Nevada § 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

§ 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

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 and, except for

services provided through audio-only interaction, in the same amount 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 or reimbursement 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 .