essential health benefits package. Issuers must provide coverage for a service provided via telemedicine if: the service be covered when provided in person; and RCW 48.43.735 the service is medically necessary; and (1)(b) (1)(c) the service is an EHB. 48.43.735 If the service is provided through store and forward technology, (2)(a) there must be an associated office visit between the covered person and the referring health care provider. The associated Requirements office visit may also occur via telemedicine. for Coverage (Cont’d) (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. Telemedicine Rules for 48.43.735 An originating site for a telemedicine health care service includes a: (Cont’d) “Originating (3)(a) Hospital; Sites” (3)(b) Rural health clinic; (3)(c) Federally qualified health center; (3)(d) Physician's or other health care provider's office; (3)(e) Community mental health center; (3)(f) Skilled nursing facility; or (3)(g) Home; or (3)(h) Renal dialysis center, except an independent renal dialysis center. RCW Any originating site may charge a facility fee for infrastructure and 48.43.735(4) preparation of the patient. Reimbursement must be subject to a negotiated agreement between the originating site and the health plan. A distant site or any other site not identified above may not charge a facility fee.
essential health benefits package. Issuers must provide coverage for a service provided via telemedicine if: the service be covered when provided in person; and RCW 48.43.735 (1)(b) the service is medically necessary; and (1)(c) the service is an EHB. Requirements for Coverage 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. (Cont’d) (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. Telemedicine (Cont’d) Rules for “Originating 48.43.735 (3)(a) An originating site for a telemedicine health care service includes a: Hospital; Sites” (3)(b) Rural health clinic; (3)(c) Federally qualified health center; (3)(d) Physician's or other health care provider's office; (3)(e) Community mental health center; (3)(f) Skilled nursing facility; or (3)(g) Home; or (3)(h) Renal dialysis center, except an independent renal dialysis center. RCW 48.43.735(4) Any originating site may charge a facility fee for infrastructure and preparation of the patient. Reimbursement must be subject to a negotiated agreement between the originating site and the health plan. A distant site or any other site not identified above may not charge a facility fee.
checklist-forms-2018-disability-sg-analyst-checklist.docx