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 06/25/2021

Audio-Only Delivery

Medicaid & Health Insurance Commissioner:  Guidance for Preventive Care Visits

STATUS: Active

Medicaid:  COVID-19 Telehealth Guidance

STATUS: Active until further notice

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

STATUS: Expired February 26, 2021

Last updated 06/25/2021

Cross-State Licensing

No Reference Found

Last updated 06/25/2021

Easing Prescribing Requirements

No Reference Found

Last updated 06/25/2021

Miscellaneous

Health Insurance Commissioner: Network Adequacy

STATUS: Active during State of Emergency

Last updated 06/25/2021

Originating Site

Medicaid:  COVID-19 Telehealth Guidance

STATUS: Active until further notice

Last updated 06/25/2021

Private Payer

Health Insurance Commissioner:  Insurance Coverage

STATUS:  Active during State of Emergency

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

STATUS: Active until June 18, 2021 (see EO 21-56)

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: Active, expires when EO 21-06 expires. Currently June 18, 2021.

Last updated 06/25/2021

Provider Type

Medicaid:  COVID-19 Telehealth Guidance

STATUS: Active until further notice

Last updated 06/25/2021

Service Expansion

Medicaid & Health Insurance Commissioner:  Guidance for Preventive Care Visits

STATUS: Active

Medicaid:  COVID-19 Telehealth Guidance

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 June 18, 2021 (see EO 21-56)

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: Expired

Last updated 06/25/2021

Definitions

No Reference Found

Last updated 06/25/2021

Email, Phone & Fax

No Reference Found

Last updated 06/21/2021

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.  Reimbursement is available for initial inpatient telehealth consultation and follow-up inpatient telehealth consultation.  See their fee schedule look-up tool and telehealth specific codes, including G0406, G0407, G0408, G0425, G0426, G0427.

SOURCE: RI Department of Health. Medicaid Fee Schedule Look-Up. (Accessed Jun. 2021).


ELIGIBLE PROVIDERS

No Reference Found


ELIGIBLE SITES

No Reference Found


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 06/25/2021

Miscellaneous

No Reference Found

Last updated 06/25/2021

Out of State Providers

No Reference Found

Last updated 06/25/2021

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 06/25/2021

Remote Patient Monitoring

POLICY

No Reference Found


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 06/25/2021

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 06/25/2021

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 Jun. 2021).

Last updated 06/25/2021

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 Jun. 2021).


PAYMENT PARITY

No explicit payment parity.

Last updated 06/25/2021

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 Jun. 2021).

Last updated 06/25/2021

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 Jun. 2021).

Last updated 06/25/2021

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 Jun. 2021).

Last updated 06/25/2021

Licensure Compacts

No Reference Found

Last updated 06/25/2021

Miscellaneous

See Department of Health Policy for Department of Health Telemedicine Guidelines for other requirements on RI providers, including medical records, disclosures, and advertising.

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

Last updated 06/25/2021

Online Prescribing

Treatment and consultation recommendations made in an online setting, including issuing a prescription via electronic means, will be held to the same standards of appropriate practice as those in face-to-face settings. Treatment, including issuing a prescription, based solely on an online questionnaire without an appropriate evaluation does not constitute an acceptable standard of care and is considered unprofessional conduct.

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 Jun. 2021).

Last updated 06/25/2021

Professional Board Standards

No Reference Found