Telehealth & Reimbursement for MNT

UPDATED August 22, 2022

 


Telehealth Update

In March 2020, the federal government announced a public health emergency (PHE) related to the COVID-19 pandemic. This led the Centers for Medicare and Medicaid Services to increase access to health care services provided via telehealth, relaxing requirements for location of patient and provider and modality of telehealth used (e.g., home-to-home, audio-only, Zoom). As of August 2022, it is expected that the federal PHE will be extended again in October, running into 2023.


On March 10, 2020, Governor Charlie Baker issued a similar state of emergency in MA, mandating coverage of and reimbursement parity for health care services provided to and from any location and via all modalities of telehealth (e.g., audio-only).

At the end of 2020, the MA legislature passed a health care bill referred to as the “no surprise billing” or telehealth bill. It took effect January 1, 2021 and will end on January 1, 2023.

Telehealth bill - Chapter 260 of the Acts of 2020

  • It called for a study on the use of telehealth during the pandemic and impact on health care spending to guide future telehealth legislation.

  • It made permanent coverage of and reimbursement parity for behavioral health care services provided via all modalities of telehealth.

  • It mandated coverage of and reimbursement parity for primary care and chronic disease management provided via all modalities of telehealth until January 1, 2023.

  • It allowed insurance carriers to change their telehealth reimbursement rates for any other health care services 90 days after the end of the governor’s state of emergency.

  • The state of emergency ended June 15, 2021 and telehealth changes took effect September 13, 2021, including allowing lower reimbursement rates for MNT provided via telehealth.

Telehealth regulation - MA Division of Insurance

The MA Division of Insurance (DOI) is the state agency that issues regulations to clarify or codify health insurance coverage and reimbursement issues affected by state legislation.

  • MA DOI held public listening sessions in the winter of 2021 to gather input on any eventual telehealth regulations it would issue.

  • MAND met with MA DOI in August of 2021 to discuss MNT coverage and reimbursement and asked for MNT to be considered part of chronic disease management and reimbursed at parity for all modalities of telehealth until 2023. View MAND’s written statement to MA DOI here.

  • MA DOI issued a public notice on September 7, 2021 which reinforced the reimbursement rate changes as outlined in the legislation.

  • MA DOI announced new draft regulations and a public hearing on May 11, 2022 for health care providers and insurance carriers to provide testimony related to proposed changes in telehealth regulations ahead of January 1, 2023.

  • MAND provided live testimony at the virtual hearing and submitted a packet of supporting documents, including our letter requesting continued reimbursement for MNT provided via telehealth and dozens of patient testimonials in support of telehealth.


MAND's Telehealth Advocacy 

In MAND’s winter 2022, MAND’s Executive Committee decided to retain a lobbying firm to work with us to advocate for coverage of and reimbursement parity for MNT provided by all modalities of telehealth, as was guaranteed for chronic disease management.

With our lobbyists, MAND met with key members of the state legislature to advocate for our services and ask that MNT be included and reimbursed fairly in any new telehealth bill.

MAND met with Senator Cindy Friedman (D-Arlington), Senate Chair, Joint Committee on Health Care Financing; Representative Kate Hogan (D-Stow), House Speaker Pro Tempore; and Representative Ann-Margaret Ferrante (D-Gloucester), Vice Chair, House Committee on Ways and Means.

At this time, meetings with legislators are on hold, as July 31st marked the end of the active legislative year. However, our lobbyists are still tracking the progress of any existing legislation until the official end of the two-year session on December 31st.


Telehealth FAQs

Can nutrition visits still be provided via telehealth?

Yes, however, as of September 13, 2021, there is no guarantee of reimbursement rate parity for nutrition services provided via telehealth. Insurance carriers are acting withing the law if they announce rate cuts.

"Carriers may choose to continue paying all providers at existing telehealth rates of reimbursement. If Carriers wish to alter telehealth rates of reimbursement where allowed under the law, they are expected, as noted in Bulletin 2021-04, to file implementation plans with the Division that highlight the methods and timing that would apply to all affected providers . . ." (MA Division of Insurance update on telehealth issued September 7, 2021)

I am a dietitian in private practice and I have relinquished my office space during the pandemic and now practice by telehealth exclusively. How should I proceed?

Per current MA DOI regulations, credentialed providers need to offer both in-person appointments and telehealth appointments to remain in compliance with many of the insurance providers’ contracts (i.e., should a patient request an in-person visit). Private insurers may have specific requirements related to in person vs remote appointments. You should review the updated telehealth information on insurance companies’ websites for credentialed providers.

What will change, and when?

A new health care bill could be passed, or an amendment made to another piece of legislation, which would take effect January 1, 2023.

What is the next step?

Further regulations may be issued by MA DOI before the end of 2022 and take effect on January 1, 2023. MAND will update this page as information becomes available.

In the meantime, RDNs are encouraged to visit MA DOI's website to view testimony submitted by MAND and other organizations in May 2022 regarding continued reimbursement for MNT provided via telehealth: https://www.mass.gov/orgs/division-of-insurance


Want to Learn More?

For more information on the MA Division of Insurance:
https://www.mass.gov/orgs/division-of-insurance

For more information on Chapter 260 of the Acts of 2020:
https://malegislature.gov/Laws/SessionLaws/Acts/2020/Chapter260

View all comments submitted to MA DOI regarding telehealth provisions here:
https://www.mass.gov/service-details/telehealth-information-sessions

Join the Academy's telehealth discussion board: https://www.eatrightpro.org/practice/practice-resources/telehealth/telehealth-discussion-board 

View the Academy's Telehealth Policy Stance here.

View the Academy's letter to CMS regarding telehealth here.

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