26B-3-122. Telemedicine -- Reimbursement -- Rulemaking.
197 words·~1 min read·
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Effective 5/3/2023
26B-3-122. Telemedicine -- Reimbursement -- Rulemaking.
(a)As used in this section, communication by telemedicine is considered face-to-face contact between a health care provider and a patient under the state's medical assistance program if:
(i)the communication by telemedicine meets the requirements of administrative rules adopted in accordance with Subsection
(3); and
(ii)the health care services are eligible for reimbursement under the state's medical assistance program.
(b)This Subsection
(1)applies to any managed care organization that contracts with the state's medical assistance program.
(2)The reimbursement rate for telemedicine services approved under this section:
(a)shall be subject to reimbursement policies set by the state plan; and
(b)may be based on:
(i)a monthly reimbursement rate;
(ii)a daily reimbursement rate; or
(iii)an encounter rate.
(3)The department shall adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act , which establish:
(a)the particular telemedicine services that are considered face-to-face encounters for reimbursement purposes under the state's medical assistance program; and
(b)the reimbursement methodology for the telemedicine services designated under Subsection (3)(a) .
Renumbered and Amended by Chapter 306 , 2023 General Session