Telemedicine Definition RCW “Telemedicine” means the delivery of health care services 48.43.735 through the use of interactive audio and video technology, RCW permitting real-time communication between the patient at the 48.43.735 originating site and the provider, for the purpose of diagnosis, (8)(g) consultation, or treatment. Telemedicine does not include (Cont’d) audio-only telephone, fax, or email. Requirements WAC Telemedicine or telehealth services are considered a method of for Coverage accessing services, and are not a separate benefit for purposes Telemedicine Requirements RCW of the essential health benefits package. Issuers must provide (Cont’d) for Coverage 48.43.735 coverage for a service provided via telemedicine if: (Cont’d) (1)(a) the service would be covered when provided in person; and 48.43.735 the service is medically necessary; and (1)(b) 48.43.735 the service is an EHB. (1)(c) 48.43.735 If the service is provided through store and forward (2)(a) technology, there must be an associated office visit between the covered person and the referring health care provider. The associated office visit may also occur via telemedicine. RCW Reimbursement of store and forward technology is 48.43.735 available only for those covered services specified in the (2)(b) negotiated agreement between the health plan and health care provider. RCW Rules for An originating site for a telemedicine health care service 48.43.735 “Originating includes a: (3)(a) Sites” Hospital; (3)(b) Rural health clinic; (3)(c) Federally qualified health center;
Telemedicine Telemedicine (Cont’d) Definition RCW 48.43.735 RCW 48.43.735 (8)(g) (Cont’d) “Telemedicine” means the delivery of health care services through the use of interactive audio and video technology, permitting real-time communication between the patient at the originating site and the provider, for the purpose of diagnosis, consultation, or treatment. Telemedicine does not include audio-only telephone, fax, or email. Requirements for Coverage Requirements for Coverage (Cont’d) WAC RCW 48.43.735 (1)(a) Telemedicine or telehealth services are considered a method of accessing services, and are not a separate benefit for purposes of the essential health benefits package. Issuers must provide coverage for a service provided via telemedicine if: the service would be covered when provided in person; and 48.43.735 (1)(b) the service is medically necessary; and 48.43.735 (1)(c) the service is an EHB. 48.43.735 (2)(a) If the service is provided through store and forward technology, there must be an associated office visit between the covered person and the referring health care provider. The associated office visit may also occur via telemedicine. RCW 48.43.735 (2)(b) Reimbursement of store and forward technology is available only for those covered services specified in the negotiated agreement between the health plan and health care provider. Rules for “Originating Sites” RCW 48.43.735 (3)(a) An originating site for a telemedicine health care service includes a: Hospital; (3)(b) Rural health clinic; (3)(c) Federally qualified health center;