Telehealth services must be delivered in accordance with all state and federal laws, including:
- The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Any HIPAA-related directives from the Office for Civil Rights at the Department of Health and Human Services issued during the COVID-19 national emergency
- 42 CFR Part 2 (Jan. 1, 2021)
We require providers who offer our members telehealth services to:
- Maintain documentation in accordance with HIPAA requirements for healthcare services delivered through telehealth
- Deliver services in accordance with rules set forth by their respective licensing board and accepted standards of clinical practice
- Document the specific telehealth modality used
If you provide telehealth services to one of our members for longer than 12 consecutive months, we expect you to:
- Conduct at least one in-person annual visit, or
- Refer the member to a practitioner or his or her usual source of clinical care (other than an emergency department) for an in-person annual visit
Please note that telehealth services:
- Do not replace provider choice and/or member preference for in-person service delivery
- Will not be considered as an alternative to meeting provider network access requirements