What does ‘Telehealth’ Mean in Minnesota?

Glossary Check

How sharp is your terminology when it comes to telehealth in Minnesota? Not to worry because thanks to Simply Research, we have you covered.

Distant Site

"Distant site" means a site at which a health care provider is located while providing health care services or consultations by means of telehealth.

Health Care Provider

"Health care provider" means a health care professional who is licensed or registered by the state to perform health care services within the provider's scope of practice and in accordance with state law. A health care provider includes a mental health professional; a mental health practitioner; a clinical trainee; a treatment coordinator; an alcohol and drug counselor; and a recovery peer.

Health Carrier

"Health carrier" means an insurance company licensed to offer, sell, or issue a policy of accident and sickness insurance; a nonprofit health service plan corporation; a health maintenance organization; a fraternal benefit society; or a joint self-insurance employee health plan.

Health Plan

"Health plan" means a policy or certificate of accident and sickness insurance offered by an insurance company; a subscriber contract or certificate offered by a nonprofit health service plan corporation; a health maintenance contract or certificate offered by a health maintenance organization; a health benefit certificate offered by a fraternal benefit society; or health coverage offered by a joint self-insurance employee health plan. Health plan means individual and group coverage, unless otherwise specified Health plan includes dental plans generally, but does not include dental plans that provide indemnity-based benefits, regardless of expenses incurred, and are designed to pay benefits directly to the policy holder.

Originating Site

"Originating site" means a site at which a patient is located at the time health care services are provided to the patient by means of telehealth. For purposes of store-and-forward technology, the originating site also means the location at which a health care provider transfers or transmits information to the distant site.

Store-and-Forward Technology

"Store-and-forward technology" means the asynchronous electronic transfer or transmission of a patient's medical information or data from an originating site to a distant site for the purposes of diagnostic and therapeutic assistance in the care of a patient.

Telehealth

"Telehealth" means the delivery of health care services or consultations through the use of real time two-way interactive audio and visual communications to provide or support health care delivery and facilitate the assessment, diagnosis, consultation, treatment, education, and care management of a patient's health care. Telehealth includes the application of secure video conferencing, store-and-forward technology, and synchronous interactions between a patient located at an originating site and a health care provider located at a distant site. Until July 1, 2027, telehealth also includes audio-only communication between a health care provider and a patient if the communication is a scheduled appointment and the standard of care for that particular service can be met through the use of audio-only communication or if, for substance use disorder treatment services and mental health care services delivered through telehealth by means of audio-only communication, the communication was initiated by the enrollee while in an emergency or crisis situation and a scheduled appointment was not possible due to the need of an immediate response. Telehealth does not include communication between health care providers that consists solely of a telephone conversation, email, or facsimile transmission. Telehealth does not include communication between a health care provider and a patient that consists solely of an email or facsimile transmission. Telehealth does not include telemonitoring services.

Telemonitoring Services

"Telemonitoring services" means the remote monitoring of clinical data related to the enrollee's vital signs or biometric data by a monitoring device or equipment that transmits the data electronically to a health care provider for analysis. Telemonitoring is intended to collect an enrollee's health-related data for the purpose of assisting a health care provider in assessing and monitoring the enrollee's medical condition or status.

Compliance Corner

A health plan sold, issued, or renewed by a health carrier in Minnesota must: 1) Cover benefits delivered through telehealth in the same manner as any other benefits covered under the health plan; and 2) comply with this section.

Coverage for services delivered through telehealth must not be limited on the basis of geography, location, or distance for travel subject to the health care provider network available to the enrollee through the enrollee's health plan.

A health carrier must not create a separate provider network to deliver services through telehealth that does not include network providers who provide in-person care to patients for the same service or require an enrollee to use a specific provider within the network to receive services through telehealth.

A health carrier may require a deductible, co-payment, or coinsurance payment for a health care service provided through telehealth, provided that the deductible, co-payment, or coinsurance payment is not in addition to, and does not exceed, the deductible, co-payment, or coinsurance applicable for the same service provided through in-person contact.

However, nothing under Minnesota law:

+ Requires a health carrier to provide coverage for services that are not medically necessary or are not covered under the enrollee's health plan

+ Prohibits a health carrier from:

(1) Establishing criteria that a health care provider must meet to demonstrate the safety or efficacy of delivering a particular service through telehealth for which the health carrier does not already reimburse other health care providers for delivering the service through telehealth

(2) Establishing reasonable medical management techniques, provided the criteria or techniques are not unduly burdensome or unreasonable for the particular service

(3) Requiring documentation or billing practices designed to protect the health carrier or patient from fraudulent claims, provided the practices are not unduly burdensome or unreasonable for the particular service.

+ Requires the use of telehealth when a health care provider determines that the delivery of a health care service through telehealth is not appropriate or when an enrollee chooses not to receive a health care service through telehealth

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