Washington State Department of Labor and Industries has issued a Telehealth Update. The changes are introduced, on a temporary basis, in response to the Coronavirus pandemic.
TeleSIMP and Telerehab Payment Policies Now Available
Effective March 25, 2020, Labor and Industries (L&I) is temporarily allowing Structured Intensive Multidisciplinary Program (SIMP) services to be delivered as part of telehealth. This Telehealth Update is part of L&I’s Chronic Pain Management payment policy. This temporary TeleSIMP policy allows SIMP services to continue, while helping to slow the spread of coronavirus (COVID-19) outbreak by reducing in-person appointments. SIMP providers may use telehealth to deliver certain services for workers enrolled in their program. This policy isn’t intended to replace Chapter 34: Chronic Pain Management.
Effective March 20, 2020, L&I is also temporarily allowing the delivery of rehabilitation services using telehealth, called telerehab. Physical therapists, occupational therapists, and speech language pathologists may use telehealth to delivery services for established patients in outpatient settings.
L&I’s current payment policy and fee schedule already covers phone calls between providers and workers, see Chapter 10: Evaluation and Management Services for more details.
Both of these temporary policies will allow the use of the worker’s home as an origination site when they are receiving services. See L&I’s Temporary Telehealth Payment Policy for additional details.
Updates and corrections are periodically posted on L&I’s Medical Aid Rules and Fee Schedules website. Both of these policies are available here.
Please note: a temporary telehealth policy is under consideration for brain injury rehabilitation services. If adopted, a future Telehealth Update will be issued.
Questions on the payment policies? Contact L&I at HPPM@lni.wa.gov.
Prior Post About Telehealth Services
DLI NEWS: TELEHEALTH VISITS
Temporary Telehealth Visits Payment Policy
To help support containment of the COVID-19 outbreak, the Department of Labor and Industries has issued a new temporary telehealth visits policy. This temporary telehealth policy allows medical providers to use the worker’s home as an origination site in some instances to treat injured workers. This policy is effective 3/9/2020, and expires 7/3/2020. This is an emerging situation, and this policy may be updated as needed.
L&I’s current payment policy and fee schedule already covers phone calls between providers and workers, and telehealth visits when provided at a medical origination site. Please see the DLI Fact Sheet for more details of the current policy: LI Telehealth Fact Sheet AUG 2019.pdf
The new temporary policy will stipulate the following:
- In addition to providing telehealth services under the current payment policy, providers who can normally provide telehealth services using video remote technologies may now bill the following CPT© evaluation and management codes with home as an origination site:
- The documentation requirements will follow the Department payment policy established in Medical Aid Rules and Fee Schedules (MARFS) Chapter 10: Evaluation and Management Services. Under this temporary measure, providers will be required to include a note about the emergency situation (limiting exposure to COVID-19, in this case) that prompted this encounter, as well as noting that the originating site of the worker is home.
- Providers are encouraged to implement their clinic’s emergency response plan.
On July 3, 2020, the temporary L&I emergency telehealth policy is scheduled to end, unless the Department decides an extension is needed. This is an emerging situation, and this policy may be updated as needed.
Policy Does Not Provide Equipment to Workers
Additionally, the temporary policy will state that L&I will not provide the worker with or reimburse the worker for equipment. If a worker doesn’t have access to high-speed internet via computer or a camera phone with reliable connectivity, the provider must work with the worker to identify an alternative.
Instructions to Claims Managers re: Time Loss Payments
Claims Administration has decided to instruct claim managers not to automatically stop time loss benefits if the restrictions on an APF expire because the worker was unable to be seen in person due to COVID-19 precautions. Claim managers will be advised to assess each case and staff with their supervisor and/or ONC to decide how best to manage the claim during the period of the forthcoming temporary policy.
Questions on the payment policy after it’s published? Contact us at HPPM@Lni.wa.gov.
If you have questions or concerns about your claim, feel free to contact our firm for assistance. We provide a free case analysis and would be happy to discuss your circumstances with you.
Prior Post with Related Content
CONTACT AN ATTORNEY EARLY IN YOUR CASE FOR THE BEST CHANCE AT A FAIR OUTCOME