Telehealth Services Must Now Be Covered by Health Plans in the State of Cornhusker. Nebraska's telemedicine providers, contractors, and patients can benefit from telehealth insurance coverage, joining the national majority. Promoted earlier this year by Senator Mark Kolterman (R) of Nebraska under the number 19459004 LB92 and signed by Governor Pete Ricketts (R) in late April, the new law came into effect on August 24, 2017. While the law contains a telehealth provision, it does not require parity of payment for telehealth services.
The new Nebraska Telehealth Insurance Coverage Act is found in section 44-7,107 of the Nebraska Constitution and states, in its entirety, the following:
Any insurer offering: (1) an insurance policy for individual or group sickness or accident, a certificate or underwriting contract delivered, delivered for delivery or renewed in that State; 2) any hospital, medical or surgical insurance policy or (3) any self-funded benefits plan to the extent that federal law does not prevail, in a policy, certificate, contract or plan offered or renewed from the date this Act comes into force coverage only because the service is provided by telehealth as defined in section 44-312 and that it is not provided through an in-person consultation or contact between a licensed health care provider and a patient. This section does not apply to a policy, certificate, contract or plan that covers a particular disease or other limited benefit coverage.
Although LB92 expresses the intention to require health care plans to cover telehealth services, the current wording of sections 44-7,107 could have been worded more precisely, depending on the language used. favorite model. The law uses the proscribed phrase "does not exclude … a coverage service solely because the service is offered through telehealth". Providers and patients may have found it easier if the law used an affirmative phrase, stating that insurers through telehealth if this service is covered by a consultation or in-person contact. But to be honest, Nebraska lawmakers did much better than the Michigan Telehealth Law
I hope that the language of the law will not be misinterpreted by insurers seeking to deny or avoid coverage of telehealth services. Fortunately, there is ample evidence in the official record reflecting the clear intention of the legislator of the law, and providers may indicate that in the event that they find telehealth claims denied by the insurers. Consider, for example, the following three documents:
"LB92 provides coverage for telemedicine services by a payer, regardless of the location of the provider relative to the patient, provided that the provider is licensed in the state of Nebraska. does not exclude a coverage service only because this service is provided by telemedicine and that it is not provided by in-person consultation or contact between a licensed health care provider and a health care provider. patient. "
This reflects the transcript of Senator Kolterman's statements to the Banking, Trade and Insurance Committee, in which he said: "The language of LB92 requires health insurance companies to cover all the services already offered by telehealth. covered for an in-person consultation. "
The Budget Memo for the budgetary impact of the bill also recognizes that the new law requires coverage because it may have a tax effect on the tax regimes. health care that does not cover telehealth services. The note states:
LB 92 provides that health insurance plans offered in the state do not exclude a coverage service solely because the service is provided by telehealth. The Department of Administrative Services and the University of Nebraska indicate that telehealth services are licensed under health insurance plans available to state employees and universities, so the project plans to law has no fiscal impact for these entities. If benefit plans covering employees of policy subdivisions do not provide such services, there could be an unknown tax impact in terms of the cost of Medicare benefits.
The promulgation of the Nebraska Telehealth Insurance Coverage Act brings the account to approximately 34 states plus D.C. as having laws requiring commercial insurance plans to cover telehealth services. The continued expansion of coverage and reimbursement means that providers can improve telehealth offerings, both for immediate savings and increasing revenue-generating opportunities, not to mention quality and patient satisfaction . We will continue to monitor states across the country on this important issue.
For more information on telemedicine, telehealth, virtual care and other innovations in health, including the team, publications and other documents, visit Foley & # 39; s Telemedicine & Virtual Care Practice
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