Coronavirus Telehealth Directive

On April 21, 2020, Gov. Bullock issued a directive regarding telehealth services and reimbursement as a result of the coronavirus (COVID-19) pandemic. The message is directed at health insurers, health plan sponsors, health care providers and state residents.

The directive follows the state’s emergency declaration and recent federal guidance regarding telehealth services. It modifies prior state regulations to ensure residents have broader access and coverage for telehealth services. The communication also provides direction for health insurers with respect to telehealth use, delivery and reimbursement.

For the duration of the emergency, limitations on the types of technology and locations that can be used to deliver telehealth services are removed. The requirement of a pre-existing provider/patient relationship is also eliminated.

The directive reinforces that under telehealth parity, insurers must generally provide coverage and reimbursements for medically necessary telehealth services to the same extent as in-person services. Insurers are reminded that federal law mandates coverage for COVID-19 testing and diagnosis without cost sharing. Additionally, insurers and self-insured plans are encouraged to lower or eliminate cost sharing for other types of telehealth visits to incentivize patients to continue necessary care during the emergency. (Recent federal guidance permits mid-year amendments that expand telehealth services and/or eliminate related cost sharing.)

With respect to licensing requirements, the directive clarifies the types of state-licensed health care providers that may deliver telemedicine. Insurers are required to take measures to ensure their telehealth network is adequate, including making out-of-state providers available, if necessary. Insurers and providers are urged to try to avoid out-of-network and surprise billing for telehealth services and reminded of the federal prohibition against “balance billing” for COVID-19 treatment services.

Employers should be aware of the directive and modifications to prior telehealth laws in the state. They may wish to contact their carriers for further information regarding the available telehealth services. The measures are effective immediately.

Directive Implementing Executive Orders 2-2020 and 3-2020 »