Rhode Island

CURRENT STATE LAWS & POLICY

AT A GLANCE

Medicaid Program

Rhode Island Medical Assistance Program

Administrator

Rhode Island Dept. of Human Services

Regional Telehealth Resource Center

Northeast Telehealth Resource Center

Medicaid Reimbursement

Live Video: Yes
Store-and-Forward: No
Remote Patient Monitoring: No

Private Payer Law

Law Exists: Yes
Payment Parity: No

Professional Requirements

Licensure Compacts: None
Consent Requirements: Yes

Last updated 02/28/2021

Audio-Only Delivery

Medicaid & Health Insurance Commissioner:  Guidance for Preventive Care Visits

STATUS: Active

Medicaid:  COVID-19 Telehealth Guidance (updated June 10, 2020)

STATUS: Active until further notice

Medicaid 1915(c) Waiver: Appendix K – Rhode Island Comprehensive Demonstration

STATUS: Expired February 26, 2021

Last updated 02/28/2021

Cross-State Licensing

No Reference Found

Last updated 02/28/2021

Easing Prescribing Requirements

No Reference Found

Last updated 02/28/2021

Miscellaneous

No Reference Found

Last updated 02/28/2021

Originating Site

Medicaid:  COVID-19 Telehealth Guidance (updated June 10, 2020)

STATUS: Active until further notice

Last updated 02/28/2021

Private Payer

Office of the Governor: Executive Order 20-06: Expanding Access to Telemedicine Services/Insurance Coverage of Telemedicine

STATUS: Active until March 24, 2021 (see EO 21-16)

Health Insurance Commissioner and Medicaid: Program Instructions During COVID-19

STATUS: Active, until end of RI State of Emergency

Health Insurance Commissioner: Emergency Telemedicine Measures

STATUS: Expired April 17, 2020

Last updated 02/28/2021

Provider Type

Medicaid:  COVID-19 Telehealth Guidance (updated June 10, 2020)

STATUS: Active until further notice

Last updated 02/28/2021

Service Expansion

Medicaid & Health Insurance Commissioner:  Guidance for Preventive Care Visits

STATUS: Active

Medicaid:  COVID-19 Telehealth Guidance (updated June 10, 2020)

STATUS: Active until further notice

Office of Health Insurance Commissioner:  FAQs

STATUS: Active, until end of RI State of Emergency

Office of the Governor: Executive Order 20-06: Expanding Access to Telemedicine Services/Insurance Coverage of Telemedicine

STATUS: Active until March 24, 2021 (see EO 21-16)

Department of Health: Online Prescribing of EpiPens

STATUS: Active

Executive Office of Health & Human Services: Managed Care Telemedicine Coverage for Adults and Elders with Disabilities

STATUS: Active, until March 19, 2021

Health Insurance Commissioner: Reinstatement of Temporary Emergency Measures Regarding Benefit Determination Review and Network Plans and Health Care Accessibility and Quality Assurance

STATUS: Active, until the expiration of the Executive Order

Last updated 02/28/2021

Definitions

No Reference Found

Last updated 02/28/2021

Email, Phone & Fax

No Reference Found

Last updated 02/28/2021

Live Video

POLICY

No Reference Found


ELIGIBLE SERVICES/SPECIALTIES

Rhode Island Medicaid’s fee schedule lists several telehealth service CPT codes for outpatient visits and limited emergency department inpatient telehealth consultations under procedure/professional services.

SOURCE: RI Department of Health. Medicaid Fee Schedule Rates. (Accessed Feb. 2021).

Reimbursement is available for initial inpatient telehealth consultation and follow-up inpatient telehealth consultation.

SOURCE: RI Department of Health. Medicaid Fee Schedule Rates. (Accessed Feb. 2021).


ELIGIBLE PROVIDERS

No Reference Found


ELIGIBLE SITES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 02/28/2021

Miscellaneous

No Reference Found

Last updated 02/28/2021

Out of State Providers

No Reference Found

Last updated 02/28/2021

Overview

The Rhode Island Medical Assistance Program reimburses for some live-video services and provides no reimbursement for store-and-forward or remote patient monitoring.

Last updated 02/28/2021

Remote Patient Monitoring

POLICY

No Reference Found


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 02/28/2021

Store and Forward

POLICY

No Reference Found


ELIGIBLE SERVICES/SPECIALTIES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 02/28/2021

Definitions

“Telemedicine” means the delivery of clinical health care services by means of real time two-way electronic audiovisual communications, including the application of secure video conferencing or store-and-forward technology to provide or support health care delivery, which facilitate the assessment, diagnosis, treatment, and care management of a patient’s health care while such patient is at an originating site and the health care provider is at a distant site, consistent with applicable federal laws and regulations.  Telemedicine does not include an audio-only telephone conversation, email message or facsimile transmission between the provider and patient, or an automated computer program used to diagnose and/or treat ocular or refractive conditions.

SOURCE:  RI General Law, Sec. 27-81-3(12). (Accessed Feb. 2021).

Last updated 02/28/2021

Parity

SERVICE PARITY

A health insurer shall not exclude a health care service for coverage solely because the health care service is provided through telemedicine and is not provided through in-person consultation or contact, subject to the terms and conditions of a telemedicine agreement between the insurer and provider.

SOURCE:  RI General Law, Sec. 27-81-4(b). (Accessed Feb. 2021).


PAYMENT PARITY

No explicit payment parity.

Last updated 02/28/2021

Requirements

Each health insurer that issues individual or group accident-and-sickness insurance policies for health-care services and/or provides a health-care plan for health-care services shall provide coverage for the cost of such covered health-care services provided through telemedicine services.

SOURCE: RI General Law, Sec. 27-81-4(a). (Accessed Feb. 2021).

Last updated 02/28/2021

Cross State Licensing

RI allows physicians who have a license in good standing in another state to consult with RI licensed physician on a singular occasion or provide teaching assistance for no more than seven days unless extended with written permission from the director.

Physicians not present in RI may not provide consultation to a patient without an established physician-patient relationship, unless that patient is in the physical presence of a physician licensed in RI.

SOURCE:  RI General Law, Sec. 5-37-16.2(a)(3). (Accessed Feb. 2021).

Last updated 02/28/2021

Definitions

Telemedicine is defined very generally as the delivery of healthcare where there is no in-person exchange. Telemedicine, more specifically, is a mode of delivering healthcare services and public health utilizing information and communication technologies to enable the diagnosis, consultation, treatment, education, care management, and self-management of patients at a distance from health care providers.

SOURCE: RI Department of Health. Telemedicine. (Accessed Feb. 2021).

Last updated 02/28/2021

Licensure Compacts

No Reference Found

Last updated 02/28/2021

Miscellaneous

See Department of Health Policy for Department of Health Telemedicine Guidelines for other requirements on RI providers.

SOURCE: RI Department of Health. Telemedicine. (Accessed Feb. 2021).

Last updated 02/28/2021

Online Prescribing

An established in-person physician-patient relationship is required prior to prescribing controlled substances. However, a covering physician may prescribe a controlled substance if an established coverage agreement is in place and the quantity reflects the prescription is only for a short duration.

SOURCE: RI Department of Health. Telemedicine. (Accessed Feb. 2021).

Last updated 02/28/2021

Professional Board Standards

No Reference Found