Message Board: IPA - An Update Of Telepsychology In Indiana

Board: IPA

Richard Rhoad


More Info
Total Posts: 39
Total Topics: 56
Since: 12/18/2017

Richard Rhoad

More Info

Total Posts: 39
Total Topics: 56
Since: 12/18/2017

3/12/2020 12:05 PM
An Update Of Telepsychology In Indiana


Here is an update on Telepsychology in Indiana.

An important notice from the Indiana State Psychology Board regarding changes to the law affecting the practice of telepsychology by licensed psychologists in the state:

Licensed Psychologists in Indiana have been capable of providing Telepsychology since July 2019.

Effective July 1, 2019, pursuanttoHouse Enrolled Act 1200, licensed psychologists in the state of Indiana may use telepsychology. House Enrolled Act 1200 further requires the psychologist who uses telepsychology to ensure that confidential communications stored electronically cannot be recovered or accessed by unauthorized persons when the psychologist disposes of electronic equipment and data.

For more information of House Enrolled Act 1200, please visit the Indiana General Assembly website at:http://iga.in.gov/legislative/laws/2019/ic/titles/025#25-33-3

The description and requirements from the website include:

Telepsychology

"Telepsychology" means the practice of psychology using electronic communications and information technology, including the following means:

(1) Videoconferencing.

(2) Telephone.

(3) Internet based communications.

Telepsychology allowed

A Psychologist may use telepsychology to treat an individual.

Requirements to use Telepsychology

Before using telepsychology, the psychologist must do the following:

  1. Establish and maintain competency in the use of telepsychology, including through continuing education, consultation, or other procedures, in conformance with prevailing standards of scientific and professional knowledge.
  2. Establish and maintain competency in the appropriate use of the information technologies used in the practice of telepsychology.
  3. Assess if the client's primary problem and apparent condition are consistent with the use of telepsychology to the client's benefit.
  4. Determine if the client has sufficient knowledge and skills to use the technology involved in telepsychology or if the client can use a personal aid or assistive device to benefit from the service.
  5. Refrain from providing telepsychology services to any client when the outcome of the psychological analysis is inconsistent with the delivery of telepsychology services, including clinical or technological issues.
  6. At each contact with the client, make reasonable efforts to verify the identity of the client.
  7. Establish an alternative means of contacting the client.
  8. Provide the client with an alternative means of contacting the psychologist.
  9. Establish a written agreement concerning the client's access to face-to-face emergency services in the client's geographical area, including instances where the client is experiencing a suicidal or homicidal crisis.
  10. When feasible, use secure communications with clients, which may include encrypted text messages via electronic mail or secure Internet web sites.
  11. Obtain and document consent for the use of nonsecure communications.
  12. Obtain the written informed consent of the client, in language that is likely to be understood and is consistent with accepted professional and legal requirements, concerning the following:
    1. The limitations and innovative nature of using telepsychology in providing psychological services.
    2. Potential risks to confidentiality of information due to the use of telepsychology.
    3. Potential risks of sudden and unpredictable disruption of telepsychology services and how an alternative means of reestablishing an electronic or other connection will be used under those circumstances.
    4. How and when the psychologist will respond to routine electronic messages.
    5. Under what circumstances the psychologist and client will use an alternative means of communication under emergency circumstances.
    6. Who else may have access to communications between the client and the psychologist.
    7. Specific methods for ensuring that a client's electronic communications are directed only to the psychologist.

Confidential communications

The Psychologist who uses telepsychology shall ensure that confidential communications stored electronically cannot be recovered or accessed by unauthorized persons when the psychologist disposes of electronic equipment and data.



Dick Rhoad

Executive Director

Indiana Psychological Association

www.indianapsychology.org







Aarika White

More Info
Total Posts: 24
Total Topics: 20
Since: 10/13/2009

Aarika White
More Info

Total Posts: 24
Total Topics: 20
Since: 10/13/2009

3/16/2020 8:19 AM

Great question Dixie. I do not know the answer in terms of hospital privileges, though perhaps someone else does. I would recommend contacting the hospital and the insurance company for clarification, as the answer may vary. I know when individuals with Medicaid are in the hospital for psychiatric reasons, our outpatient providers cannot bill for any services (e.g., case management, services provided to family) since Medicaid is paying for services while the individual is in the hospital. It would be considered double-billing for services. 


-Aarika


Dixie Pederson

More Info
Total Posts: 26
Total Topics: 1
Since: 1/1/2012

Dixie Pederson
More Info

Total Posts: 26
Total Topics: 1
Since: 1/1/2012

3/15/2020 1:18 PM

Another question that has come up in my practice:
If a patient is actually hospitalized for any reason, especially during this time period, can they receive Telehealth services from a provider who is not working at that hospital or doesn't have hospital privileges?
I would guess the answer would be negative since it would be essentially the same as providing in-house services without privileges.  This would not allow documentation in the patient's hospital record and coordination of care with inpatient providers.


Linda Brown

More Info
Total Posts: 14
Total Topics: 39
Since: 9/1/2011

Linda Brown
More Info

Total Posts: 14
Total Topics: 39
Since: 9/1/2011

3/14/2020 2:01 PM

In response to Emily’s post:

Regarding Medicare, I emailed a question about that to APA last week and got this response on 3/12 from Laurel Stine, APA’s Senior Director Congressional & Federal Affairs and Partnerships:
On Friday, the President signed into law a $8 billion emergency funding bill that included $500 million towards Medicare telehealth services (i.e., live voice/video), allowing the HHS Secretary to waive current Medicare telehealth restrictions (originating/geographic sites) during the coronavirus public health emergency so that care can be provided regardless of where a patient is located, including at home. A qualifying provider, like psychologists, would need to have provided a service to that patient in the last three years-so only applies to existing patients (defined as a Medicare patient seen within the previous 3 years).  This does not expand the definition of telehealth to include audio-only phone calls.   It still requires both audio & video capabilities.

It is important to note that the bill didn't automatically waive the CMS requirements.  Rather, it grants the Secretary the authority to waive.  CMS is reviewing the new law and will have information about implementation plans soon. But while this is great news in light of this current public health emergency, there are still limitations. Additionally, APA continues to advocate for a permanent lifting of Medicare originating and geographic site requirements, and including the home as a site of service, to improve patient access to psychologists' services. 
 
Laurel said APA plans to make an announcement about this next week.
I'm new to the telehealth world, but I’m under the impression Medicaid covers telepsychology sessions at the same rate as in-person sessions; I’m getting ready to test that out next week. 
Also, I’ve been under the impression that psychologists are covered by a telehealth parity law in Indiana that requires insurance carriers to cover telehealth at the same rate as in-person sessions. Have I misunderstood something about that?
 
Linda
Linda F Brown, PhD, HSPP                
Clinical Psychologist
Bloomington Center For Mindfulness
www.bloomingtoncenterformindfulness.com
Ph 812-360-0924
 
"Be kind whenever possible. It is always possible." —Dalai Lama
Emily Williams

More Info
Total Posts: 18
Total Topics: 2
Since: 2/15/2018

Emily Williams
More Info

Total Posts: 18
Total Topics: 2
Since: 2/15/2018

3/14/2020 10:03 AM

Dear All,

I understand that many are curious about telehealth options in these uncertain times.  Here's what I know about 3rd party payers in Indiana.  No one reimburses telephone calls--all must be videoconferencing.

CIGNA reimburses telehealth at the same rate as regular sessions for psychologists.  In order to become a telehealth provider, you must sign an attestation form that you can locate on their website.  They are the quickest.  You must meet certain guidelines and have a HIPAA compliant platform.  This is true for all insurance companies.

ANTHEM BCBS--as an in-network provider, you are eligible to provide telehealth services, but whether or not telehealth is covered is PLAN SPECIFIC.  In short, you'll have to call each plan to verify.  The Provider Relations Rep in the Indianapolis area is Jon Guthridge and can provide more information about these issues. I included in this email the attachments he gave me on COVID-19 and telehealth.

His email:  Jonathan.Guthridge@anthem.com

OPTUM/UNITED/UMR/GOLDEN RULE: You must apply to be a telehealth provider and be approved before reimbursement kicks in at the adequate rate.  I've heard rumors that you can get reimbursed, but it may be at a lower rate until you're approved.  Here is the link to more information and the form:  https://www.providerexpress.com/content/ope-provexpr/us/en/Important-upates.html

MEDICARE/MEDICAID:  In flux.  It's unclear when and how these issues will be resolved.  APA  is working on telehealth options with all major insurance providers, including Medicare.  More information will be forthcoming.  Currently, the answer appears no.

AETNA/MERITAIN HEALTH:  I'm still working on that one.  They are providing relief for telemedicine, but there's no clarity on whether or not it applies to behavioral health services.

Hope this helps,

Emily Williams


Emily F. Williams, Psy.D., HSPP
Owner of Silver Maple Psychology, LLC
13295 N. Illinois Street, Suite 207
Carmel, IN 46032
phone: (317) 208-0731
fax: (317) 564-0543
pronouns: she/her/hers



Dixie Pederson

More Info
Total Posts: 26
Total Topics: 1
Since: 1/1/2012

Dixie Pederson
More Info

Total Posts: 26
Total Topics: 1
Since: 1/1/2012

3/14/2020 9:37 AM

Is there a list of third-party payers who will pay for telepsychology sessions?
Or alternatively a list of those that we know will not?


Jeffrey Feathergill

More Info
Total Posts: 6
Total Topics: 4
Since: 9/11/2009

Jeffrey Feathergill
More Info

Total Posts: 6
Total Topics: 4
Since: 9/11/2009

3/12/2020 12:35 PM

Richard, thanks so much for sending this information at this time.  Much appreciated!  Jeff

Dr. Jeffrey T. Feathergill, Psy.D., HSPP
3625 Park  Place West, Suite 150
Mishawaka, IN 46545-3565
Office: (574) 282-1090
Fax:     (866) 540-3094
www.feathergillandassociates.com
 
In compliance with the HIPAA, rule 104-91: This message is intended only for use of the individual or entity to which it is addressed and may contain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this message is not the intended recipient or the employee or agent responsible for delivering the message to the intended recipient, redistribution is prohibited.


Ashleigh Woods

More Info
Total Posts: 29
Total Topics: 45
Since: 1/8/2014

Ashleigh Woods
More Info

Total Posts: 29
Total Topics: 45
Since: 1/8/2014

3/12/2020 12:21 PM

Thank you, Dick! On other forums, doxy.me has been recommended as a free, HIPAA-compliant telehealth service (adding modifier code 95). 

(Thanks, Dr. Crain, for sharing!)


Already a member?

Sign In
Not a member?

Sign Up