Sec. 47.07.069. Payment for telehealth.

600 words·~3 min read·/ak/title-47/chapter-7/47-07-069

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(a)[See conditional amendment note.] The department shall pay for all services covered by the medical assistance program provided through telehealth in the same manner as if the services had been provided in person, including

(1)behavioral health services;

(2)services covered under home and community-based waivers;

(3)services covered under state plan options under 42 U.S.C. 1396 — 1396p (Title XIX, Social Security Act);

(4)services provided by a community health aide or a community health practitioner certified by the Community Health Aide Program Certification Board;

(5)services provided by a behavioral health aide or behavioral health practitioner certified by the Community Health Aide Program Certification Board;

(6)services provided by a dental health aide therapist certified by the Community Health Aide Program Certification Board;

(7)services provided by a chemical dependency counselor certified by a certifying entity for behavioral health professionals in the state specified by the department in regulation;

(8)services provided by a rural health clinic or a federally qualified health center;

(9)services provided by an individual or entity that is required by statute or regulation to be licensed or certified by the department or that is eligible to receive payments, in whole or in part, from the department;

(10)services provided through audio, visual, or data communications, alone or in any combination, or through communications over the Internet or by telephone, including a telephone that is not part of a dedicated audio conference system, electronic mail, text message, or two-way radio;

(11)assessment, evaluation, consultation, planning, diagnosis, treatment, case management, and the prescription, dispensing, and administration of medications, including controlled substances; and

(12)services covered under federal waivers or demonstrations other than home and community-based waivers.

(b)[See conditional amendment note.] The department shall adopt regulations for services provided by telehealth, including setting rates of payment. Regulations calculating the rate of payment for a rural health clinic or federally qualified health center must treat services provided through telehealth in the same manner as if the services had been provided in person, including calculations based on the rural health clinic's or federally qualified health center's reasonable costs or on the number of visits for recipients provided services, and must define “visit” to include a visit provided by telehealth. The department may not decrease the rate of payment for a telehealth service based on the location of the person providing the service, the location of the eligible recipient of the service, the communication method used, or whether the service was provided asynchronously or synchronously. The department may exclude or limit coverage or reimbursement for a service provided by telehealth, or limit the telehealth modes that may be used for a particular service, only if the department

(1)specifically excludes or limits the service from telehealth coverage or reimbursement by regulations adopted under this subsection;

(2)determines, based on substantial medical evidence, that the service cannot be safely provided using telehealth or using the specified mode; or

(3)determines that providing the service using the specified mode would violate federal law or render the service ineligible for federal financial participation under applicable federal law.

(c)All services delivered through telehealth under this section must comply with the Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191).

(d)In this section,

(1)“federally qualified health center” has the meaning given in 42 U.S.C. 1396(l)(2)(B);

(2)“rural health clinic” has the meaning given in 42 U.S.C. 1396(l)(1);

(3)“state plan” means the state plan for medical assistance coverage developed under AS 47.07.040 ;

(4)“telehealth” has the meaning given in AS 47.05.270 (e).