Page 15 of 333, “The addition of telehealth options to some Virginia Waiver services is not intended to supplant community integration, but rather to complement it. The ability for individuals to connect with providers via HIPAA compliant remote platforms offers the opportunity to prepare and/or plan for community integration opportunities in secure and lower stress environments."

Existing CMS and HHS definitions and guidelines for telehealth only apply to medical services delivered by health care practitioners, and HIPAA compliance certification of existing telehealth platforms is centered on billing HCPCS medical procedure codes to Medicare. Neither Virginia agencies nor waiver providers will be able to find definitions applicable to HCBS services from any authoritative source. In addition, only some waiver services allow telehealth delivery, and only a percentage of those services may be delivered via telehealth, yet providers of those services will be required to invest in the same HIPAA compliant platforms and staff training that doctor’s offices and hospitals use for billable medical procedures.

For DMAS to ensure proper oversight and compliance with the permanent options for telehealth modes of waiver services delivery, please include definitions and types of telehealth modalities that are acceptable, and specific required elements of the platforms used to deliver them. Including definitions of the types of telehealth, or acceptable combinations of telehealth modes that are appropriate for each waiver service with an allowable telehealth option, such as live video, store and forward, mobile health, and audio only, will prevent conflicting interpretations and unrealistic provider requirements. Please see CMS publication, Telehealth for Providers: https://www.cms.gov/files/document/telehealth-toolkit-providers.pdf.