current state of telehealth in louisiana jenny smith corporate director of ehealth, franciscan...
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Current State of Telehealth in Louisiana
Jenny SmithCorporate Director of eHealth,
Franciscan Missionaries of Our Lady Health SystemChair, Louisiana Task Force for Telehealth Access
• Founded in 1911 in Monroe• Non-profit, Catholic healthcare
ministry• Special emphasis on those most
in need• Largest health system in LA• Headquartered in Baton Rouge• Care provided to over half of
Louisiana’s Citizens• Hospitals, ambulatory clinics,
senior services, nursing homes, wellness services, independent college
Access in LA
Access in LA
Access in LA
PCP Shortage/Surplus by Zip Code for LA
Specialist Shortage/Surplus by Zip Code for LA
Source: Truven Health; The Market Planner Plus; Physician Demand Estimates
Legislation
• R.S. 22:1821(F) – Parity law passed in 1995– The payment, benefit, or reimbursement to such a
licensed physician at the originating facility or terminus shall not be less than seventy-five percent of the reasonable and customary amount of payment, benefit, or reimbursement which that licensed physician receives for an intermediate office visit.
Legislation
• Act 442– Passed in 2014– Removed two key requirements previously imposed
• Licensed health care professional in the exam room with the patient
• Initial in-person visit
– Explicitly states that provider and patient can be in any location at time of consult
– Prohibits prescribing of controls without an in-person visit, unless authorized by the State Board.
Legislation• HCR 88
– Passed in 2014– Created Task Force on Telehealth Access
• Serve as an advisory body to the legislature and DHH on policies and practices that expand access to and coverage for telehealth services in a manner that ensures quality of care and patient safety.
• Serve as a coordinating forum on telehealth-related matters between and among state agencies, local government, and other nongovernmental groups.
• Study technical aspects of delivery systems utilized in telehealth, and develop basic standards based upon such study to recommend to the governor, the legislature, and the secretary of the Department of Health and Hospitals concerning modalities and features of telehealth delivery systems.
• On a regular basis, research and review state regulations, guidelines, policies, and procedures that pertain in any way to telehealth and make policy recommendations to the governor, the legislature, and the secretary of the Department of Health and Hospitals
LSBME Rules
• Proposed rules under consideration• Current rules– Telemedicine license required for out-of-state MDs– Prohibits the prescription of controls within a
telemedicine consult– Requires licensed healthcare professional in exam
room with patient during consult
Current Telehealth Landscape
• Survey of Task Force organizations conducted in late 2014.
• Telehealth initiatives in place across the State– Health systems– Hospitals– Community and School Clinics– Prisons– Nursing Homes– Patient Homes
Specialties • Cardiology• Dermatology• Diabetic Retinopathy Screenings• Endocrinology• ENT• General Surgery• Gastroenterology• Hepatology• Infectious Disease• Internal Medicine• Hematology/Oncology• Mental Health• Nephrology
• Neurology/Neurosurgery• Ophthalmology• Orthopedics• Pediatric Subspecialties• Physical Medicine and Rehabilitation• Psychiatry• Pulmonary• Remote In-Home Monitoring• Renal• Rheumatology• Urology• Virtual ICU
Reimbursement
• Medicaid reimburses a distant (consultant) site the same amount for a telemedicine encounter as for other professional services (office visit, consultations, etc.).
• Medicare allows the host (originating) site to bill the HCPCS Level II code Q3014 (Telehealth originating site facility fee), paid at approximately $25 per telemedicine encounter. – Q3014 is currently not a payable service in the LA
Medicaid program.
Where We Need to Be
• Reimbursement is often inconsistent– “Submit and see” approach often taken
• Continual discussion around LSBME rules• Reimbursement and rules needed for mid-
levels• All groups – providers, payers, boards,
government – working together
Remember
Bottom Line
Current State of Telehealth In Louisiana
Thank you!