Telehealth law Florida is constantly evolving The latest example is found with Florida’s Department of Children and Families (DCF) recent proposed rule change which now includes a definition of Telehealth as a delivery system in substance abuse. Telehealth can be used in treatment or prevention services through electronic communications from one site to another. However, it does not include delivery of services using only the audio on a telephone, or e-mails, text messages, fax transmissions, US mail or other parcel service. Proposed Rule 65D-30.0031 (83) Definitions.
Telehealth services can be used in intensive outpatient, day or night treatment, day or night treatment with community housing, outpatient, interventions, aftercare, and prevention. If a substance abuse provider plans on including telehealth services it must submit to DCF detailed procedures outlining which services it intends to provide. The provider will be responsible for the quality of the equipment and technology used in the telehealth service. Proposed Rule 65D-30.004 (20) Common Licensing Standards.
So you’ve been approached by a telehealth company to provide telehealth services to patients. What do you do next about this telehealth contract opportunity? Providing these services can be an opportunity to assist patients who cannot make it to a physician’s or practitioner’s office, and it’s an opportunity for a potential source of income. However, before you sign on the telehealth contract’s dotted line, you need to do a little background checking, a little investigation, to ensure the telehealth company you sign with is compliant with state and federal laws for providing telehealth services. In other words, perform due diligence in determining if this is the telehealth company for you.
So what should you look for in a telehealth company as a physician or practitioner presented with a telehealth contract?
Floridians are all too familiar with the business and logistical hurdles bad tropical weather can create. However, even less expected are the everyday human errors such as an overzealous backhoe operator digging above a fiber optic cable and inadvertently cutting a data connection. The reality is that disruption can happen anytime, not just during hurricane season. The good news is that recent developments in technology provide a new way to both augment the practice of medicine and insulate a business against downtime. Telemedicine or telehealth is rapidly becoming an inexpensive and secure way to interact with patients and medical professionals just short of the tactile response from pressing flesh during an introductory handshake.
Granted, telemedicine and telehealth are generic terms that incorporate layers of many technologies. For simplicity’s sake we’ll discuss some of the most popular options for video conferencing, cloud based technology and virtualization. If that sounds intimidating just look past the buzzwords you may hear in commercials mentioning a certain character from a Sir Arthur Conan Doyle novel. It’s all elementary. See what I did there?
If you are having issues with Medicare telehealth claim matters then you want to hire an experienced legal team that can guide you through the process, ensuring the best possible outcome. You also have the benefit of knowing that you are getting the best counsel for any legal matters and do not have to rely on amateur advisement like blogs and forums. These are some of the questions you can get answers to:
What experience do you have? When you hire an attorney to handle a legal matter for your business, you want them to be experienced and have a well established presence in this industry because there’s a chance they will be going up against insurance companies who have a lot of money and an experienced team of their own.
How can you help me with this situation? When you are dealing with this matter you want to make sure that everything is taken under consideration. For example, are you compliant with all the rules and regulations, new changes in policy or anything else that comes up? Do you have all the licensing you need to conduct business and so forth? An experienced team will make sure you have everything you need to move forward.
How can you help me in the future? One of the biggest advantages of hiring a law firm rather than an individual attorney is that we can assist you with several legal matters that come up in the future. Today you may need assistance with a contract for hiring a new doctor but a year from now it may be to purchase or sell a practice.
With the rise in services provided to patients via telehealth entities, it is important that both practitioners and patients understand what criteria must be met in order to provide and bill telehealth on behalf of Medicare patients. Here are a few of the basics.
First, “telehealth service” for Medicare purposes means “professional consultations, office visits, and office psychiatry services, and any additional service specified by the Secretary. To be eligible for payment, telehealth services must be rendered to an eligible individual, that is, an individual enrolled in Medicare, who receives telehealth services at an originating site from a physician or practitioner at a distant site via telehealth communications system. An eligible individual does not need to be presented by a physician or practitioner at the originating site to a physician or practitioner at a distant site, unless it is medically necessary. Determination of whether a presenting physician or practitioner is necessary at the originating site is made by the physician or practitioner at the distant site.
Most commercial health plans require that prior to admission to a substance abuse treatment facility, patients must have a face-to-face individual assessment by a licensed behavioral health clinician 72 hours prior to admission, to determine if the admission is both medically necessary and clinically appropriate. Many potential patients reside in states outside of Florida (or a given destination), so complying with a face-to-face requirement when a patient is in another state before admission is a challenge. Telehealth is being increasingly utilized to evaluate these out-of-state patients and perform the necessary face-to-face evaluation in advance of arrival at a given facility. However, as with anything healthcare, there is a right way and a wrong way to implement this technology. In the coming weeks, we’ll be discussing many of the facets involved from telemedicine claims overpayments to Medicare telehealth law issues.
Health law is the federal, state, and local law, rules, regulations and other jurisprudence among providers, payers and vendors to the healthcare industry and its patient and delivery of health care services; all with an emphasis on operations, regulatory and transactional legal issues.