Arizona has a well-developed telemedicine program that incorporates both the use of private insurance companies and Medicaid. The program makes special stipulations for services provided in rural areas. (Learn More)
Because university-backed research groups work with legislators, Arizona uses a broad definition for telemedicine. (Learn More) The state has a comprehensive telemedicine policy that is open for revision. (Learn More)
Arizona does recognize parity, (Learn More) but the state has a limited list of qualified telemedicine providers. (Learn More) Providers of telemedicine services must be licensed to practice in Arizona, but out-of-state providers can be certified to practice in the state. (Learn More)
Despite a limited list of recognized providers, there is a long list of potential services for both private payers and Medicaid that can be delivered via telemedicine. (Learn More) Providers must establish a relationship and get consent from the patient before providing telemedicine services. (Learn More)
A Long History of Telemedicine
The beginnings of telemedicine goes back to the days when radio was a primary mode of electronic communication and to the use of the electronic transfer of medical records in the late 1940s. In the 1950s, video equipment was used to transmit medical information between different sites for medical students at the University of Nebraska, leading to later developments in the use of audio and video communications for actual patient evaluations.
Medical professionals envisioned telemedicine as useful to reach patients in rural areas where access to in-person care is limited. They also saw it as useful in situations where a patient might need immediate medical advice.
As the field has expanded, telemedicine is now available in some states for routine visits and other types of medical consultations.
Inconsistency in Telemedicine Across States
Part of the issue with the delivery of telemedicine is inconsistency regarding the standards of coverage, providers, and other services from state to state.
You must understand the state statutes in your own state in order to effectively use telemedicine services where you live. States continue to redefine how telemedicine services should be delivered and what should be covered.
Sources
Because states continue to augment their policies regarding the implementation of telemedicine, it is a good idea to learn more about specific guidelines and policies in each state.
- Center for Connected Health Policy – Arizona State Page
- AHCCS Telehealth Training Manual
- Arizona Telemedicine Program at University of Arizona
Arizona Utilizes a Broad Definition
Arizona defines telemedicine as health care practice and consultation through the use of audio, video, or other data-driven communications equipment.
Telehealth is broadly defined as the use of telecommunications to provide assessment, diagnosis, consultation, intervention, and supervision across distances.
Within its broader definition, Arizona recognizes that technologies that are normally not recognized as being part of telemedicine in other states, like fax machines, telephones, email, and other similar devices, do not fit the strict definition of telemedicine, but these may be covered in some instances.
Arizona Telemedicine Policy
Arizona remains on the cutting edge for the improvement of telemedicine coverage. The University of Arizona’s Arizona Telemedicine Program schedules regular meetings with legislators to report on innovations in telemedicine and to update and revise telemedicine standards within the state.
Parity Law
Parity laws describe how certain services should be covered or reimbursed compared to other types of services within an insurance program. For instance, parity laws often state that mental health services should be covered and reimbursed to the same extent that other services in an insurance policy are covered.
Arizona has a partial parity law regarding telemedicine that requires reimbursements through private insurance companies, but only for certain types of services that are delivered to patients in rural areas. A rural area is defined as an area or city located in a county of fewer than 900,000 individuals.
The parity law is a minimum requirement. Many private insurance companies cover telemedicine services outside the parity law. Check with your private insurer regarding how telemedicine services are covered under your specific policy.
Eligible Telemedicine Providers in Arizona
Under Arizona Medicaid (also known as the Arizona Health Care Cost Containment System, or AHCCCS), there are limitations to the types of providers that can perform telemedicine services in Arizona. The following providers are acceptable:
- Licensed physicians
- Licensed physician assistants
- Registered nurse practitioners
- Certified nurse midwives
- Licensed clinical psychologists
- Licensed clinical social workers
- Licensed marriage and family counselors
- Licensed professional counselors
Status on Interstate Providers
At the time of this writing, it appears that all eligible providers for telemedicine services in Arizona must be licensed within the state of Arizona and currently enrolled in the Arizona Medicaid program.
Private insurance companies can only utilize eligible providers that are licensed within the state of Arizona as well.
Arizona is a member of the Interstate Medical Licensure Compact, which allows out-of-state providers to be licensed to practice in the state of Arizona.
What Is Covered?
Private insurance companies are required to cover specific health services when they are delivered through a live telemedicine session for patients in rural areas. These include services for the following:
- Burns
- Trauma
- Mental health disorders
- Cardiac issues
- Infectious diseases
- Neurological disorders, including strokes
- Dermatological issues
- Pulmonary issues
In 2022, the following services were added:
- Substance abuse treatment services.
- Pain medicine services.
- Urology services (to begin in 2020)
Services covered by Medicaid include the following:
- Pharmacy management.
- Surgical follow-up consultations
- Pain management
- Medical nutrition consultations
- Rheumatology services
- Radiological services
- Pediatric specialties
- Orthopedic services
- Ophthalmology services
- Obstetrics/gynecology services
- Neurology services
- Treatment for infectious diseases
- Hematology services
- Endocrinology services
- Dermatology services
- Cardiology services
- Home health care services
- Inpatient consultations
Consent
Some states do not stipulate whether providers must get written consent from a patient before treating them via a telemedicine service.
In Arizona, providers must get oral or written consent from the patient before they can engage in a telemedicine visit. They must place a note in the patient’s record regarding consent.
Medications
Prescriptions for medications via a telemedicine visit cannot be made by physicians unless there is a physical or mental health examination first in order to establish a relationship with the patient.
Approved Sites
Private insurance companies are required to provide coverage for patients in rural regions at any site within the defined region. Medicaid in Arizona stipulates that the provider must be delivering telemedicine services from a specific type of location, which can include:
- A recognized hospital.
- The office of a physician or other telemedicine-approved licensed practitioner.
- A federally qualified health center.
- An urban clinic for Native American patients.
- A recognized tribally governed facility/IHS clinic.
Conclusions
Arizona has a well-developed working telemedicine program that is designed to deliver extensive services for Medicaid participants. It requires private payers to provide telemedicine services for people in established and defined rural areas. Private payers may also provide telemedicine services to others according to the stipulations of the patient’s insurance policy.
References
Evolution and Current Applications of Telemedicine. (November 1996). Institute of Medicine, Committee on Evaluating Clinical Applications of Telemedicine.
The State Telehealth Laws. (September 2018). Center for Connected Health Policy.
AHCCS Telehealth Training Manual. (March 2015). Arizona Health Care Cost Containment System.
Arizona Telemedicine Program. (2019). University of Arizona.
The IMLC. (2019). Interstate Medical Licensure Compact.
