26B-3-123. Reimbursement of telemedicine services and telepsychiatric consultations.
| (1) |
As used in this section:
Terms Used In Utah Code 26B-3-123- Division: means the Division of Integrated Healthcare within the department, established under Section 26B-3-102. See Utah Code 26B-3-101
- Medicaid program: means the state program for medical assistance for persons who are eligible under the state plan adopted pursuant to Title XIX of the federal Social Security Act. 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) |
“Telehealth services” means the same as that term is defined in Section 26B-4-704. |
| (b) |
“Telemedicine services” means the same as that term is defined in Section 26B-4-704. |
| (c) |
“Telepsychiatric consultation” means a consultation between a physician and a board certified psychiatrist, both of whom are licensed to engage in the practice of medicine in the state, that utilizes:
| (i) |
the health records of the patient, provided from the patient or the referring physician; |
| (ii) |
a written, evidence-based patient questionnaire; and |
| (iii) |
telehealth services that meet industry security and privacy standards, including compliance with the:
| (A) |
Health Insurance Portability and Accountability Act; and |
| (B) |
Health Information Technology for Economic and Clinical Health Act, Pub. L. No. 111-5, 123 Stat. 226, 467, as amended. |
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| (2) |
This section applies to:
| (a) |
a managed care organization that contracts with the Medicaid program; and |
| (b) |
a provider who is reimbursed for health care services under the Medicaid program. |
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| (3) |
The Medicaid program shall reimburse for telemedicine services at the same rate that the Medicaid program reimburses for other health care services. |
| (4) |
The Medicaid program shall reimburse for audio-only telehealth services as specified by division rule. |
| (5) |
The Medicaid program shall reimburse for telepsychiatric consultations at a rate set by the Medicaid program. |
Amended by Chapter 295, 2023 General Session
Renumbered and Amended by Chapter 306, 2023 General Session
