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Delivery of telehealth services

Telehealth services must be delivered in accordance with all state and federal laws, including:

  • The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
  • Any HIPAA-related directives from the Office for Civil Rights at the Department of Health and Human Services issued during the COVID-19 national emergency
  • 42 CFR Part 2 (Jan. 1, 2021)

We require providers who offer our members telehealth services to:

  • Maintain documentation in accordance with HIPAA requirements for healthcare services delivered through telehealth
  • Deliver services in accordance with rules set forth by their respective licensing board and accepted standards of clinical practice
  • Document the specific telehealth modality used

If you provide telehealth services to one of our members for longer than 12 consecutive months, we expect you to:

  • Conduct at least one in-person annual visit, or
  • Refer the member to a practitioner or his or her usual source of clinical care (other than an emergency department) for an in-person annual visit

Please note that telehealth services:

  • Do not replace provider choice and/or member preference for in-person service delivery
  • Will not be considered as an alternative to meeting provider network access requirements