2023 Colorado Revised Statutes › Title 25.5 - HEALTH CARE POLICY AND FINANCING (§§ 25.5-1-101 — 25.5-11-101) › COLORADO MEDICAL ASSISTANCE ACT (§§ 25.5-4-101 — 25.5-6-2001) › Article 5 - COLORADO MEDICAL ASSISTANCE ACT - SERVICES AND PROGRAMS (§§ 25.5-5-101 — 25.5-5-804) › Part 3 - SERVICES WITH SPECIAL STATE PROVISIONS (§§ 25.5-5-301 — 25.5-5-338) › Section 25.5-5-337 - [Effective 8/7/2024] Telehealth remote monitoring services for outpatient clinical services - grant program - federal authorization - rules - definitions

(1)
As used in this section, unless the context otherwise requires:
(a)
"Grant program" means the telehealth remote monitoring grant program created in subsection (6) of this section.
(b)
"Member" means any person who has been determined eligible to receive benefits or services under this title 25.5.
(c)
"Telehealth remote monitoring" means the ongoing remote assessment and monitoring of clinical data through technological equipment in order to detect changes in a member's clinical status, which allows health-care providers to intervene before a health condition exacerbates and requires emergency intervention or inpatient hospitalization.
(2)
(a)
On or before September 1, 2024, the state department shall initiate a stakeholder process to determine the billing structure for telehealth remote monitoring for outpatient clinical services:
(b)
The state department stakeholder process, required by subsection (2)(a) of this section, must engage with health-care providers who serve rural and underserved populations, including rural health clinics and federally qualified health centers to ensure the billing structure is sustainable in these health-care settings.
(c)
On or before June 30, 2025, the state board shall promulgate rules regarding the billing structure based on feedback from the stakeholder process required in subsections (2)(a) and (2)(b) of this section.
(3)
(a)
Beginning July 1, 2025, the state department shall provide reimbursement for the use of telehealth remote monitoring for outpatient clinical services if:
(I)
The member's health-care provider determines that telehealth remote monitoring is medically necessary based on the member's medical condition or status;
(II)
The member's health-care provider determines that telehealth remote monitoring would likely prevent the member's admission or readmission to a hospital, emergency department, nursing facility, or other clinical setting;
(III)
The member is cognitively and physically capable of operating the telehealth remote monitoring device or equipment or the member has a caregiver who is able and willing to assist with the telehealth remote monitoring device or equipment; and
(IV)
The member resides in a setting that is suitable for telehealth remote monitoring and does not have health-care staff on site.
(b)
The state board shall promulgate rules regarding additional eligibility requirements. The eligibility requirements must prioritize members with chronic conditions and members who are pregnant and carrying a high-risk pregnancy.
(4)
The assessment and monitoring of the health data transmitted by telehealth remote monitoring must be performed by one of the following licensed health-care professionals:
(a)
Physician;
(b)
Podiatrist;
(c)
Advanced practice registered nurse;
(d)
Physician assistant;
(e)
Respiratory therapist;
(f)
Pharmacist; or
(g)
licensed health-care professional working under the supervision of a medical director.
(5)
The state department may seek any federal authorization necessary to implement subsections (3) and (4) of this section.
(6)
(a)
There is created in the state department the telehealth remote monitoring grant program to provide grants to outpatient health-care facilities located in a designated rural county or a designated health-care professional shortage area to assist the hospitals and clinics with the financial costs associated with providing telehealth remote monitoring for outpatient clinical services.
(b)
The state department shall administer the grant program and, subject to available appropriations, shall award grants as provided in this subsection (6).
(c)
To be eligible for a grant, an outpatient health-care facility must:
(I)
Apply for a grant in the manner prescribed by the state department;
(II)
Be located in a designated rural county or designated health-care professional shortage area; and
(III)
Have a demonstrated need for financial assistance to purchase equipment to provide telehealth remote monitoring for outpatient clinical services.
(d)
The state department may award up to five grants through the grant program. Each grant awarded must be in the amount of one hundred thousand dollars.
(e)
In selecting grant recipients, the state department shall prioritize applicants that serve populations experiencing disparities in health-care access and outcomes, including, but not limited to, historically marginalized and underserved communities, determined by the communities with the highest proportion of patients receiving assistance through the "Colorado Medical Assistance Act", this article 5 and articles 4 and 6 of this title 25.5.
(f)
Grant recipients may use money received through the grant program to implement telehealth remote monitoring for outpatient clinical services and includes the following:
(I)
Training staff to use, assess, and monitor telehealth remote monitoring equipment and devices; and
(II)
Acquiring telehealth remote monitoring equipment and devices.
(g)
Money allocated to the grant program must not be considered in rate-setting for federally qualified health centers, as defined in the federal "Social Security Act", 42 U.S.C. sec. 1395x (aa)(4).
(7)
The state department is authorized to receive and expend gifts, grants, and donations from individuals, private organizations, foundations, or any governmental unit; except that no gift, grant, or donation may be accepted by the state department if it is subject to a condition that is inconsistent with this section or any other law of this state.
(8)
This section does not apply to home health-care benefits provided pursuant to section 25.5-5-321.
Added by 2024 Ch. 281,§ 2, eff. 8/7/2024.
2024 Ch. 281, was passed without a safety clause. See Colo. Const. art. V, § 1(3).