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North Dakota

North Dakota

Commercial Payer Policies

*proposed update* Audio-only telehealth may be used for e-visits (“A face-to-face digital communication initiated by a patient to a provider through the provider’s online patient portal”) and virtual check-ins (“A brief communication via telephone or other telecommunications device to decide whether an office visit or other telecommunications device to decide whether an office visit or other service is needed”) (private payer law).

TELEHEALTH DEFINITION: “the use of interactive audio, video, or other telecommunications technology… [and] the use of electronic media for consultation relating to the health care diagnosis or treatment of a patient in real time or through the use of store-and-forward technology.” Telehealth does not include audio-only, email, or fax.

SERVICE PARITY: Insurers may not offer policies unless the policy “provides coverage for health services delivered by means of telehealth which is the same as the coverage for health services delivered by in-person means."

PAYMENT PARITY: Payment/reimbursement for a telehealth service must be established “in the same way” as it would be for the same in-person, through negotiations with health care provider.

*proposed update* PAYMENT PARITY PILOT PROJECT: Reimbursement for telehealth cannot be less than in-person, deductibles/cost sharing/co-pays cannot be more than in-person, telehealth includes audio-only if no other means of communications technology is available to patients. The pilot project would end July 31, 2023.

Temporary COVID-19 Policies (ND Commercial Payers)

WAIVED REQUIREMENTS:

  • “Secure connection” provision suspended
  • “Audio-only” provision (barring use of audio-only telehealth) suspended

NEWLY ELIGIBLE SERVICES:

OTHER TEMPORARY ND COMMERCIAL PAYER POLICIES:

 

>> CONTINUE TO NORTH DAKOTA: MEDICAL BOARD & PHYSICIAN POLICIES

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