Delaware Medicaid Program to Reimburse for Telemedicine-Delivered Services Beginning July 1
NEW CASTLE – Beginning July 1, the Delaware Medical Assistance Program will reimburse for telemedicine-delivered services provided to Delaware Medicaid clients in order to improve access to behavioral health services and general health care services, including medical subspecialties not widely available in the state.
The State Division of Medicaid & Medical Assistance, which administers Medicaid in Delaware, will reimburse for telemedicine-delivered services provided by an originating site. An originating site provider is the facility where the telemedicine space and equipment is located and where the patient receives the medical service provided by the consulting or distant provider. Originating site providers may be hospitals, federally qualified health centers, skilled nursing facilities, mental health and substance abuse centers, public health clinics, PACE centers, etc. Consulting or distant site providers deliver medical services which can include consultations, office or outpatient visits, psychotherapy, medication management, psychiatric interview or examination, substance abuse screening and brief interventions, neurobehavioral examination, end stage renal disease services, medical nutrition therapy and more.
The originating site will be paid a facility fee for the telemedicine space and equipment, and the consulting services will be reimbursed as if delivered face-to-face. For services to be covered, both the distant provider and the originating site provider must be enrolled in the Delaware Medical Assistance Program or in one of the program’s managed care organizations (MCOs). Most individuals covered by Medicaid receive services through a managed care delivery system, and the individual’s MCO will primarily cover the telemedicine-delivered services.
Telemedicine is the use of telecommunication and information technologies to provide clinical health care at a distance. It is a cost-effective alternative to face-to-face encounters where access to care is restricted because of the lack of available service providers in the patient’s geographical location. It also is used to save lives in critical care and emergency situations.
“Telemedicine will improve access to information and medical care for Delawareans, especially for people in rural areas of our state and for seniors who can’t travel as easily to medical appointments,” Gov. Jack Markell said. “For many people, it means more immediate access to the care of a specialist. Timely and proper medical care leads to better health outcomes for patients and reduced costs for hospitalizations and transportation.”
Rita Landgraf, secretary of the Department of Health and Social Services, which oversees the Delaware Medical Assistance Program, said telemedicine also will help the state continue its transformation of the mental health system.
“With a shortage of psychiatrists in Kent and Sussex counties, telepsychiatry will help improve the access to care and provide it more quickly for individuals who need it,” Landgraf said. “When it comes to the sometimes difficult things that individuals need to talk about, many consumers are quite receptive to telemedicine. To patients, it can seem less threatening and, therefore, more conducive to openness.”
Landgraf said telemedicine also could be used to help in the care and treatment of such conditions as Parkinson’s disease, dementia, Alzheimer’s disease, post-stroke, diabetes, HIV/AIDS and many more.
According to the American Telemedicine Association, more than 10 million Americans now are benefiting directly from telemedicine each year.