PCH TELEHEALTH CENTER OF EXCELLENCE in conjunction with WVAFP
Nancy A. Lohuis, M.D. FAAFP, Board Certified ABFM and American Board of Preventative Medicine Subspecialty of Clinical Informatics
Board Member WV AFP

Comprehensive Primary Care Guide for Telehealth in West Virginia was created with funding assistance from the Health Promotion and Chronic Disease Division of the West Virginia Bureau for Public Health within the West Virginia Department of Health and Human Resources, with support from Cooperative Agreement Number 18-NU58-DP006528 from the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.
Nancy A. Lohuis, M.D., FAAFP, Board Certified ABFM and American Board of Preventative Medicine, Subspecialty of Clinical Informatics.Dr. Lohuis has no disclosures.
Telehealth policy, rules and regulations, coding and billing and guidelines are changing on a daily basis. There are many telehealth bills pending in Congress and others are likely to change at the state level as well. The information in this guide will be affected by the fluidity of the material it addresses. We state that the information provided is what we believe to be correct as of February 1, 2022 and is intended for informational purposes only. Those using the guide must confirm current legal and billing information with their own sources and should not use this guide as a sole reference in their business and clinical policy decision making. The views presented in this guide are not necessarily the views of the author’s employer.
I want to thank all who played a role in making this project possible especially the following:
Gerry Stover, Executive of WV AFP
Sheryn Carey, WV Bureau of Public Health
Susan Sims, WV Bureau of Public Health
Donna Umberger, Senior Office Manager at Mercer Medical Group, Princeton Community Hospital
Melissa Kosinar, Nurse IT Analyst Ambulatory at Princeton Community Hospital
Helenia Sedoski, R.D. who agreed to pilot our Medical Nutritional Therapy Telehealth Project
Those at the Center for Connected Health Policy, National Consortium of Telehealth Resource Centers, and WV Medicaid who fielded my many questions.
My clinical team at Mercer Medical Group
Dr. Wallace Horne who gave us the vision for PCH Telemedicine Center of Excellence

Introduction

Why is a Telehealth guide specific to WV necessary?

Telehealth is not new. It existed long before the Covid pandemic and will continue afterward. What is new is the rapid increase in utilization of telehealth and the resulting changes in laws, licensure rules, coding, billing, prescribing and documentation. Complexity has arisen from the federal control of telehealth parameters for delivery of care to patients insured by Medicare, Medicare Advantage plans and the veteran’s health system, while state specific laws largely control parameters for Medicaid, PEIA and commercial insurers. The result is a jungle of rules and regulations leaving health care providers who would like to adopt telehealth as a tool in their practice feeling confused and helpless. One can find the information needed but this would require staff, time, and resources many of our primary care practices do not possess. This uphill climb prompts many practices give up a telehealth program before starting or shortly thereafter.

Telehealth is particularly important to the people of West Virginia due to the high percentage of chronic disease in our state. Continuity of care in primary care practices is potentially threatened by the emergence of direct to consumer or private insurer based virtual programs. Telehealth is not for every visit or every situation. It is imperative that we as primary care providers become champions of telehealth and use both virtual and in-person modalities to provide efficient, equitable, and effective continuity of care throughout and beyond the pandemic.

The WVAFP, Bureau of Public health has provided resources through a grant to compile the information in this guide. The original guide was current as of June 2021. A second grant has been provided for update and improvement of the guide. Information in the updated guide is what is believed to be accurate as of Feb 1, 2022. Again, the guide is for informational purpose only. Legal and billing counsel is suggested before action. The express purpose of this endeavor is to produce a practical, simplified reference to ease appropriate adoption of telehealth as part of primary care practice in the state of West Virginia.

Nancy A. Lohuis, M.D., FAAFP, Board Certified ABFM and American Board of Preventative Medicine Subspecialty of Clinical Informatics.

Table of Contents

Examples of Marketing Videos

The following videos give you an overview of how Mercer Medical Group Multispecialty Group incorporated a telehealth program into daily clinical life. The subsequent guide gives details of the knowledge and research behind the program.

Terminology, Statistics and Challenges

Telehealth Consent, Laws, Licensure, Liability and Prescribing

Telehealth Practice Programs

Telehealth Coding, Billing and Insurance

Integrating Telehealth with Other Programs

Additional Resources and Links

*** Those in RED represent most important summaries in form of tables or spreadsheets which could be useful for quick reference.

Comprehensive Primary Care Guide for Telehealth in West Virginia