![]() ![]() HHSC allowed the use of telemedicine, telehealth, and audio-only for many new Medicaid services during the COVID-19 PHE. House Bill (HB) 4 (87th Legislative Session, 2021): ![]() Rules required by legislation were formally posted for public comment and published as adopted.Changes to medical benefit policies were completed.Phase IV: Finalizing Policy - Fall 2022 through 2023 - Complete Changes to medical benefit policies were posted for public comment.Phase III: Rulemaking - Summer 2022 - Complete HHSC posted draft rules required by legislation for informal comment.HHSC released guidance about additional services that are approved for telemedicine, telehealth, and audio-only delivery methods.HHSC requested stakeholders for input about additional services that were available for remote delivery during the PHE to help determine whether permanent telemedicine, telehealth, and audio-only delivery methods would be cost-effective and clinically appropriate.Phase II: Analysis - Spring 2022 - Complete HHSC began releasing draft rules and other policy updates.HHSC released guidance about certain services that are approved for telemedicine, telehealth, and audio-only delivery methods on an ongoing basis.Timeline Phase I: Analysis - Winter 2022 - Complete If you have general questions or comments about Medicaid and CHIP teleservices, please e-mail Medicaid Benefit Request. You can find additional information about HHSC’s evaluation framework (PDF). With input from advisory committees and other stakeholders, HHSC staff evaluated services to determine whether this method of delivery is cost-effective and clinically appropriate. This includes many services that were made available through telemedicine, telehealth, and audio-only methods during the COVID-19 public health emergency (PHE) as well as other services. We will continue to study patterns in telehealth and will use this data to revise or update the policy in the future.Certain Medicaid and CHIP services may now be delivered using telemedicine, telehealth, and audio-only methods. To inform our new telehealth policy, Blue Cross NC assessed more than two years of usage data since the onset of the pandemic. Federal Employee Program members can find details in their Service Benefit Plan Brochure.Healthy Blue members have certain telehealth visits covered at parity under Medicaid benefits determined by the state.Medicare Advantage members should review their evidence of coverage.Members who do not have a commercial plan can find more information about their telehealth coverage below. It does not apply to Blue Cross NC members receiving care from out-of-state providers. The new policy will apply to all Blue Cross NC fully insured and administrative services only (ASO) plans, including the State Health Plan. The new policy will continue to cover services that make up more than 97% of the telehealth claims received during the last two years, particularly behavioral health, primary care and outpatient office visits. On January 1, 2023, a new telehealth policy will go into effect, significantly expanding the list of covered telehealth services compared to before the pandemic. In March 2020, Blue Cross NC was one of the first insurers in the nation to quickly respond to the pandemic by expanding telehealth coverage to pay doctors and facilities the same as in-person visits for all video and audio-only visits. Has the potential to lower costs for members Non-Discrimination Policy and Accessibility Services.Get a Quote for Individual and Family PlansĪncillary and Specialty Benefits for Employees.Health Plans for Individuals and Families. ![]()
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