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State Medicaid & CHIP Telehealth Toolkit


The Centers for Medicare & Medicaid Services (CMS) is working hard to make sure we help our beneficiaries and the people who are working on the front lines to care for patients during this pandemic. We have taken numerous steps to respond to the pandemic, and have issued new rules and a sweeping array of waivers of federal requirements to ensure that local hospitals and health systems have the capacity to absorb and effectively manage potential surges of COVID-19 patients. In addition, CMS has issued guidance on nursing home health and safety standards, essential surgeries and procedures, as well as preservation of personal protective equipment, beds, and ventilators. We also issued guidance and provided waivers or flexibilities to states and health care providers to ensure that they can focus on delivering the necessary items and services during this pandemic. You can find more information about our ongoing efforts on CMS’s Current Emergencies website, which is linked to the home page.

Although telehealth services have been available in many states for decades, the recent public health emergency (PHE) resulting from COVID-19 has accelerated the interest in service delivery through telehealth. The purpose of this document is to identify for states the policy topics that should be addressed in order to facilitate widespread adoption of telehealth services, especially when they reside outside the immediate authority of a Medicaid or CHIP program.

CMS is committed to ensuring that Medicaid agencies have the necessary tools to prepare for and respond to this emergency on behalf of the nation’s 71 million Medicaid and CHIP beneficiaries, including children. To that end, CMS has also created a dedicated website for Medicaid-related COVID-19 information, which includes our Medicaid & CHIP Disaster Response Toolkit and links to other relevant information regarding COVID-19. We are also releasing updated guidance on a rolling basis in the form of frequently asked questions (FAQs) so that we can provide states with the most current and useful information during this evolving situation, including information on the implementation of recent congressional actions. We have also developed standardized Medicaid waiver and state plan amendment checklists to provide states with a comprehensive suite of flexibilities in order to streamline their ability to request and implement the necessary program adjustments in light of the pandemic. In addition, CMS continues to hold direct technical assistance sessions with states, as well as regular all-state calls, to answer questions and to better understand state needs. Recordings and transcripts of our allstate calls are also made available online, and our website will continue to be updated with additional information as it becomes available.

To support state policymakers in their efforts to expand the use of telehealth services in Medicaid programs, this Medicaid Telehealth Toolkit aggregates information and highlights questions that states may ask themselves when establishing new telehealth policy, including telehealth policies for pediatrics. This toolkit will evolve throughout the COVID-19 emergency.

Initially it will offer general considerations for telehealth expansion, but as state Medicaid telehealth coverage and payment policy evolves, this toolkit will include examples of the telehealth changes implemented by states.

This guide is intended to help states identify which aspects of their statutory and regulatory infrastructure may impede the rapid deployment of telehealth capabilities in their Medicaid program. As such, this guide will describe each of these policy areas and the challenges they present below. The toolkit concludes with a list of questions state policymakers can use to ensure they have explored and/or addressed potential obstacles.

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