Medicare Payment Rules and Telemedicine

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Adeoye O Hornung R Khatri P Kleindorfer D. Recombinant tissue-type plasminogen activator use for ischemic stroke in the United States: A doubling of treatment rates over the course of 5 years. Stroke 2011;42:1952–5.

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42 U.S.C. $1395j-w-5.

42 U.S.C. $1395m(m)(4)(C).

UnitedHealthcare. Coverage summary: Telemedicine/telehealth services, UnitedHealthcare Medicare Advantage plans [cited 2013 Nov 19]. Available from: URL: https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/Provider-StaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/UnitedHealthcare%20Medicare%20Coverage/Telehealth_and_Telemedicine_SH_Ovations.pdf.

UnitedHealthcare. 2013 evidence of coverage: UnitedHealthcare Group Medicare Advantage (PPO), group name (plan sponsor): County of Henrico-Schools group number: 68145 [cited 2013 Nov 19]. Available from: URL: http://www.co.henrico.va.us/hr/benefits/retire/retire_uhc_eoc_ppo.pdf.

Aetna. 2013 evidence of coverage for Aetna Medicare PPO. 2013 Jan 1 [cited 2013 Nov 19]. Available from: URL: https://www.strsoh.org/pdfs/AetnaEOC13B.pdf.

Anthem Blue Cross Life and Health. University of California: High option supplement to Medicare: Summary plan description. 2010 [cited 2013 Nov 19. Available from: URL: http://www.anthem.com/ca/member/f0/s0/t0/pw_b138483.pdf?refer=group&name=uc.

Highmark. Highmark Medicare advantage medical policy in West Virginia. 2011 Aug 8 [cited 2013 Nov 19]. Available from: URL: https://www.highmarkbcbswv.com/medadvpolicy/printerfriendly/Z-68-005.html.

Medicaid and CHIP Payment and Access Commission (US). Report to the Congress on Medicaid and CHIP. Washington: MACPAC; March 2011.

National Conference of State Legislatures. State coverage for telehealth services. January 2013 [cited 2013 Nov 19. Available from: URL: http://www.ncsl.org/issues-research/health/state-coverage-for-telehealth-services.aspx.

Texas Health and Human Services Commission. Telemedicine medical services in Texas Medicaid: Biennial report to the Texas Legislature. Austin (TX): Texas Health and Human Services Commission; December 2010. Also available from: URL: http://www.hhsc.state.tx.us/reports/2010/Telemedicine-Medical-Services-0910.pdf [cited 2013 Nov 19].

State of West Virginia Department of Health and Human Resources. Chapter 519 covered services, limitations, and exclusions for practitioner services, including physicians, physician assistants, and advanced registered nurse practitioners [cited 2013 Nov 19. Available from: URL: http://www.dhhr.wv.gov/bms/Documents/manuals_Chapter_519_Practitioners.pdf.

Tex Gv. Code Ann. $531.02173 (2003).

California Telemedicine & eHealth Center. Telemedicine reimbursement handbook. 2006 [cited 2013 Nov 19. Available from: URL: http://www.nrtrc.org/wp-content/uploads/Telemedicine-Reimbursement-Handbook1.pdf.

Alabama Medicaid Agency. Provider manual. July 2012 [cited 2013 Nov 19. Available from: URL: http://medicaid.alabama.gov/documents/6.0_Providers/6.7_Manuals/6.7.6_Provider_Manual_2012/6.7.6.3_July_2012/6.7.6.3_Jul12_28.pdf.

Kansas Department of Health and Environment, Division of Health Care Finance. Kansas medical assistance program provider manual. February 2012 [cited 2013 Nov 19. Available from: URL: https://www.kmap-state-ks.us/Documents/Content/Provider%20Manuals/Gen%20benefits_02242012_12025.pdf.

Illinois Department of Healthcare and Family Services. Informational notice: Expansion of telehealth services. 2010 Jan 12 [cited 2013 Nov 19. Available from: URL: http://www.hfs.illinois.gov/assets/011210n2.pdf.

Indiana Health Coverage Programs. Provider bulletin: Telemedicine. 2008 Jan 8 [cited 2013 Nov 19. Available from: URL: http://www.indianamedicaid.com/ihcp/bulletins/bt200802.pdf.

Veterans Health Administration (US), Office of Telehealth Services. A new era of telehealth expansion. VHA Telehealth Quarterly February 2012;11(1). Also available from: URL: http://www.telehealth.va.gov/newsletter/2012/021312-Newsletter_Vol11Iss01.pdf [cited 2013 Nov 19].

38 C.F.R. Part 17: Exempting in-home video telehealth from copayments: Direct final rule; confirmation of effective date. Fed Reg 2012;77:58952–3.

2020Health.org. Cruickshank J. Telehealth: What can the NHS learn from experience at the US Veterans Health Administration? London: 2020Health.org; January 2012.

TriCare policy manual 6010.54-M: Telemental health (TMH)/telemedicine. 2003 Apr 17 [cited 2013 Nov 19]. Available from: URL: http://www.humana-military.com/southmanuals/policy/AsOf/C7S22_1.pdf.

National Center for Telehealth & Technology (T2) Defense Centers of Excellence for Psychological Health & TBI. DoD telemental health guidebook. 2011 Jun 9 [cited 2013 Nov 19. Available from: URL: http://t2health.org/sites/default/files/cth/guidebook/tmh-guidebook_06–11.pdf.

MD Code $15–139(f).

BlueCross BlueShield of North Carolina. Corporate medical policy: Telemedicine. February 2012 [cited 2013 Nov 19]. Available from: URL: http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/telemedicine.pdf.

Empire BlueCross BlueShield. Empire BlueCross BlueShield professional reimbursement policy: Telemedicine and telehealth services. 2012 Nov 30 [cited 2013 Nov 19]. Available from: URL: http://www.empireblue.com/provider/noapplication/f5/s4/t0/pw_b157689.pdf.

Pub. L. No. 111–148, 124 Stat. 119, $3021 (March 23, 2010).

Centers for Medicare & Medicaid Services (US). Health Care Innovation Award project profiles. 2012 Jul 30 [cited 2013 Nov 19. Available from: URL: http://innovation.cms.gov/Files/x/HCIA-Project-Profiles.pdf.

Centers for Medicare & Medicaid Services (US). 2013 annual report of the boards of trustees of the federal hospital insurance and federal supplementary medical insurance trust funds. Communication to Honorable John A. Boehner, Speaker of the House of Representatives, and Honorable Joseph R. Biden, Jr., President of the Senate. 2013 May 31 [cited 2013 Nov 19. Available from: URL: http://downloads.cms.gov/files/TR2013.pdf.

H.R. 6719, 112th Congress (2012).