205.559 Requirements for Medicaid reimbursement to participating providers for telehealth consultations -- Report of impact on health care delivery system required -- Administrative regulations. - Kentucky Statutes

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Page 1 of 2 205.559 Requirements for Medicaid reimbursement to participating providers for telehealth consultations -- Report of impact on health care delivery system
required -- Administrative regulations. (1) The Cabinet for Health and Family Services and any regional managed care partnership or other entity under contract with the cabinet for the administration or
provision of the Medicaid program shall provide Medicaid reimbursement for a
telehealth consultation that is provided by a Medicaid-participating practitioner who
is licensed in Kentucky and that is provided in the telehealth network established in
KRS 194A.125(3)(b). (2) (a) The cabinet shall establish reimbursement rates for telehealth consultations. A request for reimbursement shall not be denied solely because an in-person
consultation between a Medicaid-participating practitioner and a patient did
not occur. (b) A telehealth consultation shall not be reimbursable under this section if it is provided through the use of an audio-only telephone, facsimile machine, or
electronic mail. (3) A health-care facility that receives reimbursement under this section for consultations provided by a Medicaid-participating provider who practices in that
facility and a health professional who obtains a consultation under this section shall
establish quality-of-care protocols and patient confidentiality guidelines to ensure
that telehealth consultations meet all requirements and patient care standards as
required by law. (4) The cabinet shall not require a telehealth consultation if an in-person consultation with a Medicaid-participating provider is reasonably available where the patient
resides, works, or attends school or if the patient prefers an in-person consultation. (5) The cabinet shall request any waivers of federal laws or regulations that may be necessary to implement this section. (6) (a) The cabinet and any regional managed care partnership or other entity under contract with the cabinet for the administration or provision of the Medicaid
program shall study the impact of this section on the health care delivery
system in Kentucky and shall, upon implementation, issue a quarterly report to
the Legislative Research Commission. This report shall include an analysis of:
1. The economic impact of this section on the Medicaid budget, including
any costs or savings as a result of decreased transportation expenditures
and office or emergency room visits; 2. The quality of care as a result of telehealth consultations rendered under
this section; and 3. Any other issues deemed relevant by the cabinet. (b) In addition to the analysis required under paragraph (a) of this subsection, the cabinet report shall compare telehealth reimbursement and delivery among all
regional managed care partnerships or other entities under contract with the
cabinet for the administration or provision of the Medicaid program. Page 2 of 2 (7) The cabinet shall promulgate an administrative regulation in accordance with KRS Chapter 13A to designate the claim forms, records required, and authorization
procedures to be followed in conjunction with this section. Effective: June 26, 2007
History: Amended 2007 Ky. Acts ch. 24, sec. 26, effective June 26, 2007. -- Amended 2005 Ky. Acts ch. 99, sec. 233, effective June 20, 2005. -- Created 2000 Ky. Acts
ch. 376, sec. 4, effective July 15, 2001. Legislative Research Commission Note (7/15/2001). Under 2000 Ky. Acts ch. 376, sec. 24(1), this statute takes effect "on July 15, 2001, or upon approval of any federal
waivers, whichever first occurs." Because federal waivers were not approved, the
effective date is July 15, 2001.