California Eyes Medicaid Reimbursement for Telehealth Counseling

California Gov. Jerry Brown is expected to sign into law a bill that would expand the state’s Medicaid program to reimburse certain healthcare providers who use telehealth to deliver substance abuse counseling.

AB 2861 mandates that certified providers under the state’s Medi-Cal program “shall receive reimbursement for individual counseling services provided through telehealth, as defined in Section 2290.5 of the Business and Professions Code, by a licensed practitioner of the healing arts or a registered or certified alcohol or other drug counselor, when medically necessary and in accordance with the Medicaid state plan.”

With passage of the bill, which was unanimously approved by state legislators, California joins a growing list of states who are enabling reimbursement for connected care services that address substance abuse addiction disorders. Telehealth and telemedicine experts say a telemental health platform can improve access to care for underserved communities, giving more people with substance abuse issues the ability to access virtual treatment.

They also have the support of the Centers for Medicare & Medicaid Services. Earlier this year, CMS sent a letter to state Medicaid directors urging them to consider telehealth and mHealth in new programs addressing the nation’s opioid abuse crisis.

Medi-Cal currently offers telehealth as part of the Drug Medi-Cal Organized Delivery System, but that coverage doesn’t extend across the entire state. This bill would enable providers across California to quality for reimbursement.

“The opioid epidemic has ravaged communities and ruined the lives of too many families,” the bill’s sponsor, State Assemblyman Rudy Salas, D-Bakersfield, said in a press release. “For those seeking treatment, we need to ensure that they can access help when they need it most. Telehealth is an innovative way to remove barriers for people seeking help in rural areas so that they can get treatment from specialists and get on the road to recovery.”

The bill drew support from several organizations.

“Pediatricians see firsthand the effects of substance abuse in youth, which can include significant physical and social health consequences, such as poor academic performance, poorer health status, changes in brain structure, and increased risk of death from overdose and suicide,” Angela Dangvu, MD, a Fellow of the American Academy of Pediatrics, said in a letter from the AAP’s California chapter.

“Substance abuse can be especially hard to combat in rural communities due to limited resources for prevention, treatment, and recovery,” she added. “Telehealth has the ability to overcome the barriers of distance and time that plague rural communities and other medically underserved populations. Numerous studies have demonstrated telehealth’s effectiveness in reaching those with the greatest barriers to access.”

“Individual counseling services provided by telehealth are an invaluable tool for increasing treatment capacity across the state at a time when drug overdose is a leading cause of accidental death,” Tom Renfree, interim executive director of the County Behavioral Health Directors Association, said in a statement. “This bill will help to ensure timely access to substance use disorder treatment in all of our communities.”

The legislature’ s unanimous support for the bill comes despite a detailed analysis from the California Health Benefits Review Program (CHBRP) that found limited or insufficient evidence that a telehealth program would aid in treating substance abuse disorders.

“Additional medical and clinical research is needed to definitively examine the potential for telehealth to improve substance use disorder treatment in the Medi-Cal population,” the report concluded.