Colorado Bill Seeks Medicaid Reimbursement for Telehealth in FQHCs

Colorado lawmakers will soon be debating a bill that would allow federally qualified health centers to be reimbursed through Medicaid for telehealth services.

House Bill 20-1092, with both House and Senate sponsorship, aims to help community health centers and clinics that deal with predominantly underserved populations and use connected health technology to improve access and outcomes, but aren’t reimbursed for those services by Medicare.

According to the bill, there are 208 FQHCs in Colorado, handling care for a quarter of the state’s children’s basic health plan enrollees, 27 percent of those on Medicaid and 40 percent of the state’s uninsured.

“FQHCs are key partners in the Colorado Medicaid program and help to reduce total cost of care, improve population health, and improve patient experience,” the proposed legislation states. “Research has shown that the federally qualified health center model, which integrates physical, behavioral, and oral health care in a team-based setting, results in lower per-patient spending on FQHC patients compared to non-FQHC patients as a result of lower spending on specialty care, lower inpatient costs, and fewer hospital admissions.”

“Telemedicine helps connect Medicaid enrollees to health care providers through live video and audio, enabling enrollees to receive the care and consultation they need without traveling to visit a provider in another city or area of the state,” the bill continues. “Telemedicine visits can lead to cost savings for the Medicaid system by improving access to primary care and helping to avoid unnecessary trips to emergency departments.”

Telehealth advocates have long lobbied to have the Centers for Medicare & Medicaid Services ease its burdensome guidelines and restrictions on Medicare reimbursement for FQHCs, noting they serve as safety net providers for a wide swath of the nation’s underserved populations.

Late last year in Washington, members of the Congressional Telehealth Caucus reintroduced – for the third time – the Creating Opportunities Now for Necessary and Effective Care Technologies for Health Act of 2019. Also known as the CONNECT for Health Act, the bill would, among other things, remove geographic restrictions on originating sites for FQHCs and other locations and allow them to qualify as distant sites for telehealth reimbursement.

“Telehealth is the future of health care,” Hawai’i Senator Brian Schatz, a sponsor of the bill and longtime advocate for connected health, said in a press release. “The technology is advancing, more providers and patients are relying on it, and we have broad bipartisan support. This bill will help ensure that every American gets the care they need no matter where they live.”

The Colorado bill would require the state Medicaid program to reimburse FQHCs for telehealth services at the same rate as in-person care.

In addition, it would enable FQHCs to be reimbursed for services provided by a clinical pharmacist, opening the door to telehealth and mHealth programs targeting medication management and chronic care.

If passed, the bill would makes things a lot easier for the Mountain Family Health Center in Glenwood Springs, whose patient population is 30 percent Medicaid-supported and 40 percent uninsured.

“We feel like telemedicine, telehealth, is the wave of the future, and can provide a lot of convenience for patients in particular, and help us get more care out to people in a more convenient way,” Dr. Chris Tonozzi, a physician at the center, told the Post Independent.