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Telemedicine for Medicaid

At Sunshine Health, we know that the more options your Medicaid patients, our members, have to see and communicate with their healthcare providers, the better. That is why we are here to support you as you expand or begin using telemedicine to effectively and efficiently deliver healthcare services to your patients.

Telemedicine can help you:

  • Engage patients to take a more active role in their health
  • Treat patients with non-emergent health issues remotely, or after hours
  • Improve efficiency with fewer no-show appointments
  • Expand your geographic reach, especially to patients in rural areas
  • Refer patients to out-of-area specialists
  • Improve health outcomes and care coordination

To help ensure our members have access to the healthcare services they need, we are committed to helping you overcome barriers in the delivery of telemedicine. Please call us if you have questions or need assistance with issues like technology, billing or reimbursement.

   Telemedicine Training

Sunshine Health is excited to offer monthly Telemedicine Training.

How to sign up

  1. Click the link below to register for the webinar.
  2. A webinar invitation will be sent to you via email. Once the invitation is received, click on the link provided in the email to register (this step is required for attendance).
  3. You will receive a confirmation email with a link and instructions for joining the webinar. NOTE: Please check junk folder if confirmation is not received.
  4. When you join the webinar, the call-in telephone number and an attendee passcode will be displayed.

Training highlights

  • Telemedicine guidelines and requirements
  • Telemedicine defined
  • Methods to provide telemedicine
  • Billing guidelines
  • Reimbursable services
  • Educational material and resources

State Regulations on Telemedicine

The Agency for Health Care Administration (AHCA) contracts with Medicaid health plans to provide services to members. The transition to a new contract begins Dec. 1, 2018, and continues until Feb. 1, 2019. As part of this contract, members will have access to providers through expanded telemedicine.

Highlights of the coming changes:

  • Allows providers to be reimbursed for telemedicine services to the same extent they would be covered if provided through an in-person visit.
  • Coverage requirements cannot be more restrictive for telemedicine than those established for services provided in person.
  • Broadens options for telemedicine by covering store-and-forward and remote patient monitoring services, when appropriate.
  • Stresses member choice. Members can always choose a face-to-face encounter if they prefer and should never be required to use telemedicine services.

The AHCA Policy (PDF) provides additional information about the state’s telemedicine rules and regulations. AHCA’s Telehealth Advisory Council was set up to monitor and submit reports on the status and scope of telehealth activities in Florida. The group submitted its final report (PDF) in October 2017. We encourage you to read the report as it contains helpful information about telemedicine/telehealth.

Technology

  • Interactive audio and video telecommunications must meet AHCA requirements per Rule 59G-1.057, F.A.C. and 45 CFR 164.312.
  • The technology must provide real time communications between the distant site provider or practitioner and the member.
  • All communications must be on a secure network in compliance with HIPAA Encryption and Redundancy requirements. Encryption is the conversion of plaintext into cipher text using a key to make the conversion.

Telemedicine FAQ