On January 5, 2023, CMS published a State Health Official letter clarifyingpolicy on reimbursement for interprofessional consultation services inMedicaid and CHIP. The letter outlines that interprofessional consultation isa distinct, coverable service in Medicaid and CHIP, and that payment can bemade directly to consulting providers. This welcomed change will bringclarity to states in adding interprofessional consultation…

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In December, the Association of American Medical Colleges (AAMC) and Virginia Medicaid (Department of Medical Assistance Services) met with the Centers for Medicare and Medicaid Services to discuss Medicaid’s payment policies with a focus on new concerns that have been raised in some states about the ability of Medicaid to provide a federal match for…

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E-Consult Coalition News February 2023 E-Consult Coalition News January 2023 Part 2 E-Consult Coalition News January 2023 Part 1 E-Consult Coalition News December 2022 E-Consult Workgroup News June 2022 E-Consult Workgroup News May 2022 E-Consult Workgroup News April 2022 E-Consult Workgroup News March 2022 E-Consult Workgroup News February 2022 E-Consult Workgroup News December 2021 E-Consult…

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The E-Consult Workgroup and California Telehealth Policy Coalition hosted our annual meetings November 16-17, 2020. Thank you to our speakers and sponsors of our annual meeting, made possible by California Health Care Foundation, Anthem Blue Cross, ConferMed, IEHP, Safety Net Connect, WISE Healthcare, AristaMD, and RubiconMD. To sponsor the Workgroup in 2021, contact econsultworkgroup@bluepathhealth.com. View Fireside…

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Septmeber’s webinar featured the launch of the CAPP child and adolescent psychiatry e-consult program, presented by Petra Steinbuchel, MD and Michelle Riederer, MD, UCSF Benioff Children’s Hospitals. In addition, we shared upcoming opportunities including free CME on e-consult for behavioral and mental health, and access to e-consults for uninsured patients.  

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This study aims to determine which psychiatric diagnoses are most commonly used for e-consults  inquiries, what types of questions are being asked by primary care providers to psychiatrists via e-consults, and what questions and which diagnoses result in a recommendation for in-person evaluations by psychiatrists. The study found that certain diagnoses and question types appear to influence…

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A new study explores he demand for neurology services at Geisinger, which exceeds the current clinical capacity. The utility of Ask-a-Doc (AAD), an electronic medical record-based interface developed at Geisinger to facilitate communication between primary care physicians (PCPs) and specialists, was implemented and assessed. It was found that AAD provides an interface between PCPs and…

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California Health Care Foundation recently released a piece titled “Reimbursing FQHCs for Telehealth Post-COVID-19 Pandemic: Medi-Cal’s Options”. The publication addresses needs to continue to support the much-needed telehealth services that have been spearheaded by FQHCs in response to COVID-19. Rafael A. Gomez, Pacific Health Consulting Group, mapped out recommendations including: Exploring prospective payment system (PPS)…

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Senator Anna M. Caballero, 12th Senate District, California, has sponsored a bill requiring Medi-Cal to reimburse all participating primary care providers, including those who operate out of a federally qualified health center (FQHC) or rural health clinic (RHC) for e-consult services. Read SB 365 bill language here. To sign the E-Consult Workgroup letter of support for…

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CMMI Project CORE: Coordinating Optimal Referral Experiences https://www.aamc.org/what-we-do/mission-areas/health-care/project-core

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California State Medicaid manual for provider delivery of telehealth including e-consult. https://files.medi-cal.ca.gov/pubsdoco/publications/masters-mtp/Part2/mednetele.pdf

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