Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. Existing law prohibits a requirement of in-person contact between a health care provider and patient under the Medi-Cal program for any service otherwise covered by the Medi-Cal program when the service is appropriately provided by telehealth, as defined. Existing law, for purposes of payment of covered treatment or services provided through telehealth, prohibits the department from limiting the type of setting where services are provided for the patient or by the health care provider.
This bill would prohibit the department from requiring a health care
provider licensed in California to be located in California as a condition of Medi-Cal provider enrollment or reimbursement for telehealth services provided to Medi-Cal beneficiaries located in California at the time of service. require, effective July 1, 2015, in order for a health care provider that is not located in California to be enrolled in Medi-Cal for the purpose of providing health care services by way of telehealth for beneficiaries receiving care in California, the provider to meet specified conditions and criteria, including that the provider be enrolled and in good standing in the Medicaid program for the state where the provider is located, be enrolled in good standing in Medicare, or be enrolled in good standing in both programs, and that the provider not be located outside the United States of
America.