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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
 
4043.0: Tuesday, December 13, 2005 - 9:15 AM

Abstract #109297

Medicaid and Title V strategies for financing and reimbursing telemedicine: Providing access to specialty care for CSHCN

Lise M. Youngblade, PhD, Donna Hope Wegener, MA, Laura A. Curry, PhD, and Kara B. Lustig, BA. Institute for Child Health Policy, University of Florida, 1329 SW 16th St., Room 5130, Gainesville, FL 32608, (352) 265-7220 x 86269, lmy@ichp.ufl.edu

Coordinating access to specialty care through the child's medical home is critical for children with special health care needs (CSHCN). As states struggle to find cost effective ways to reduce geographic and provider-network barriers to specialty care for their low-income citizens, many have implemented telemedicine programs. A major factor in long-term sustainability of these programs is reimbursement. To identify current practices in telemedicine utilization and reimbursement, two surveys were conducted. First, a survey was conducted with the Medicaid program in each of the 50 states. States were screened as to whether they reimbursed for telemedicine or not. If so, states were interviewed about what services were provided and how they were reimbursed. States also provided reasons for not reimbursing telemedicine. A second survey was conducted with the Title V director in each of the 50 states to examine further the telemedicine services available specifically for CSHCN. Currently, 26 states reimburse for telemedicine through Medicaid. States vary by: conditions covered by telemedicine; how providers are reimbursed (e.g., at the “hub” or “spoke” site); whether the provider is an MD or physician extender; whether the consultation is live or “store and forward”; and particular codes that are used to bill for telemedicine. In states that do not, Title V programs have been instrumental in supporting pilot programs and demonstrations. This presentation describes results of the surveys, and synthesizes common and “best” telemedicine reimbursement practices among states. Recommendations for programs wishing to implement telemedicine and implications related to long-term financial sustainability are discussed.

Learning Objectives: At the end of this presentation session participants will

Keywords: Telemedicine, Children With Special Needs

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

[ Recorded presentation ] Recorded presentation

The Impact of Financing Structures on Coverage and Care

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA