Reimbursing FQHCs for telehealth post-COVID-19 pandemic: Medi-Cal’s options
- Collection:
- Health Policy and Services Research
- Author(s):
- Gomez, Rafael A., author
- Contributor(s):
- California HealthCare Foundation, issuing body.
- Publication:
- [Oakland, CA] : California Health Care Foundation, January 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Community Health Centers Insurance, Health, Reimbursement Medicaid -- organization & administration Telemedicine California United States
- Genre(s):
- Technical Report
- Abstract:
- The COVID-19 pandemic unleashed extraordinary burdens on Californians in low-income communities, including making it difficult to access health care services in a safe and timely way. Among those especially hard hit by COVID-19 were those enrolled in Medi-Cal, California’s Medicaid program, which provides health care coverage to 14 million people in low-income households including children, parents, working adults, seniors, and persons with disabilities. California policymakers rapidly secured temporary flexibilities from the federal government and established policies to enable health care providers to deliver covered services to MediCal enrollees via telehealth during the public health emergency, including video and telephone visits. While the pandemic created enormous burdens for communities and health care service providers, it has also accelerated adoption of telehealth services at rates previously unthinkable and elevated discussions in California and around the country about the longterm possibilities for telehealth to maximize use of our health care workforce and meaningfully improve access for underserved populations. This paper examines the choices and considerations for California policymakers to expand Medi-Cal coverage and reimbursement for telehealth provided by FQHCs by addressing the following questions: $ What independent authority and flexibility does the California Department of Health Care Services have to extend Medi-Cal coverage for telehealth and to determine reimbursement levels for FQHCs? $ What are the different reimbursement options and considerations for FQHCs, and what other levers does the Medi-Cal program have to manage appropriate telehealth use? $ How have other states approached permanent expansion of Medicaid coverage for telehealth, including coverage and reimbursement for FQHCs? What lessons can be learned and applied in California? This report explores California’s authorities to extend telehealth coverage and define reimbursement methodologies, and it examines activities in other states to define permanent Medicaid telehealth coverage and reimbursement policies for FQHCs. This includes six case studies developed from examination of activities in 10 other locations (9 states and the District of Columbia) and an overview of what services, modalities, and reimbursement methodologies they have permanently extended.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY-NC-ND license. (More information)
- Extent:
- 1 online resource (1 PDF file (21 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918351269706676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918351269706676