BISMARCK -- North Dakota Medicaid is issuing a temporary policy to provide flexibility for members and providers to receive and deliver services via telephone or other technology.

The new policy was announced during a statewide webinar and conference call Friday, March 20, hosted by the North Dakota Department of Health and Human Services. The call was held to address various issues related to the coronavirus pandemic.

According to the number of phone calls the department received in recent days, most questions are related to accessing medical services via telephone or by audio and video applications.

“We understand that providers and members are very concerned about wanting to practice social distancing and not go into appointments, and we want to support that in every way that we can,” said Krista Fremming, deputy director of the department’s Medical Services Division.

Fremming moderated the conference, which included around 170 participants. She said some changes in the policy are due to a March 17 notice from the U.S. Office of Civil Rights.

“This is going to allow covered health care providers that want to use audio or video that is not compliant (with the Health Insurance Portability and Accountability Act) to do so during this public health emergency without fear of OCR imposing penalties for noncompliance with the HIPAA rules,” she said.

That means health care providers and members can use audio and video applications – as long as it’s not a public-facing application such as Facebook Live – to access some medical services.

Under the temporary policy change, non-public-facing audio and video applications – such as Apple FaceTime, Facebook Messenger, Google Hangouts and Skype – may be used.

As for billing telemedicine claims, Fremming referred to information on the department’s website about the differences between professional and institutional claims, an issue about which she said the department has tried to be “very specific.”

She said providers should be prudent with regard to services they provide via technology, because the totality of communication and information exchanged “must be of an amount and nature that would be sufficient to meet … requirements” if the same service were rendered in person.

“I think this is really where providers have to make those really important judgment calls regarding whether a service is appropriate to be delivered via telemedicine,” Fremming said.

Some items not covered in telehealth include therapies in a group setting, visual check-ins and e-visits.

As more people move to remote work, including most of the staff at the state’s Medicaid office, there are some who still go to work every day to process paper medical claims. Caprice Knapp, director of the department's Medical Services Division, said she’d like to see that load lessened by having more people move to electronic filing.

Knapp, who also addressed modifications related to Section 1135 of the Social Security Act, said those who need help learning to file electronically, or for questions about Medicaid and other related matters, should check the department’s website.

She urged patience and understanding, as her staff also is trying to navigate through the current crisis.

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