§ 422.2721 — State Plan for Medicaid: Inclusion of requirement for payment of certain costs for services provided through telehealth; inclusion of prohibition against certain practices related to such services

Nevada § 422.2721

• Jurisdiction: Nevada
• Title 38: PUBLIC WELFARE
• Ch. 422: Health

Text

1. The Director shall include in the State Plan for Medicaid:
(a) A requirement that the State shall pay for the nonfederal share of expenses for services provided to a person through telehealth to the same extent as though provided in person or by other means;
(b) A requirement that the State shall pay the nonfederal share of expenses for services described in paragraph (a) in the same amount as though provided in person or by other means:
(1) If the services:
(I) Are received at an originating site described in 42 U.S.C. § 1395m(m)(4)(C) or furnished by a federally-qualified health center or a rural health clinic; and
(II) Except for services described in subparagraph (2), are not provided through audio-only interaction; or
(2) For counseling or treatment relating to a mental health condition or a substance use disorder, including, without limitation, when such counseling or treatment is provided through audio-only interaction; and
(c) A provision prohibiting the State from:
(1) Requiring a person to obtain prior authorization that would not be required if a service were provided in person or through other means, establish a relationship with a provider of health care or provide any additional consent to or reason for obtaining services through telehealth as a condition to paying for services as described in paragraph (a) or (b). The State Plan for Medicaid may require prior authorization for a service provided through telehealth if such prior authorization would be required if the service were provided in person or through other means.
(2) Requiring a provider of health care to demonstrate that it is necessary to provide services to a person through telehealth or receive any additional type of certification or license to provide services through telehealth as a condition to paying for services as described in paragraph (a) or (b).
(3) Refusing to pay for services as described in paragraph (a) or (b) because of:
(I) The distant site from which a provider of health care provides services through telehealth or the originating site at which a person who is covered by the State Plan for Medicaid receives services through telehealth; or
(II) The technology used to provide the services.
(4) Requiring services to be provided through telehealth as a condition to paying for such services.
(5) Categorizing a service provided through telehealth differently for purposes relating to coverage than if the service had been provided in person or through other means.
2. The provisions of this section do not:
(a) Require the Director to include in the State Plan for Medicaid coverage of any service that the Director is not otherwise required by law to include; or
(b) Require the State or any political subdivision thereof to:
(1) Ensure that covered services are available to a recipient of Medicaid through telehealth at a particular originating site; or
(2) Provide coverage for a service that is not included in the State Plan for Medicaid or provided by a provider of health care that does not participate in Medicaid.
3. As used in this section:
(a) “Distant site” has the meaning ascribed to it in NRS 629.515 .
(b) “Federally-qualified health center” has the meaning ascribed to it in 42 U.S.C. § 1396d(l)(2)(B).
(c) “Originating site” has the meaning ascribed to it in NRS 629.515 .
(d) “Provider of health care” has the meaning ascribed to it in NRS 439.820 .
(e) “Rural health clinic” has the meaning ascribed to it in 42 U.S.C. § 1395x(aa)(2).
(f) “Telehealth” has the meaning ascribed to it in NRS 629.515 .

Legislative History

(Added to NRS by 2015, 630 ; A 2021, 3008 , 3009 , 3010 , 3011 ; 2023, 235 , 237 )