023.

REMOTE MONITORING: MHCP covers telemonitoring services for MHCP members in fee-for-service programs. Assessment and monitoring of the data must be performed by one of the following providers: physician, physician assistant, advanced practice registered nurse, registered nurse, podiatrist, respiratory therapist, a licensed professional working under the supervision of a medical director (for example, an LPN). MHCP covers telemonitoring services for members in high-risk, medically complex patient populations. These members have medical conditions like congestive heart failure, chronic obstructive pulmonary disease (COPD) or diabetes.

ORIGINATING SITES: A site at which a patient is located at the time health care services are provided to the patient by means of telehealth. Minnesota health care programs do not pay an originating site facility fee.

ELIGIBLE PROVIDERS: Physician, NP, PA, Nurse midwife, clinical nurse specialist, RD/nutrition professional, dentist/hygienist/therapist, mental health professional, pharmacists, certified genetic counselor, podiatrist, ST, OT, PT, audiologist, public health nursing organization 

PREREQUISITES TO TELEHEALTH: Providers must complete the Provider Assurance Statement for Telemedicine

PROVIDER REQUIREMENTS: Providers must document “the provider's basis for determining that telemedicine is an appropriate and effective means for delivering service to the recipient” 

NON-COVERED SERVICES: Connections using non-HIPAA compliant technology, Prescription renewals, Scheduling a test or appointment, Clarification of issues from a previous visit, Reporting test results, Non-clinical communication, Communication via telephone, email or fax, Day treatment, Partial hospitalization programs, Residential treatment services, Case management face-to-face contact

FQHCs & RHCs:

• PROSPECTIVE PAYMENT SYSTEM (PPS) REIMBURSEMENT STRUCTURE

• Most in-person services can be provided via telehealth and are reimbursed at the PPS/encounter rate

• Can provide all services except evaluation and management via synchronous audio/visual telehealth

OTHER: 

• MHCP reimburses for interactive audio/visual communications & asynchronous store-and-forward (to send information to a reviewing physician)

• Physician services may be delivered by telemedicine to provide intensive residential treatment services

• Tele-home care is covered under the Elderly Waiver (EW) and Alternative Care (AC) Programs

• Telemedicine delivery of mental health services

• COVERED SERVICES: Mental health services covered by medical assistance as direct face-to-face services may be provided via telehealth and are covered by MHCP. 

• ELIGIBLE PROVIDERS: Mental health professionals who are qualified under Minnesota Statute 245.462 Subd. 18 (qualified in psychiatric nursing, clinical social work, psychology, psychiatry, marriage and family therapy, licensed professional counseling, or allied fields), Mental health practitioners working under the supervision of a mental health professional, Mental health certified peer specialists, Mental health certified family peer specialists, Mental health rehabilitation workers, Mental health behavioral aides

• Telemedicine delivery of substance use disorder services

• COVERED SERVICES: Comprehensive assessments, individual and group treatment services, peer recovery support services

• ELIGIBLE PROVIDERS: Providers currently authorized to provide services may conduct the same services via telehealth.

• Teledentistry: “Reimbursement for teledentistry is the same as face-to-face encounters. The distant site can bill for the services provided by a licensed dentist.”

• Early intensive developmental and behavioral intervention: MHCP does not reimburse for connection charges or origination, set-up, or site fees

• Additional originating sites for SUD treatment services: Drug court office, Correctional facility-based office (including jails), Substance abuse disorder treatment facility (residential or outpatient), Withdrawal management facility

*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below.

Significant changes for COMMERCIAL PAYERS include:

• Requiring coverage (at the same rate) of audio-only telehealth services until July 1, 2023

• Forbidding commercial payers from limiting coverage of telehealth visits on the basis of geography, special provider networks, or technology used

• Requiring coverage of telemonitoring services

• Allowing telehealth visits to satisfy the face-to-face requirement for reimbursement under the payment methods that apply to FQHCs, RHCs, IHS, and CCBHCs if the service would have otherwise qualified for payment if performed in person.

• Providing a new definition for telehealth: “The delivery of health care services or consultations through the use of real time two-way interactive audio and visual communications to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Until July 1, 2023, telehealth also includes audio-only communication between a health care provider and a patient in accordance with subdivision 6, paragraph (b). Telehealth does not include communication between health care providers that consists solely of a telephone conversation, e-mail, or facsimile transmission. Telehealth does not include communication between a health care provider and a patient that consists solely of an e-mail or facsimile transmission. Telehealth does not include telemonitoring services (the remote monitoring of clinical data related to the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a health care provider for analysis).”

Summary and text of HF 33

SERVICE PARITY: “A health carrier shall not exclude a service for coverage solely because the service is provided via telemedicine and is not provided through in-person consultation or contact between a licensed health care provider and a patient.”

• Commercial payers cannot limit coverage of telehealth visits on the basis of geography, special provider networks, or technology used

• Requiring coverage of telemonitoring services

PAYMENT PARITY: “A health carrier shall reimburse the distant site licensed health care provider for covered services delivered via telemedicine on the same basis and at the same rate as the health carrier would apply to those services if the services had been delivered in person by the distant site licensed health care provider… the deductible, co-payment, or coinsurance [must not be in] addition to, and [must] not exceed, the deductible, co-payment, or coinsurance applicable if the same services were provided through in-person contact”

*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below. Significant changes for PROVIDERS include:

• Eligible licensed providers updated: A health care professional who is licensed or registered by the state to perform health care services within the provider's scope of practice and in accordance with state law. A health care provider includes a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26; a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, subdivision 5; and a recovery peer under section 245G.11, subdivision 8.

• INELIGIBLE PROVIDERS: Pharmacists, Respiratory Therapists, and Genetic Counselors

Summary and text of HF 33

TELEMEDICINE DEFINITION: “The delivery of health care services or consultations while the patient is at an originating site and the licensed health care provider is at a distant site” provided via real-time two-way interactive audio and visual communications. Telemedicine does not include telephone, email, or fax.

Physician-patient relationship may be established via telemedicine

A physician licensed from another state may provide interstate telemedicine services to a patient in MN if they are licensed without restrictions in their home state, does not meet with or open an office in MN, and registers with the MN Board. The physician does not need to register with the MN Board IF: 1) the services are provided in response to an emergency medical condition; 2) the services are provided on an irregular or infrequent basis; OR 3) the physician provides interstate telehealth services in this state in consultation with a physician licensed in this state and the Minnesota physician retains ultimate authority over the diagnosis and care of the patient.

Medically managed abortions are allowed via telemedicine

*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below. Significant changes for PROVIDERS include:

• Eligible licensed providers updated: A health care professional who is licensed or registered by the state to perform health care services within the provider's scope of practice and in accordance with state law. A health care provider includes a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26; a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, subdivision 5; and a recovery peer under section 245G.11, subdivision 8.

• INELIGIBLE PROVIDERS: Pharmacists, Respiratory Therapists, and Genetic Counselors

Summary and text of HF 33

Service parity: Health carriers cannot exclude a service from coverage solely because it is provided via telemedicine and not through in-person consultation or contact between a licensed health care provider and a patient.

Payment parity: Health carriers must reimburse distant site licensed providers for telehealth services on the same basis and at the same rate as they would for the same services delivered in-person.

*Effective July 1, 2021* The omnibus bill HF33, which includes a revised Minnesota Telehealth Act (2021), enacted several changes for private and state health payers and providers. A document describing these changes alongside the text of the legislation can be downloaded below. Significant changes for PROVIDERS include:

• Eligible licensed providers updated: A health care professional who is licensed or registered by the state to perform health care services within the provider's scope of practice and in accordance with state law. A health care provider includes a mental health professional as defined under section 245.462, subdivision 18, or 245.4871, subdivision 27; a mental health practitioner as defined under section 245.462, subdivision 17, or 245.4871, subdivision 26; a treatment coordinator under section 245G.11, subdivision 7; an alcohol and drug counselor under section 245G.11, subdivision 5; and a recovery peer under section 245G.11, subdivision 8.

• INELIGIBLE PROVIDERS: Pharmacists, Respiratory Therapists, and Genetic Counselors

• Allowing Medical Assistance clients to consent verbally to treatment plans for mental health and substance use disorder services

• Mental health case management & targeted case management services can be delivered via telehealth in most situations (Medical Assistance programs)

Summary and text of HF 33

A nonresident may engage in the practice of professional counseling within the state without a license for up to 30 days during any calendar year if the nonresident is authorized to provide the services under the law of the state or country of residence and the nonresident has provided proof of credentials to the board, been found qualified to render services in the state, and been granted permission by the board to practice.

Service parity: Health carriers cannot exclude a service from coverage solely because it is provided via telemedicine and not through in-person consultation or contact between a licensed health care provider and a patient

Payment parity: Health carriers must reimburse distant site licensed providers for telehealth services on the same basis and at the same rate as they would for the same services delivered in-person

Psychologists must demonstrate competency in order to practice, including via telehealth

LICENSED PROVIDERS FROM THE MN TELEMEDICINE ACT: MD (147), PA (147A), Chiropractors (148), Nurses (148.171), Speech Language Pathologists (148.511), Optometrists (148.52), Dieticians/Nutritionists (148.621), OT/OTA (148.6401), PT/PTA (148.65), Athletic Trainers (148.7801), Psychologists (148.79), Doulas (148.995), Marriage and Family counselors, Licensed Professional Counseling, (148B), Social Work (148E), Alcohol and Drug Counselors (148F), Dentistry (150A), Podiatry (153)

• Service parity: Health carriers cannot exclude a service from coverage solely because it is provided via telemedicine and not through in-person consultation or contact between a licensed health care provider and a patient

• Payment parity: Health carriers must reimburse distant site licensed providers for telehealth services on the same basis and at the same rate as they would for the same services delivered in-person

Many of Minnesota's temporary COVID-19 telehealth policies were made permanent by the omnibus bill HF33.

ACTIVE DHS GUIDANCE:

• Legislative changes made to telehealth allow all eligible MHCP providers currently enrolled with the Telehealth Provider Assurance Statement (DHS-6806) (PDF) to continue providing services via telehealth beyond the public health emergency. The following applies to providers who want to provide and bill for services via telehealth. PROVIDERS ELIGIBLE TO PROVIDE TELEHEALTH INCLUDE: Providers that meet the definition of “licensed health care provider” under Minnesota Statutes, 256B.0625, subdivision 3b(e) who did not already have a telehealth assurance statement on file with MHCP, Community Health Worker, Public Health Nurse Clinic, Doula (pre and postnatal care only), Physician extenders, Licensed Alcohol and Drug Counselors, Alcohol and Drug Counselors, Alcohol and Drug Counselor – Temps Recovery, Peers and student interns in SUD programs licensed under chapter 245G, Pharmacists enrolled to perform medication therapy management, mental health works across a variety of practice areas

• Expires 6 months after the end of the federal PHE: DHS will allow remote support (real-time, two-way communication) temporarily as a service delivery option for several Home and Community Based (HCBS) waiver services. Providers may deliver services remotely through phone or other interactive technology medium. Remote delivery of HCBS waiver services is not the same as telehealth. Providers cannot use telehealth to deliver HCBS waiver and Alternative Care services.

• AFFECTED PROGRAMS: Alternative Care, Brain Injury waiver, Community Alternative Care waiver, Community Access for Disability Inclusion waiver, Developmental Disabilities waiver, Elderly waiver, Essential Community Supports.

• Effective through the end of the federal PHE: Beginning Sept. 1, 2022, MHCP will temporarily cover programming and reprogramming of cochlear implants for ages 12 years and older done via telehealth. You must complete and submit a Telehealth Provider Assurance Statement (DHS-6806) (PDF) to be eligible for reimbursement for services provided via telehealth.

• Effective through the end of the federal PHE: Providers may conduct targeted case management (TCM) services via telephone and video-conferencing in place of in-person, face-to-face contact. TCM providers do not need to meet the telehealth standards and do not need to submit a Telehealth Provider Assurance Statement (DHS-6806) (PDF) because telehealth does not apply to TCM.

• AFFECTED PROGRAMS: Child welfare targeted case management (CW-TCM), Children’s mental health targeted case management (CMH-TCM), Adult mental health targeted case management (AMH-TCM), Vulnerable adult or adult with developmental disabilities targeted case management (VA/DD-TCM).