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  • Length: A minimum of 180 words per post, not including references
  • Citations: At least one high-level scholarly reference in APA per post from within the last 5 years

Number 1: MK

In California, telemedicine is defined as the remote provision of health care services using technology to exchange information for the diagnosis, treatment, and prevention of disease, specifically allowing patients in the rural and extra-provincial areas are examined by specialists from a distance. Disparities in access to care, an aging population, and a shortage of healthcare providers led forward-thinkers to begin considering telemedicine as a viable solution. As we are learning during this COVID-19 pandemic, telemedicine and telehealth are critical to public health and are poised to become trusted and recognized methods of care accepted in many situations. With the growing demand for telemedicine, several changes have been made to telemedicine policy, coverage, and implementation, to make telemedicine widely accessible in this state of emergency.

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With Newsom’s signature on AB 744, requiring payers to reimburse telehealth providers “on the same basis and to the same extent” when they pay for in-person services, California became one of about a dozen states requiring parity payments. AB-744 as a landmark piece of legislation. In the past, the concept has been contested by payers, who wanted the freedom to negotiate specific coverage rates with healthcare providers. “These changes are intended to correct regulatory deficiencies that confuse physicians and ultimately prevent patients from obtaining meaningful coverage for services provided via telehealth (Lacktman, 2019). According to the California Department of Health Care Services (2021), Medi-Cal reimbursement for telemedicine providers have flexibility in determining if a particular service or benefit is clinically appropriate for telehealth through videoconferencing, store-and-forward; no restrictions on the origin or distant sites; CPT-4 Code 99451 can be used for e-consultations under the auspice of store-and-forward. Healthcare reimbursement models emphasize cost-effective decisions about a patient’s medical care without compromising the quality of patient service. Innovations like patient engagement apps and pricing transparency tools help make changes to healthcare costs (California Department of Health Care Services, 2021).

Number 2: AW

Telemedicine is health services through the use of electronic audio, or video communication technology (Utah State Telehealth Laws, 2021). These services include consultations, diagnosis, treatments, remote patient monitoring, education, and transferring of medical data (Utah State Telehealth Laws, 2021). Telemedicine continues to expand across this country. Telemedicine is beneficial both for the provider and patient. In the state of Utah, the terms telehealth and telemedicine are used interchangeably. The state of emergency issued due to COVID-19 temporarily changed some reimbursement policies to assist in healthcare accessibility.

The United States government reimbursement policies impact the use of telemedicine in Utah. Medicaid in Utah covers what they define as “medically appropriate” live video services by all healthcare provider types (Utah Telemedicine Policy, Simplified., 2018). Medically appropriate service includes consultations, evaluation and management services, mental health services, long term outpatient cardiac monitoring, and substance abuse services (Utah Telemedicine Policy, Simplified., 2018). Unfortunately, reimbursement from private insurers is not guaranteed for telemedicine visits in Utah. No parity law currently exists in Utah for telemedicine. Patients in Utah may be skeptical of seeking telemedicine healthcare if they have commercial insurance. Utah Medicaid also allows the patient to see providers via telemedicine that are out of the state (Utah State Telehealth Laws, 2021). Telemedicine allows patients in rural areas to seek healthcare instead of traveling for a long time. Telemedicine can also allow a patient to see a specialty doctor they may not otherwise be able to see. Expansion of telehealth technology must continue to expand and laws change to encourage telemedicine in Utah.

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