The Office of the Insurance Commissioner (OIC) finalized its regulations for Washington state’s new audio-only telemedicine law that was passed as HB 1196 (2021) earlier this year. The audio-only telemedicine law requires payers to reimburse providers for audio-only telemedicine services at the same rate of compensation the carrier would pay the provider if the health care service was provided in person by the provider. WSHA strongly supported HB 1196 and we were pleased the bill became law earlier this year. OIC’s new regulations mirror the statutory language found in RCW 48.43.735 and take effect December 22, 2021. Importantly, OIC’s new regulations add clarity to the statutory requirement for providers to obtain their patients’ consent for the billing of audio-only telemedicine services.
Under new WAC 284-170-433, each patient must consent to be billed for audio-only telemedicine and their consent must be documented in their medical record. According to WAC 284-170-433(6)(b)(iii), consent may be obtained:
- As part of the process for making the audio-only telemedicine appointment; or
- Verbally as part of the audio-telemedicine encounter record.
Consent may be obtained either verbally or in writing by the provider or auxiliary personnel under the provider’s general supervision. The patient’s initial consent is valid for 12 months before expiring and must be reobtained for each subsequent 12-month period to continue billing for audio-only telemedicine services. The documentation of the patient’s consent must be retained for a minimum of five years and made available to payers as needed as a condition for claim payment. WAC 284-170-433(6)(b)(iv) authorizes patients to revoke their consent for billing either verbally or in writing. If a patient revokes their consent, the revocation must also be documented in the patient’s medical record and retained for a minimum of five years.
The new regulations also specify in WAC 284-170-433 (7) that an insurance carrier cannot deny or reduce payment for an audio-visual telemedicine encounter that shifts to audio-only telemedicine due to unanticipated circumstances. WSHA appreciated OIC’s engagement with stakeholders during this fall’s rule development phase. Please see the Code Reviser filing for the full text of the new rules and WSHA’s bulletin on HB 1196 for background on the audio-only telemedicine law. (David Streeter, DavidS@wsha.org)
