Missouri Code of State Regulations › Title 13 - DEPARTMENT OF SOCIAL SERVICES › Division 70 - MO HealthNet Division › Chapter 3 - Conditions of Provider Participation, Reimbursement, and Procedure of General Applicability › Section 13 CSR 70-3.330 - Telemedicine Services

Current through Register Vol. 49, No. 14, July 15, 2024
PURPOSE: The purpose of this rule is to establish the
				  division's guidelines regarding coverage and reimbursement for telemedicine
				  services. The goal of this policy is to allow greater access to care for MO
				  HealthNet participants.
PUBLISHER'S NOTE: The secretary of state has
				  determined that the publication of the entire text of the material which is
				  incorporated by reference as a portion of this rule would be unduly cumbersome
				  or expensive. This material as incorporated by reference in this rule shall be
				  maintained by the agency at its headquarters and shall be made available to the
				  public for inspection and copying at no more than the actual cost of
				  reproduction. This note applies only to the reference material. The entire text
				  of the rule is printed here.
(1) Administration.
(A) The telemedicine program shall be
				administered by the MO HealthNet Division (MHD). This rule is established
				pursuant to the authority granted to the Missouri Department of Social
				Services, MO HealthNet Division, to promulgate rules governing the practice of
				telemedicine in the MO HealthNet Program and to provide services under
				established, approved MO HealthNet benefits.
(B) Definitions.
1. Asynchronous store-and-forward shall mean
				the transfer of a participant's clinically important digital samples, such as
				still images, videos, audio, text files, and relevant data from an originating
				site through the use of a camera or similar recording device that stores
				digital samples that are forwarded via telecommunication to a distant site for
				consultation by a consulting provider without requiring the simultaneous
				presence of the participant and the participant's treating provider.
A. Asynchronous store-and-forward technology
				shall mean cameras or other recording devices that store images which may be
				forwarded via telecommunication devices at a later time.
B. Asynchronous store-and-forward transfer
				shall mean the collection of a participant's relevant health information and
				the subsequent transmission of that information from an originating site to a
				provider at a distant site without the participant being present.
2. Distant site shall mean a
				telemedicine site where the health care provider providing the telemedicine
				service is physically located.
3.
				Originating site shall mean a telemedicine site where the MO HealthNet
				participant receives the telemedicine service. Originating sites include, but
				are not necessarily limited to health care provider facilities, participants'
				homes, and schools. For the purposes of asynchronous store-and-forward
				transfer, the originating site shall also mean the location from which the
				referring provider transfers information to the distant site.
4. Licensed health care provider-patient
				relationship shall mean that a health care provider licensed under Chapter 334,
				RSMo, and/or other providers utilizing telemedicine, shall ensure that a
				properly established provider-patient relationship exists with the participant
				who receives telemedicine services.
5. Telemedicine shall mean the delivery of
				health care services by means of information and communication technologies
				that facilitate the assessment, diagnosis, consultation, treatment, education,
				care management, and self-management of a participant's health care while such
				participant is at the originating site and the provider is at the distant site.
				Telemedicine shall also include the use of telephonic or asynchronous
				store-and-forward technology. Telemedicine services must be performed with the
				same standard of care as an in-person, face-to-face service.
6. Health care professional shall mean a
				physician or other health care practitioner licensed, accredited, or certified
				by the state of Missouri to perform specified health services consistent with
				state law.
7. Health care provider
				or provider shall mean a health care professional or a health care
				facility.
8. Health care service
				shall mean a service for the diagnosis, prevention, treatment, cure, or relief
				of a health condition, illness, injury, or disease, including but not limited
				to the provision of drugs or durable medical equipment.