26B-3-122. Telemedicine — Reimbursement — Rulemaking.
| (1) |
Terms Used In Utah Code 26B-3-122- Medical assistance: means services furnished or payments made to or on behalf of a member. See Utah Code 26B-3-101
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
| (a) |
As used in this section, communication by telemedicine is considered face-to-face contact between a health care provider and a patient under the state‘s medical assistance program if:
| (i) |
the communication by telemedicine meets the requirements of administrative rules adopted in accordance with Subsection (3); and |
| (ii) |
the health care services are eligible for reimbursement under the state’s medical assistance program. |
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| (b) |
This Subsection (1) applies to any managed care organization that contracts with the state’s medical assistance program. |
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| (2) |
The reimbursement rate for telemedicine services approved under this section:
| (a) |
shall be subject to reimbursement policies set by the state plan; and |
| (b) |
may be based on:
| (i) |
a monthly reimbursement rate; |
| (ii) |
a daily reimbursement rate; or |
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| (3) |
The department shall adopt administrative rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, which establish:
| (a) |
the particular telemedicine services that are considered face-to-face encounters for reimbursement purposes under the state’s medical assistance program; and |
| (b) |
the reimbursement methodology for the telemedicine services designated under Subsection (3)(a). |
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Renumbered and Amended by Chapter 306, 2023 General Session
