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ND Telemedicine

North Dakota passed House Bill 1038, on January 06, 2015, effectively creating and enacting an Act requiring the coverage of telemedicine/telehealth services. North Dakota defines telemedicine as “the use of interactive audio-video equipment to link practitioners and patients, at different sites. Telemedicine involves two collaborating provider sites: an originating site, and a distant site. The client/patient is located at the originating site, and the practitioner enrolled in North Dakota Medicaid, is located at the distant provider site, to provide those professional services allowed/reimbursed by North Dakota Medicaid.

However, there are currently no parity laws in North Dakota, so while the State’s Medicaid has been instructed to cover all telemedicine/telehealth services, as they would, were the service performed in-person — including live video office or outpatient visits; new evaluation visits and established management visits; individual psychotherapy visits; and pharmacological management visits — private payers have not yet been obligated, to reimburse telemedicine services. However, telemedicine reimbursements are limited to patients who live “a sufficient distance” from comparable services.

The Act requires that all health care practitioners providing telemedicine services, first establish a physician-patient relationship with a patient, prior to providing a diagnosis or treatment — however, telemedicine may be used to satisfy this requirement.

All out-of-state health care practitioners intending to provide telemedicine services, to patients geographically situated in the state of North Dakota, must first obtain a valid medical license, from the North Dakota Medical Board, prior to commencing service — the State does not allow physician-to-physician (P2P) exemptions, at this time.

HIPAA is a federal law that protects the privacy of identifiable patient information, requires electronic and physical security standards related to the storage and use of PHI, and establishes standard transactions and code sets to simplify billing and other electronic transactions. HIPAA standards were updated in 2009 by the implementation of the HITECH Act and again in 2013 by the HIPAA Omnibus Rule. In accordance with HIPAA standards, is HITECH and BAA certified, and has put in place measures to protect the confidentiality of health information in any form, whether written, oral, or electronic.

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