Connecticut Health Law

Today (July 28, 2020) the Connecticut Senate passed House Bill No. 6001 with this House amendment to further extend and expand the telehealth services offered by in-network providers for fully-insured health plans in the state as well as those providing care and services to established Medicaid and HUSKY B patients under the Connecticut Medical Assistance Program (CMAP).  The Senate’s approval follows last week’s passage of the bill by the Connecticut House of Representatives in the July Special Session of the General Assembly and sets the stage for Governor Lamont to sign into law the legislation that will impact Connecticut telehealth rules through March 15, 2021.

As the Office of Legislative Research (OLR) summary of the bill and Pullman & Comley’s earlier coverage of Executive Orders 7G, 7DD and 7FF (which will now largely be codified into law) make clear, these state insurance benefit mandates do not apply to self-insured benefit plans governed by the federal Employee Retirement Income Security Act (ERISA) although many of these plans have similarly expanded telehealth coverage for their beneficiaries.  The highlight of the bill allows these in-network and CMAP telehealth providers to provide telehealth services via audio only and would authorize the Commissioner of the Department of Social Services (DSS) to allow Connecticut Medicaid to cover applicable services provided through audio-only telehealth services, to the extent allowed under federal law.

Other key portions of the bill modify current state law to allow telehealth providers to use additional information and communication technologies like Apple FaceTime in accordance with HIPAA requirements as directed by the federal Department of Health and Human Services (HHS) Office of Civil Rights.  The bill also allows impacted telehealth providers to provide telehealth services from any location and adds to the current legal requirement that, at the first telehealth interaction with the patient, the telehealth provider document in the medical record the patient’s consent to the services after explaining the telehealth methods and limitations by now requiring that the patient also be furnished information on the limited duration of the bill’s provisions.

Possibly in anticipation of the passage of the legislation, DSS has already issued notice of proposed Medicaid State Plan Amendment (SPA) 20-V to alter its COVID-19 Medicaid telehealth coverage rules and implement other Medicaid program changes beyond the current federal COVID-19 public health emergency.  The federal declaration of the public health emergency was set to expire on July 25, 2020 but last week was extended for an additional 90 days or until the Secretary of HHS determines that the emergency no longer exists, whichever occurs first. Since the period to comment on the proposed SPA changes runs until August 5, 2020, providers will want to refrain from relying upon the proposed SPA as a basis for submitting any claims for the present. Instead providers should continue to look to Department of Social Services (DSS) Provider Bulletins and Manuals for rules applicable to their claims.

Under the SPA, the proposed new telehealth coverage provisions would enable audio-only telehealth evaluation and management service charges through the end of the state declared public health emergency by physician, physician assistants, advance practice registered nurses (APRNs), certified nurse-midwives, free-standing medical clinics, behavioral health clinics (including enhanced care clinics), outpatient hospital behavioral health clinics, public and private psychiatric outpatient hospital clinics, and family planning clinics.

Also through the end of the state declared emergency, audio-only psychotherapy would be allowed by independent licensed behavioral health clinicians (licensed psychologists, licensed clinical social workers (LCSWs), licensed marital and family therapists (LMFTs), licensed professional counselors (LPCs), and licensed alcohol and drug counselors (LADCs)), behavioral health clinics (including enhanced care clinics), outpatient hospital behavioral health clinics, public and private psychiatric outpatient hospital clinics, free-standing medical clinics, rehabilitation clinics, behavioral health FQHCs, physicians, advanced practice registered nurses, and physician assistants.

 DSS expects all providers to follow all Provider Bulletins and provider communications that address Connecticut Medicaid’s temporary telemedicine and telephonic coverage in response to COVID-19, as it does with all Medicaid billings.   Early in Connecticut’s COVID-19 response, the state expanded the list of authorized telehealth providers. The expanded list and the list identified in the proposed SPA V-20 differ. Providers may also benefit from resort to the DSS’s recently updated Responses to Frequently Asked Questions (FAQs)  to determine the status of the rules covering their telehealth activities. The July 10 update includes links to Provider Bulletins 2020-10 to 2020-54, all COVID-19 response-related and all pertinent to an assessment of the currently applicable Medicaid billing requirements.

Readers are invited to follow future developments here and encouraged to keep careful track of new announcements from the Governor's office and DSS on the topic.

For additional information, please visit our prior Telehealth posts: Telehealth Boom, Expanded Coverage, Remote Care.