A group picture of SCTA telehealth champions.

Since 2020, temporary telehealth flexibilities from the Centers for Medicare and Medicaid Services (CMS) and South Carolina Medicaid have remained in effect under the Public Health Emergency (PHE) 90-day renewals. Over the years, SC providers and patients have found these flexibilities to be extremely beneficial to the digital transformation of healthcare. With this instrumental change in the healthcare landscape, SCTA sustainability stakeholders heightened their efforts toward sustainable telehealth coverage and reimbursement policies. Looking to 2023, SCTA champions will continue this work to ensure telehealth policies are kept up to date with the changing role of virtual care in our health care systems.

In April, SC Medicaid: SC Department of Health and Human Services (SC DHHS), released a bulletin regarding the telehealth flexibilities issued during the COVID-19 Public Health Emergency. The agency categorized the flexibilities into those which will remain permanent, those that will be extended for one year post-PHE for further evaluation, and flexibilities that will expire at the end of the PHE. Included in those flexibilities being made permanent was the patient home as referring site, for certain evaluation and management services rendered by a physician, nurse practitioner, or physician assistant – a huge win in aligning SC Medicaid’s telehealth policies with SCTA Sustainability workgroup priorities. SCTA sustainability champions will continue to work with Medicaid to provide supporting data and information regarding those services to be evaluated for one-year post-PHE, as well as other SCTA telehealth coverage priorities.

SCTA 2022 Advocacy Efforts:

In March, SCTA stakeholders collaborated with Representative Bill Herbkersman to introduce the South Carolina Telehealth and Telemedicine Modernization Act (SC Bill H. 5161), with the goal of updating the previously passed South Carolina Telemedicine Act by introducing a new definition of ‘telehealth’ and removing confusing and antiquated tele-prescribing language. Although the bill did not advance from committee, its introduction opened the door for ongoing engagement and discussion with SC payers.

The SCTA also created the SC Payer Telehealth Coverage Scorecard, a tool that outlines how SC’s largest payers align or misalign with SCTA payer priorities. The scorecard has proven to be a helpful guide in conversations with SC payers and telehealth stakeholders, and is available to review on the SCTA website. Moving forward, the scorecard tool will be updated to reflect the changing telehealth coverage landscape.