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The Kaiser Family Foundation recently looked at state trends with regard to expanding access to telehealth-based behavioral care during the pandemic and found that states see telemedicine as a key component of maintaining access to behavioral healthcare for Medicaid enrollees. WHY IT MATTERS.
As an FQHC, 75% of patients are enrolled in Medicaid or Medicare; another 7% are uninsured. THE PROBLEM Prior to 2020 and the COVID-19 pandemic, there were federal and statepolicies in place that discouraged FQHCs like Ryan Health from adopting telehealth services due to payment restrictions.
Health Insurance Portability and Accountability Act (HIPAA) and Centers for Medicare and Medicaid Services (CMS) urge the providers to not only bill accurately but also adhere to their compliance rules. Medicare demands detailed written reports about its medical necessity and process details before releasing funds for reimbursement.
Telehealth payments and provider practices are highly regulated on the Federal level, said Quinn Shean, strategic advisor at Tusk Ventures and the statepolicy advisor for ATA and ATA Action. But even if providers do not serve Medicare populations, "Medicarepolicy trickles down," added Herber.
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