On April 9, 2021, Commissioner Anderson released Bulletin 2021-04, supplementing and superseding Bulletin 2020-04 (Emergency Measures to Address and Stop the Spread of COVID-19). Chapter 260 of the Acts of 2020 was passed after that, and requires coverage for telehealth services within insured health plans issued or renewed in the state.
Until the Division of Insurance promulgates rules regarding telehealth services, providers should comply with Bulletin 2020-04’s requirements. One notable exception is that Chapter 260 allows carriers to undertake utilization review, including preauthorization to determine the appropriateness of telehealth as a means of delivering healthcare services, if the determination is made in the same manner as if the services were delivered in person. However, the division expects carriers not to make changes until they provide the division with an implementation plan.
Carriers are also expected to provide clear communication materials to in-network providers to explain how to submit reimbursement claims for telehealth services. Additionally, they must reimburse providers for services delivered via telehealth at a rate that is no less than the reimbursement required under Chapter 260.
Although this guidance affects insurance carriers, employers should be aware of these mandates.
Bulletin 2021-04 »
PPI Benefit Solutions does not provide legal or tax advice. Compliance, regulatory and related content is for general informational purposes and is not guaranteed to be accurate or complete. You should consult an attorney or tax professional regarding the application or potential implications of laws, regulations or policies to your specific circumstances.
Subscribe