Recently, the Oregon Health Authority (OHA) released guidance related to telehealth services in conjunction with the directors of the Department of Consumer and Business Services (DCBS). The guidance expands the ability for providers to provide telehealth services to improve parity in reimbursement to in-patient visits.
The guidance specifies that the state of Oregon expects commercial health plans regulated by DCBS and Medicaid health plans regulated by OHA to provide increased access to health care services through telehealth delivery platforms.
It also instructs health plans to encourage the use of telehealth delivery options to limit the amount of in-person health care services.
The items below are addressed in the guidance.
- Health plans shall cover telehealth services delivered by in-network providers to replace in-person visits whenever possible and medically or clinically appropriate.
- Health plans shall examine reimbursement rates for telehealth services to ensure they’re adequate and enable providers to increase capacity to serve patients with appropriate telehealth delivery methods.
- Health plans shall ensure cost-sharing requirements for services delivered via telehealth aren’t greater than service delivered through in-person settings.
- Health plans shall clearly communicate options about receiving health care services via appropriate telehealth delivery modes for their members and provider networks by prominently posting information on their website. They will also post information on how they bill for such services.
- Health plans shall examine their provider networks to ensure robust telehealth services are available and consider contracting with more providers to help bolster telehealth capacity during the current outbreak.
- Health plans shall use telehealth service delivery methods to ensure patients maintain access to behavioral health services.
- Health plans shall eliminate barriers to providing medically and clinically appropriate care using appropriate telehealth delivery models.
Additional information on each bulleted item is provided in the guidance.
Both agencies plan to continue to expand and provide more guidance as well.
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For more information about Oregon’s telehealth guidance, contact your Moss Adams professional.
For regulatory updates, strategies to help cope with subsequent risk, and possible steps to bolster your workforce and organization, please see the following resources: