Medicaid Reimbursement News and Resources for Healthcare

NY Payer Launches Virtual Care Solution for Medicaid Members

January 26, 2022 - MVP Health Care, a nonprofit payer with members in New York and Vermont, has partnered with technology-driven medical group Galileo to launch a virtual primary and specialty care solution for Medicaid members. Through Galileo's bilingual application, MVP Health Care's Medicaid members in New York will have 24/7 access to clinicians via text...

Pharmacy Owner Convicted for Leading $174M Telemedicine Fraud Scheme

December 07, 2021 by Victoria Bailey

A pharmacy owner has been convicted for participating in a $174 million telemedicine fraud, waste, and abuse scheme that deceived pharmacy benefit managers, payers, and consumers. Peter Bolos, age 44,...

A Snapshot of Telehealth Payment Policies Across States

November 22, 2021 by Victoria Bailey

Telehealth policies vary from state to state but in the past few months there have been some common regulation changes across the country. Specifically, states modified their Medicaid reimbursement...

Congress Again Eyes a Thorough Study of Telehealth During the Pandemic

August 03, 2021 by Eric Wicklund

Lawmakers are once again eyeing a thorough evaluation of telehealth services offered during the coronavirus pandemic through Medicare and Medicaid. That’s the gist of the Evaluating Disparities...

Texas Lawmakers OK Telehealth Expansion for Medicaid, Public Health Plans

June 01, 2021 by Eric Wicklund

Texas is set to approve legislation that would give the state’s Medicaid program and other public health plans more leeway to cover telehealth and allow audio-only telehealth services in some...

California Doctors’ Group Pushes Full Coverage for Audio-Only Telehealth

May 20, 2021 by Eric Wicklund

California’s largest medical association is challenging Governor Gavin Newsom’s plan to set Medicaid reimbursement for audio-only telehealth at 65 percent, saying providers should be...

GAO Tells Congress to Wait on Expanding Telehealth Coverage Past the Pandemic

May 20, 2021 by Eric Wicklund

The US government’s financial watchdog is advising lawmakers to wait a while and gather more data before deciding on whether to permanently expand telehealth coverage for Medicare and Medicaid...

Virginia Expands Coverage for School Telehealth, Remote Patient Monitoring

March 12, 2021 by Eric Wicklund

A pair of bills headed to Virginia Gov. Ralph Northam’s desk will expand the state Medicaid program to cover remote patient monitoring services and school-based telehealth programs. HB 1987,...

Utah Expands Telehealth Coverage for Mental Health Services

March 09, 2021 by Eric Wicklund

Utah Governor Spencer Cox has signed into law a bill that allows coverage for mental healthcare services delivered by telehealth. SB 41, sponsored by State Sen. Luz Escamilla, requires the...

Will Telehealth Payment Parity Be Permanent or a Passing Fancy?

February 22, 2021 by Eric Wicklund

As federal and state lawmakers look to establish telehealth policy beyond the coronavirus pandemic, much of the conversation will focus on payment parity. That’s the biggest take-away from a...

Florida Mulls Medicaid Coverage for Asynchronous Telehealth, RPM

February 09, 2021 by Eric Wicklund

Florida lawmakers are considering legislation that allow Medicaid coverage for asynchronous (store-and-forward) telehealth and remote patient monitoring services. S.852, filed last month by State...

California Eyes Post-COVID-19 Telehealth Policy for Medicaid Patients

February 04, 2021 by Eric Wicklund

California’s Department of Health Care Services is planning an aggressive post-COVID-19 telehealth policy for the state’s Medicaid program. In a 14-page report issued this week, the DHCS...

Vermont Workgroup Outlines Long-Term Coverage for Audio-Only Telehealth

January 06, 2021 by Eric Wicklund

A workgroup of payers, providers and others in Vermont is recommending that the state continue coverage of audio-only telehealth services beyond the coronavirus pandemic. In a 114-page report to state...

California Lawmaker Eyes Permanent Telehealth Coverage for Medicaid

December 29, 2020 by Eric Wicklund

California lawmakers will debate a bill next month that aims to make expanded telehealth coverage permanent for the state’s Medicare program. AB 32, introduced earlier this month by State...

How Should State Medicaid Programs Expand Telehealth Coverage?

October 20, 2020 by Eric Wicklund

With most state governments enacting emergency measures to improve Medicaid coverage for telehealth services during the coronavirus pandemic, a national law firm has drafted a list of actions those...

CMS Adds Reimbursement for Cardiac Rehab Services Via Telehealth

October 15, 2020 by Eric Wicklund

The Centers for Medicare & Medicaid Services has announced that 11 more telehealth services will qualify for Medicare reimbursement during the coronavirus pandemic. The agency also released new...

DC Council Votes to Extend Telehealth Coverage for Postpartum Care

September 09, 2020 by Eric Wicklund

Washington DC lawmakers are set to enact a new law that would greatly expand telehealth coverage for postpartum care. The Postpartum Coverage Expansion Act Amendment of 2020, which was passed...

Ohio Medicaid Asks to Make Expanded Telehealth Coverage Permanent

September 02, 2020 by Eric Wicklund

Ohio’s Medicaid program is petitioning the state to make permanent telehealth coverage that had been expanded to address the coronavirus pandemic. The state’s Department of Medicaid has...

States Announce Partnership to Coordinate Their Telehealth Efforts

August 07, 2020 by Eric Wicklund

The governors of four western states have announced plans to coordinate their activities on telehealth access and coverage. The announcement from the governors of Colorado, Nevada, Oregon and...

Connecticut Lawmakers Vote to Extend Telehealth Coverage - For a While

July 30, 2020 by Eric Wicklund

Connecticut lawmakers have approved a bill extending several telehealth freedoms until next March, saying they want to study the issue more before addressing permanent coverage. HB 6001, which now...

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