The Texas Health and Human Services Commission (HHSC) is adopting amendments to the Telehealth Services Policy and Telemedicine Services Policy to implement Senate Bill 670 (SB 670), adding parity requirements into Texas Medicaid statutes. Previously, section 531.0216(g)(2), which prohibits Medicaid Managed Care Organizations from denying telehealth or telemedicine reimbursement based on the provider’s choice of platform, was not directly specified in the policy amendments. The APRN Alliance, of which TxANA is a member, is a partnership of Texas APRN organizations that seek to advance common interests, submitted comments to HHSC on June 29, 2020 requesting language be added regarding open platform use.
On October 23, 2020, the HHSC responded to the comment submitted by the APRN Alliance:
8. Two stakeholders highlighted the draft Telemedicine Services policy omitted the following provision of S.B.670: The commission shall ensure that a Medicaid Managed Care Organization: (2) does not limit, deny, or reduce reimbursement for a covered health care service or procedure delivered by a health care provider with whom the MCO contract to a Medicaid recipient as a telemedicine medical service or a telemedicine served based on the health care provider’s choice of platform for providing telemedicine services. Stakeholders recommended adding language related to this provision to the policy.
HHSC agrees to add the following language to the Telemedicine Services policy: Texas Medicaid MCOs cannot limit, deny, or reduce reimbursement for a covered health care service or procedure delivered by a health care provider with whom the MCO contract to a Medicaid recipient as a telemedicine medical service or a telemedicine service based on the health care provider's choice of platform for providing telemedicine services.
As a member, TxANA is proud of the work the APRN Alliance has dedicated to this issue, and others, to improve the practice environment for APRNs in Texas. The full list of agency responses can be found here.