SB1674113th GA (Historical)Introduced

Amends TCA Title 71, Chapter 5.

No later than December 31, 2024, this bill requires the bureau of TennCare ("bureau") to amend existing rules, or promulgate new rules, on fee-for-service and medicaid managed care plans regarding reimbursement to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests utilizing established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient's provider and the same standard of care is met. This bill requires that when amending or promulgating rules pursuant to this bill, the bureau must ensure the following: (1) That a remote ultrasound procedure or remote fetal nonstress test is only reimbursable when the provider uses digital technology that is compliant with HIPAA, approved by the federal food and drug administration, and used to collect medical and other forms of health data from a patient and electronically transmit that information securely to a healthcare provider who is in a separate location for the purpose of interpretation and making recommendations; and (2) That a fetal nonstress test is only reimbursable with a place of service modifier for at-home monitoring with remote monitoring solutions that are cleared by the federal food and drug administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.

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Overview

No later than December 31, 2024, this bill requires the bureau of TennCare ("bureau") to amend existing rules, or promulgate new rules, on fee-for-service and medicaid managed care plans regarding reimbursement to allow for the reimbursement of remote ultrasound procedures and remote fetal nonstress tests utilizing established CPT codes for such procedures when the patient is in a residence or other off-site location that is separate from the patient's provider and the same standard of care is met. This bill requires that when amending or promulgating rules pursuant to this bill, the bureau must ensure the following: (1) That a remote ultrasound procedure or remote fetal nonstress test is only reimbursable when the provider uses digital technology that is compliant with HIPAA, approved by the federal food and drug administration, and used to collect medical and other forms of health data from a patient and electronically transmit that information securely to a healthcare provider who is in a separate location for the purpose of interpretation and making recommendations; and (2) That a fetal nonstress test is only reimbursable with a place of service modifier for at-home monitoring with remote monitoring solutions that are cleared by the federal food and drug administration for on-label use for monitoring fetal heart rate, maternal heart rate, and uterine activity.

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Sponsor

Unknown

Details
Session

113th General Assembly

Introduced

January 9, 2024

Subjects
4761

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