The Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2023 Final Rule for Marketplace health plans has a Network Adequacy provision regarding telehealth services. As of January 2023, HHS requires health plans to identify and report the in-network providers who offer telehealth services.
According to the final rule the data regarding telehealth services provision for 2023 will be for informational purposes. It is intended to help inform the future development of telehealth standards and would not be displayed to consumers.
The final rule clarifies that telehealth services could not be counted in place of in-person service access for the purpose of network adequacy standards.
There were many comments and responses during the comment period of the rule. In the end, HHS finalized the policy as proposed. See the final rule at https://www.govinfo.gov/content/pkg/FR-2022-05-06/pdf/2022-09438.pdf.
Expect to receive requests from commercial networks enquiring whether your providers offer telehealth services. This may be wrapped into network directory verifications, recredentialing applications, and certainly new provider credentialing applications. Many payors such as Anthem will offer an online form to allow you to update such information.
Contact nCred for all your payor credentialing needs. Call our office at 423.443.4525 to speak with someone or fill out our request for information and someone will get back to you.