Bringing you up-to-date telehealth information resources on the southwest region and the USA
Payment Parity for Telehealth
Payment parity requires that private insurers pay the same rate for healthcare services provided in-person and via telehealth. Coverage parity only requires that private insurers cover healthcare services provided via telehealth but not necessarily at the same rate as in-person services. Some states had policies in place prior to the COVID-19 pandemic, while others, as part of their COVID-19 response, implemented temporary payment parity through the end of the public health emergency (PHE). Now, many states are implementing payment parity on a permanent basis. The Centers for Medicare and Medicaid Services (CMS), through a waiver, established broad payment parity for telehealth, including audio-only telehealth for the duration of the PHE.
In this issue of the SWTRC newsletter, we are highlighting resources related to telehealth coverage & payment parity. As you can see illustrated in the following map, the southwest region is helping to lead the way when it comes to equal payment for telehealth and in-person healthcare services.
May 5, 2021, Governor Ducey signed H.B. 2454, legislation which dramatically expanded access to telehealth services in Arizona. The law requires health insurance companies to provide payment parity—reimbursement by the health plan for telehealth services at the same or equivalent rate as paid for in-person services—to providers for telehealth services rendered through audio-visual format.
On March 20, 2015, Colorado Governor John Hickenlooper signed into law HB 15-1029, which requires that insurers operating in Colorado reimburse health care providers for telehealth services in all of Colorado’s counties. Since January 2017, Colorado now has a full parity law, requiring reimbursement across the entire state. Recently, Colorado passed House Bill No. 1076, which allows for the prescribing, selecting, and fitting of hearing aids via telehealth.
In 2015, laws in Nevada required coverage and reimbursement for telehealth under private insurance and Medicaid, as well as workers compensation (the first state to include this) to the same extent and at the same price as provided in person.
New Mexico (NM) issued Executive Order 2021-049 on August 16, 2021, extending the public health emergency. In 2019, NM’s legislature passed SB 354, saying that a health plan shall provide coverage for services provided via telemedicine to the same extent the health plan covers the same services when those services are provided via in-person consultation or contact.
