The establishment of a bona fide practitioner patient relationship via telemedicine is consistent with federal law and regulations and any waiver thereof. Nothing in this section shall preclude coverage for a service that is not a telemedicine service, including services delivered through real-time audio-only telephone. Medicaid Bulletin: Clarification of DMAS Requirements Related to the Use of Telemedicine in Providing MAT for OUD. 54.1-3408.3. Preferred OBATs services must have regular access to in-person/on-site visits and services shall not be delivered solely or predominantly through telemedicine. National Telehealth Resource Center Partners, Continuing COVID flexibilities based on federal authority, Virginia Medicaid FAQs for Accessing ARTS Services during COVID-19, Virginia Medicaid FAQs for Accessing Behavioral Health Services During COVID-19, Virginia Medicaid Recommendations for Therapeutic Day Treatment Service Delivery During COVID-19, New 1135 Waiver and Administrative Provider Flexibilities (5/26), Appendix K Commonwealth Coordinated Care Plus, Family and Individuals Supports, Community Living, and Building Independence, Appendix K Addendum Commonwealth Coordinated Care Plus, Family and Individuals Supports, Community Living, and Building Independence, Behavioral Health and ARTS Provider Flexibilities Related to COVID-19 (3/27), Home and Community Based Services Waivers (HCBS) COVID-19 Policy Continuation and Timeline, COVID Active Flexibilities Update for April 19, 2022, Frequently Asked Questions: Personal Care/Assistance, Respite, and Companion Services, ew 1135 Waiver and Administrative Provider Flexibilities (5/26), Delivery of Group Based Services in Behavioral Health and Addiction (ARTS) during COVID-19 (7/1), Commonwealth Coordinated Care Plus, Family and Individual Supports, Community Living, and Building Independence, Commonwealth Coordinated Care Plus, Family and Individuals Supports, Community Living, and Building Independence. The Board, subject to the approval of the Governor, is authorized to prepare, amend from time to time, and submit to the U.S. Secretary of Health and Human Services a state plan for medical assistance services. A licensed psychiatrist or nurse practitioner (who is acting within the scope of their professional license and applicable State law) must be available to the program 24/7 either in-person or via telemedicine to provide assessment, treatment recommendations and consultation meeting the licensing standards for residential crisis stabilization and medically monitored withdrawal services at ASAM level 3.7. Such telemedicine use shall be consistent with federal requirements for the prescribing of Schedule II through V controlled substances. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022) (Accessed Nov. 2022). The second section of the Code of Virginia pertinent to telemedicine is 38.2-3418.16 of the Code of Virginia, which provides the definition of telemedicine in the Insurance Title. Nursing services; 2. Services can be provided face-to-face or by telemedicine according to DMAS policy regarding telemedicine. VA Dept. Book E - Compensation/Loans. SOURCE: VA Department of Medical Assistance Services. Medicaid Provider Manual, Addiction and Recovery Treatment Services, Opioid Treatment Services/Medication Assisted Treatment, (Mar. Providers must meet state licensure, registration or certification requirements per their regulatory board with the Virginia Department of Health Professions to provide services to Virginia residents via telemedicine. Virginia code uses the term home attendant and notes that other terms may be used: home health aide, home care aide, personal care aide, certified nursing assistant/ CNA. Providers delivering services using telemedicine shall follow the requirements set forth in the DMAS Telehealth Services Supplemental Manual. SOURCE: VA Dept. An agency might be exempted because it was regulated by an acceptable national organization or because it provided only very basic services like homemaking and chores. (Accessed Nov. 2022). WebThe Regulations governing nursing home staffing and care standards mandate that each patient get a least 4.1 hours of in- dividualized care services per 24-hour period, with the minimum increase in increments as defined (HB 2156 Nursing home staffing and care standards; regulations, report. PLEASE NOTE: CCHP is providing the following for informational purposes only. Store-and-forward means the asynchronous transmission of a members medical information from an originating site to a health care Provider located at a distant site. (Accessed Nov. 2022). P. 4 (Aug. 19, 2021). The member and provider of telemedicine services are not in the same physical location during the consultation. Telemedicine assisted assessment means the in-person service delivery encounter by a QMHP-A, QMHP-C, CSAC with synchronous audio and visual support from a remote LMHP, LMHP-R, LMHP-RP or LMHP-S to: obtain information from the individual or collateral contacts, as appropriate, about the individuals mental health status; provide assessment and early intervention; and, develop an immediate plan to maintain safety in order to prevent the need for a higher level of care. Home care organization means a public or private entity providing an Such services shall include those covered under the state plan for medical assistance services or by the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), and shall include a provision for payment of medical assistance for health care services provided through telemedicine services. Member of the Psychology Interjurisdictional Compact, Member of Occupational Therapy Interjurisdictional Licensure Compact. Does not explicitly specify that an FQHC is eligible. # 85-12. (Accessed Nov. 2022). Service providers must include the modifier GT on claims for services delivered via telemedicine. (Accessed Nov. 2022). The member receiving the RPM service must fall into one of the following five populations, with duration of initial service authorization in parentheses as per below: All service authorization criteria outlined in the DMAS Form DMAS-P268 are met prior to billing the following CPT/HCPCS codes: Providers must meet the criteria outlined in the DMAS Form DMAS-P268 and submit their requests to the DMAS service authorization contractor by direct data entry (DDE) via their provider portal. Billing Instructions, (July 2022) (Accessed Nov. 2022). (Accessed Nov. 2022). The Medicaid member is in a physical location where telemedicine services can be received per requirements set forth in the Telehealth Supplement. SOURCE: VA Dept. 4.3. SOURCE: Medicaid Bulletin: Clarification of DMAS Requirements Related to the Use of Telemedicine in Providing MAT for OUD. See: VA Medicaid Live Video Facility/Transmission Fee, Telehealth services may be included in a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), or Indian Health Center (IHC) scope of practice, as approved by HRSA and the Commonwealth. Virginia Administrative Code (Last Updated: January 10, 2017) Title 12. Certain types of services that would not be expected to be appropriately delivered via telemedicine include, but are not limited to, those that: If, after initiating a telemedicine visit, the telemedicine modality is found to be medically and/or clinically inappropriate, or otherwise can no longer meet the requirements stipulated in the Reimbursable Telehealth Services section, the Provider shall provide or arrange, in a timely manner, an alternative to meet the needs of the individual (e.g., services delivered in-person; services delivered via telemedicine when conditions allow telemedicine to meet requirements stipulated in the Reimbursable Telehealth Services section). Telemedicine does not include an audio-only telephone. # 85-12. Telemedicine is a means of providing services through the use of two-way, real time interactive electronic communication between the member and the Provider located at a site distant from the member. Examples of originating sites include: medical care facility; Providers outpatient office; the members residence or school; or other community location (e.g., place of employment). Doc. This includes monitoring of both patient physiologic and therapeutic data. Prescribing of controlled substances via telemedicine shall comply with the requirements of 54.1-3303and all applicable federal law. Telemedicine Guidance. Some patients receive multiple health-related therapies and services in their homes. Training requirements may be met in any of several ways. Web4.2.a. Medicaid Provider Manual, Durable Medical Equipment and Supplies Manual, Covered Svcs. See manual for eligible MAT codes. We are not providing legal advice or interpretation of the laws and regulations and policies. VA Dept. VA Board of Medicine. An informal or relative family child care home shall be registered under the name of only one caregiver per residence. Clarification of Existing Medicaid Coverage of Continuous Glucose Monitoring for Members in Medicaid/FAMIS/FAMIS MOMS Fee-for-Service Programs. Doc. Telehealth services may be included in a Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC), or Indian Health Center (IHC) scope of practice, as approved by HRSA and the Commonwealth. All home health services that exceed 60 visits in a calendar year require prior authorization. of Medical Assistance Svcs. A members medical information may include, but is not limited to, video clips, still images, x-rays, laboratory results, audio clips, and text. # 85-12. 32.1-325, (Accessed Nov. 2022). (Accessed Nov.2022). The difference is the overall setup of the organization. The Provider or designee may be present to assist with initiation of the visit but the presence of the Provider or designee in the actual visit shall be determined by a balance of clinical need and member preference or desire for confidentiality. I have chosen Virginia's Nursing Home Staffing and Care Standard bill. Additions to the Telehealth Supplement include defining virtual check-in services, identifying covered codes, specifying reimbursement requirements, and outlining fee-for-service (FFS) billing details. An informal or relative family child care home shall comply with the provisions of this rule. Certain audio-only codes are eligible for reimbursement in VA Medicaid. See Appendix D of the Physician/Practitioner manual for details on the current service authorization contractor and accessing the provider portal. Webalso covered by Medicare may be recovered by the home health agency if the member resides outside of a 15-mile radius of the home health agency. (Federal Travel Regulations are published in the Federal Register.) Speech therapy services; 5. WebPrincess Anne Health & Rehabilitation Center has an exciting opportunity for a Unit Manager, RN in our 120bed skilled rehab center in Virginia Beach.. Looking for fee assistance or respite care? seq. Place of Service (POS), the two-digit code placed on claims used to indicate the setting where the service occurred, must reflect the location in which a telehealth service would have normally been provided, had interactions occurred in person. Occupational therapy services; 4. WebThe West Virginia Medicaid Home Health Program does not follow the Medicare guideline definition for homebound status. The Provider must have an established relationship with the member receiving the RPM service, including at least one visit in the last 12 months (which can include the date RPM services are initiated). WebSLP) in all treatment settings SNF, outpatient, home health, acute rehab, acute care, industry, psychiatric, military medicine. The Emergency Ambulance Transport provider must be enrolled as such with DMAS. QBns-q89k:cTfBxE)3\R?p/K%7z[V>_PH&+I}x21_'QO1g]m!L>p4a85W]g:;1`vF%LY> K,TD"spF"l1,l$VK,2Wda2R(4 24 %};%cU. VA Medicaid reimburses for Continuous Glucose Monitoring. Medicaid Provider Manual, Residential Treatment Services, Covered Services and Limitations, (Accessed Nov. 2022). A bona fide dentist-patient relationship shall exist if the dentist has: SOURCE: VA Statute 54.1-2711. VA Board of Medicine. MCOs will adopt equivalent service authorization criteria and quantity limits as FFS. Providers working in the Mobile OBAT setting shall provide services in-person as well as be permitted to utilize technology to provide telemedicine sessions with providers located at the Preferred OBATs primary location. Prescribing controlled substances requires the establishment of a bona fide practitioner-patient relationship in accordance with 54.1-3303 (A) of the Code of Virginia. VA Code Annotated Sec. P. 3 (Aug. 19, 2021). Aides who have only personal care duties may be trained in accordance with the state personal care curriculum. The first is the consultant exemption found in 54.1-2901 which lists Exceptions and Exemptions Generally to licensure. VA Board of Medicine. VA Board of Medicine. The Consolidated Appropriations Act of 2023 extended many of (Accessed Nov. 2022). SOURCE: Telemedicine Guidance. This assessment must be done in-person, through telemedicine or through a telemedicine assisted assessment. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Physician/Practitioner), (Oct. 2022) (Accessed Nov. 2022). of Medical Assistance Services. WebHome attendants are also known as home care aides, home health aides, or personal care aides. SOURCE: VA Department of Medical Assistance Services, Coverage of Virtual Check-In and Audio Only Services/Updates to Telehealth Services Supplement, April 1, 2022. Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in traditional, in-person encounters. 2021). Department of Medical Assistance Services, The following Manuals and Supplements can be found on the, DMAS - Department of Medical Assistance Services, Breast & Cervical Cancer Prevention and Treatment Act, Addiction and Recovery Treatment Services, Hospital Presumptive Eligibility Information, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Behavioral Health Service Utilization and Expenditures, Legislative and Congressional District Reports, Monthly Expenditure Reports of the Medicaid Program, Nursing Facility Value-Based Purchasing Program, CHIP State Plan and Waiver-Related Documents, | | s -w-po-ny | | | Deutsch | | Tagalog | Franais | | Igbo asusu | | | Espaol | | Ting Vit | Yorb, Community Mental Health Rehabilitative Services, Peer Recovery Support Services Supplement. General Information. Psychiatric evaluation may be provided through telemedicine. The originating site provider cannot bill an originating site fee unless the Member is assisted by a Medicaid enrolled telepresenter at the originating site. A nurse practitioner or physician assistant working under the licensed psychiatrist may provide this coverage for the psychiatrist. All Home Health services that exceed 60 visits in a calendar year require prior authorization. Training requirements for hospice aide/ homemaker are similar to those for home health aide. The practitioner shall use his professional judgement to determine the manner and frequency of patient care and evaluation and may employ the use of telemedicine provided that the use of telemedicine includes the delivery of patient care through real-time interactive audio-visual technology. Telemedicine utilizes audio/video connections linking medical practitioners in one locality with medical practitioners in another locality. of Medical Assistance Svcs. The following school-based services may be provided via telemedicine: PT, OT, speech and language, psychological and mental health, and medical evaluation services. VA Dept. 32.1-122.03:1 (C(1). (Accessed Nov. 2022). Doc. WebThe Division of Licensing Programs protects children and vulnerable adults in day and residential care settings. Code Ann. There must be regular communication between the consultant and the Virginia practitioner while the consultation/care is being provided. 54.1-3408.3. WebRegulations and Provider Manual Regulations and Provider Manual DMAS - Department of Medical Assistance Services Cardinal CareVirginia's Medicaid Program Department of 8 Preferred Office-Based Addiction Treatment Programs, (Accessed Nov. 2022). 4.3. This electronic communication must include, at a minimum, the use of audio and video equipment. SOURCE: VA Dept. They include at least 16 hours of practical experience. and Limitations, (Oct 2021). See Code for required provisions for statewide telehealth plan. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022) (Accessed Nov 2022). Certification for use of cannabis oil for treatment. VA Board of Medicine. Code Ann. Telehealth is permissible for prescreening activities pursuant to section 37.2-800 et. Under federal nursing home regulations, nursing homes must:Have sufficient nursing staff. Conduct initially a comprehensive and accurate assessment of each residents functional capacity. Develop a comprehensive care plan for each resident. Prevent the deterioration of a residents ability to bathe, dress, groom, transfer and ambulate, toilet, eat, and to communicate. More items VA Dept. If approved, these facilities may serve as the Provider or originating site and bill under the encounter rate. A provision for payment of medical assistance for remote patient monitoring services provided via telemedicine for: Medically complex infants and children; Transplant patients; Patients who have undergone surgery, for up to three months following the date of such surgery; and. VA Dept. Some titles, like CNA, denote particular types of training. of Medical Assistant Svcs., Medicaid Provider Manual Supplement-Telehealth Services (Available in multiple manuals, including physician/practitioner, see overview for full list), (Oct. 2022). The Board believes that these communications do not constitute telemedicine, and therefore do not require licensure, when used in the follow-up care of a Virginia resident with whom a bona fide practitioner-patient relationship has been previously established. Virginia home health aides made an average hourly wage of $10.88 an hour in 2016, according to the Bureau of Labor Statistics. Medicaid: Behavioral Health and ARTS Provider Flexibilities Related to COVID-19 (3/27), Medicaid: Home and Community Based Services Waivers (HCBS) COVID-19 Policy Continuation and Timeline, Medicaid: COVID Active Flexibilities Update for April 19, 2022, Medicaid: Frequently Asked Questions: Personal Care/Assistance, Respite, and Companion Services, Medicaid:Virginia Medicaids Response to COVID-19New Emergency Flexibilities, Medicaid: Delivery of Group Based Services in Behavioral Health and Addiction (ARTS) during COVID-19 (7/1), Medicaid 1915(c) Waiver: Commonwealth Coordinated Care Plus, Family and Individual Supports, Community Living, and Building Independence, Medicaid 1915(c) Waiver:Commonwealth Coordinated Care Plus, Family and Individuals Supports, Community Living, and Building Independence, STATUS: Active, expires six months after the end of the public health emergency. Payment will be set at a rate per mile as established by the General Services Administration in the Federal Travel Regulations. Doc. 600 East Broad StreetRichmondVirginia. independent research before making any education decisions. These circumstances may include but are not limited to: member transportation issues, member childcare needs, member employment schedule, member co-morbidities, member distance to provider, etc.). It provides an opportunity for Virginia residents to benefit Medicaid Bulletin: Clarification of DMAS Requirements Related to the Use of Telemedicine in Providing MAT for OUD. Prescribing controlled substances in Schedule II through V via telemedicine also requires compliance with federal rules for the practice of telemedicine. Telemedicine services as it pertains to the delivery of health care services, means the use of electronic technology or media, including interactive audio or video, for the purpose of diagnosing or treating a patient, providing remote patient monitoring services, or consulting with other health care providers regarding a patients diagnosis or treatment, regardless of the originating site and whether the patient is accompanied by a health care provider at the time such services are provided.