On August 7, 2017 the MPS submitted comments [telehealth svcs regs comments] to the Maryland Department of Health (MDH) on the proposed amendments to 10.09.49 Telehealth Services regulations.  The changes would expand Medicaid coverage of mental health and substance use disorder treatment delivered remotely via telehealth services.

Although we support most of the proposed changes, the MPS expressed concern about the reference to clinical appropriateness and requested that the proposed language in .05.A(3) “Clinically appropriate to be delivered via telehealth;” be removed. The rationale is that the proposed language already addresses the standard of care (.05.B) and licensing board standards (.05.D).

Furthermore, retaining the language in A(3) would add confusion.  What is and is not “clinically appropriate” is not spelled out, and does not lend itself to definition through regulation.  The requirement would predispose coverage decisions to unnecessary debate and could be used to arbitrarily exclude some services from coverage, which could lead to adverse consequences for patients.

The MPS reached out to three other organizations whose members would be affected by this regulatory change, asking for support of our position.  The Maryland-DC Society of Addiction Medicine and the Maryland Psychological Association both sent letters to MDH echoing our concerns.