COVID-19 telehealth services

The Department of Managed Health Care (DMHC) issues instructions to covered health plans regarding telehealth services.  During the COVID-19 state of emergency, a health plan may not exclude coverage for certain types of services or categories of services because they are provided via telehealth, if the provider determines the services can be delivered effectively by telehealth.  During the COVID-19 state of emergency, a health plan may not place limits on covered services because they are provided by telehealth if such limits would not apply if the services were provided in person.

A health plan may not require enrollees to use the plan’s telehealth vendor or a different provider from the one the enrollee usually sees if the provider agrees to deliver services via telehealth and the enrollee consents to receiving services via telehealth.

Plans cannot impose credentialing or approval requirements specific to telehealth if the provider is otherwise appropriate to deliver services and the health plan would cover the provider’s services if the provider had provided services in person.

Health plan cannot require providers to use a particular platform or modality to deliver services via telehealth.  However, providers must consider their obligation to protect confidentiality of their patients.  (APL 20-013, April 6, 2020.)