California Insurance Companies Directed to Provide Increased Telehealth Services During the COVID -19 State of Emergency

On March 30, 2020, California Insurance Commissioner Ricardo Lara and the California Department of Insurance (“CDI”) directed health insurance companies to increase access to services delivered via telehealth during the COVID-19 state of emergency.

The agency said that increasing the availability of telehealth will “lessen the strain on the supply chain, reduce the need to use scarce stocks of provider personal protective equipment and protect the ability of the healthcare workforce to provide care by limiting physical exposure to potential sources of infectious disease,” the notice states.

To support expanded telehealth, CDI said insurers should allow all network providers to use all available modes of virtual care delivery, including video and telephone-based communication. Insurers are also required to reimburse telehealth services costs at the same rate as in-person office visits, effective March 30, 2020.

The Notice from Commissioner Lara also provides that insurance companies should:

  • Allow all network providers to use all available and appropriate modes of telehealth delivery including, but not limited to, synchronous video, and telephone-based service delivery
  • Immediately implement reimbursement rates for telehealth services that mirror payment rates for an equivalent office visit
  • Eliminate barriers to providing medically and clinically appropriate care using appropriate telehealth delivery models
  • Use telehealth service delivery methods to enable consumers to have access to mental health and substance use disorder services, family therapy, and behavioral health services, including services to treat autism, among others

Click here to read the full text of The Notice.

If you or someone you know are being denied telehealth benefits or other medically necessary health care by your insurance company, please call Kantor & Kantor for a free consultation at 877-783-8686 or use our online contact form.We understand, and we can help.

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