Telemedicine as we know it today began to take shape in the 1940s and 1950s. (Learn More) Despite advancements in technology since that time, the practice of telemedicine is inconsistent across different states. (Learn More)
Georgia defines telemedicine as a real-time interaction via audiovisual communications equipment. (Learn More)
Medicaid in Georgia limits overall coverage for telemedicine services. (Learn More) It does offer a pretty extensive variety of telemedicine services. (Learn More)
Georgia also lists the specific providers that can deliver telemedicine services. (Learn More) Interstate providers are not allowed at the current time. (Learn More)
The state also specifically defines the locations where both providers and patients can utilize telemedicine services. (Learn More)
There may be limitations on the type of prescriptions that can be written strictly on the basis of a telemedicine visit. (Learn More) The state of Georgia promotes parity, allowing private payers to reimburse for telemedicine services (Learn More)
Telemedicine in the Beginning
Although the beginnings of telemedicine in the United States can be traced back to at least the 1920s, it was not until the late 1940s and early 1950s that telemedicine began to develop into the version that is similar to what is being offered today.
In 1948, the very first radiological images were sent by telephone line across the eastern part of Pennsylvania. The University of Nebraska was the first institute to use video communication for medical purposes, being inspired by a teleradiology system developed in Canada in the 1950s. Clinicians at the University of Nebraska began to use two-way interactive televisions to send information across the campus.
The major focus of telemedicine in the 1960s was to adopt technology to reach patients in rural areas. As the practice developed, broad uses across all areas were implemented.
Telemedicine Practice Inconsistency
There are no uniform policies across all states regarding the types of telemedicine services that are covered by insurance companies, whether or not insurance companies should offer the same level of telemedicine services as they do for in-person services, and whether or not physicians must be licensed in the state where the patient lives in order to deliver services to them.
Every state has its own set of rules and regulations of the time of this writing.
Georgia
Georgia does have some advantages regarding the delivery of telemedicine services compared to some other states. You can access the following sources to learn more about telemedicine in Georgia:
- Center for Connected Health Policy – Georgia State Page
- Georgia Department of Public Health, Office of Telehealth & Telemedicine
- Federation of State Medical Boards.
Definition of Telemedicine According to the State of Georgia
Unlike some states, Georgia offers a very broad working definition of telemedicine.
According to the state, telemedicine is the exchange of medical information across different sites via use of electronic communication to improve a patient’s health. Telecommunication includes video and audio communications equipment and the use of real-time, two-way interactive communication equipment to exchange information.
Georgia also defines the term telehealth as the use of telecommunication technology to aid in clinical care (telemedicine), professional health education, program planning, and other aspects of the health care system.
Georgia Medicaid Limits Coverage
Medicaid utilizes the definition used by the state for telemedicine. The definition covers the use of real-time video medical practices, but it does not cover remote monitoring of a patient’s health, often referred to as store-and-forward services (the collection of clinical data at one site and then sending it to another site for evaluation).
Medicaid Covers a Wide Variety of Services
Georgia Medicaid covers a wide variety of video telemedicine services as long as the services are considered medically necessary. The definition of medical necessity means that a procedure is justified or appropriate (necessary) based on clinical standards of care or on research findings.
These services are covered:
- Regular office visits
- Psychiatric office visits on a limited basis
- Pharmacological management
- Some radiological services
- Other physician services
These services are specifically not covered:
- Telephone conversations
- Faxes
- Emails
- Video cellphone calls
- Services that are rendered through internet-based technologies like Skype that do not meet HIPAA encryption compliances
- The cost of telemedicine equipment
Medicaid Providers That Are Covered for Telemedicine Services
In some states, only licensed physicians within the state can provide telemedicine services. Georgia has a broader list of telemedicine-eligible providers that include the following:
- Physicians
- Physician assistants
- Nurse practitioners
- Clinical nurse specialists
- Nurse anesthetists
- Nurse midwives
- Dentists
- Dental hygienists
- Clinical psychologists
- Clinical social workers
- Speech language pathologists
- Nutrition professionals or dietitians
Interstate Provider Status
Georgia is still in the process of joining the Interstate Medical Licensure Compact, which would allow out-of-state providers to participate in telemedicine services within the state of Georgia.
At the current time, providers must have a Georgia license within their field in to order practice telemedicine in Georgia. They must be enrolled in the Georgia Medicare program.
Restrictions on Locations
Medicaid in Georgia restricts where the patient and provider can be located during any telemedicine visit. Under Georgia Medicaid statutes, both the provider of the service and the patient must be located at one of the eligible sites during the visit in order for Medicaid to provide coverage.
The eligible sites include the following:
- Professional provider offices, such as a doctor’s office, clinic, therapy office, and so forth
- Hospital
- Rural health clinic
- CAH-based renal dialysis center
- Skilled nursing facility
- Emergency medical service ambulance
- School-based clinic
- A state-licensed pharmacy
- County board of health
- Federally qualified health center
Prescriptions
Currently, Georgia does not allow the prescription of controlled substances and potentially dangerous drugs (open to interpretation by the state) solely based on a telemedicine conference or visit. These substances must be prescribed in person.
Consent Laws & the Development of a Relationship
Before any telemedicine visit, the patient must provide written consent to the provider. The establishment of a clinical relationship, such as initiating the first visit through the telemedicine conference, appears to be acceptable to Georgia Medicaid.
Private Payer Regulations
There is a parity law enacted in Georgia, meaning that private insurance companies must cover telemedicine services. Specific private insurance plans may have provisions for the reimbursement of certain telemedicine services, and Georgia provides for this in the same way they do for in-person services.
Services covered under the plan are subject to the terms of the contract, but telemedicine services must be covered by your private insurance to the same extent that the same in-person services are covered under that specific policy.
References
Telemedicine: A Guide to Assessing Telecommunications for Health Care. (November 1996). Institute of Medicine, Committee on Evaluating Clinical Applications of Telemedicine.
The State Telehealth Laws. (September 2018). Center for Connected Health Policy
Office of Telehealth & Telemedicine. Georgia Department of Public Health.
Telemedicine Policies. Federation of State Medical Boards.
The IMLC. (2019). Interstate Medical Licensure Compact.
