State Extends Pay Parity For Telehealth

Telemedicine visit at Kaiser Permanente Northwest.jpg

Expanded coverage of telemedicine visits is closer to being the norm.

The Department of Consumer and Business Services has announced that it has struck an agreement with health insurance companies in Oregon to continue coverage through June 30 for in-network telehealth visits with providers. The agreement follows a decision by state officials in March to require insurers to reimburse the visits through video and phone links. The arrangement includes reimbursement parity, making a telehealth visit equal to one in person. The visits have protected providers and patients during the pandemic. 

“It is vital for Oregonians to continue to use telehealth services to limit physical contact during this public health emergency,” Andrew Stolfi, Oregon's insurance commissioner and department director, said in a release. “Telehealth allows for Oregonians to get important care, often from the comfort of their home. I want to thank the insurance carriers that have joined us in this agreement to provide expanded telehealth services and pay parity for Oregonians.”

Providers in small clinics and large hospital systems have expanded telehealth options under the new system. In the past, insurers paid providers less for a telehealth visit than for an office consultation.

Kaiser Permanente has a long history with telemedicine. Oregon Health & Science University first offered the service a decade ago, partly to serve hospitals in rural regions. This year it expanded to offering tele-consultations for intensive care units, with a plan to convert to a full-service virtual ICU this coming spring.

"The recent announcement by the Oregon Department of Coinsumer and Business Services that it will continue expanded reimbursement for telemedicine services will greatly benefit our patients, our staff and our providers as we work to maintain high-quality access to our clinical services," OHSU said in a statement.

 

The insurance companies that have agreed to the reimbursements are: Cambia, which owns Regence and BridgeSpan; Providence; Health Net; Regence; Kaiser Permanente; Samaritan; Moda; UnitedHealthcare and PacificSource.

The Oregon Health Authority also agreed to offer telehealth pay parity for providers serving Oregon Health Plan patients, including for physical health services, behavioral health services and some dental and long-term care services.

On the federal level, lawmakers have included a provision in year-end legislation that would make mental health services available through telemedicine for all Medicare beneficiaries, allowing them to receive care in their home.

Oregon's U.S. Senator Ron Wyden, who had introduced a similar bill, praised the move: “Mental health care should be a right for all Americans, and these reforms will begin to make that a reality." Wyden said.

The Centers for Medicare and Medicaid Services sets the standard for commercial insurers. Though they're not obligated to follow CMS, they usually do.

You can reach Lynne Terry at [email protected] or on Twitter @LynnePDX.

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