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INDIANA SPEECH-LANGUAGE-HEARING ASSOCIATION (ISHA)

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Telehealth


Announcements

Updates from the ISHA Telepractice Task Force

Telepractice in Indiana during the pandemic response to questions document for ISHA members (5/27/2020)

Telehealth guidance document for ISHA members (4/6/2020)

See Events: Professional Development page for new Continuing education opportunities related to telehealth


Indiana Medicaid allows Telemedicine

Update from Central Office (03/19/20):

Indiana Medicaid allows telemedicine and telephone options for most health care and mental health interactions

Policy intended to streamline access to health services, protect frontline health care workers and help ensure appropriate utilization of emergency services

INDIANAPOLIS – The Indiana Family and Social Services Administration announced today that, to help contain the spread of the coronavirus (COVID-19), Indiana Medicaid will allow interactions between patients and doctors and other health care providers, as well as other Medicaid service deliveries, to occur either over the phone or through the use of telemedicine technologies whenever possible. Effective immediately, most health services – including covered mental health services and Medicaid home- and community-based services – will be reimbursed as if they took place in person. This policy will remain in place – and telemedicine/telephone interactions will be encouraged – for as long as Indiana remains under a declaration of a public health emergency by Governor Eric Holcomb.

"As we continue our work to protect the health of Hoosiers, in-person human interactions must be held to an absolute minimum and, in this extraordinary time, that must include contact between doctors, other health care professionals and patients," said Jennifer Sullivan, M.D., M.P.H., FSSA Secretary. "We also hope this will help Hoosiers get the care they need faster and more efficiently, while helping reserve our emergency rooms and hospital beds for sick patients who truly need a higher level of care during this public health emergency."

Telephone and telemedicine visits will be covered for both in- and out-of-state providers and for all covered services, with some exceptions for certain services that require physical interaction. These exceptions include surgical procedures, radiology, laboratory services, anesthesia services, audiological services and chiropractor services. A complete list of exceptions and additional guidance for Indiana Health Coverage Programs-enrolled providers will be published shortly on this page.

Reimbursement will be allowed for covered services for both Traditional (fee-for-service) Medicaid as well as all managed care programs. All services rendered must be within the provider's applicable licensure and scope of practice. Neither text nor email messages will be reimbursable.

Indiana Medicaid recommends patients call their health care providers to inquire about telephone/telehealth visit options, especially if the patient has an appointment scheduled.

News Media Contacts:
Name: Jim Gavin
Phone: 317-234-0197
Email: Jim.Gavin@fssa.IN.gov
Name: Marni Lemons
Phone: 317-234-5287
Email: Marni.Lemons@fssa.IN.gov


National Emergency: Changes to HIPAA

The government has issued a change in HIPAA regulation (specifically enforcement discretion) related to the provision of telehealth during this national health emergency:

https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html


Telesupervision in Indiana

Update from Central Office (03/18/20): Indiana SLPs and AUDs,

In response to recent closures and questions regarding supervision of graduate students, we have gathered the following information regarding telepractice:

  • Indiana has no statutes or rules pertaining to telemedicine (the Indiana term for telepractice, etc.) for SLPs and AUDs. In the absence of statutes or rules, it is assumed that telemedicine is permitted.
  • The Indiana Code has a definition of "direct supervision" that requires "onsite observation and guidance". However, the words "direct supervision" are not used elsewhere in the statutes governing SLPs and AUDs, so the definition is effectively moot.
  • The only reference to individuals engaged in training in your statutes, which would include students, is in the section that exempts individuals in training from needing a license. See IC 25-35.6-1-4(5) below. That provision only requires individuals in training to work under the "supervision" of a licensed SLP or AUD. Thus, given no restrictions on telemedicine and no definition of supervision that requires onsite presence, we believe that "tele-supervision" is permitted under Indiana law.


IC 25-35.6-1-4Persons and practices not affected
Sec. 4. Nothing in this article shall be construed as preventing or restricting the following:
(1) A physician or surgeon from engaging in the practice of medicine in this state, or a person under the supervision and control of a physician or surgeon from conducting hearing testing, provided such a person is not called an audiologist.
(2) Any hearing aid dealer from:
(A) engaging in the testing of hearing and other practices and procedures necessary for the business for which the dealer is registered in this state under IC 25-20-1; and
(B) using the title hearing aid specialist or any similar title or description of service.
(3) Any person licensed or registered in this state by any other law from engaging in the profession or occupation for which the person is licensed or registered.
(4) A person employed as a speech-language pathologist or audiologist by the government of the United States, if such person performs speech-language pathology or audiology services solely within the confines or under the jurisdiction of the governmental organization by which the person is employed. However, such person may, without obtaining a license under this article, consult with or disseminate the person's research findings and other scientific information to speech-language pathologists and audiologists outside the jurisdiction of the organization by which the person is employed. Such person may also offer instruction and lectures to the public without being licensed under this article. Such person may additionally elect to be subject to this article.
(5) The activities and services of persons pursuing a course of study leading to a degree in speech-language pathology or audiology at a postsecondary educational institution, if:
(A) such activities and services constitute a part of a supervised course of study;
(B) such person is designated speech-language pathology or audiology intern, speech-language pathology or audiology trainee, or by other such titles clearly indicating the training status appropriate to the person's level of training; and
(C) the person works only under the supervision of a speech-language pathologist or audiologist licensed under this article.
(6) The activities and services of persons fulfilling the clinical experience requirement of section 5(2)(B)(ii) or 6(3)(B) of this chapter, if such activities and services constitute a part of the experience required for that section's fulfillment.
(7) The performance of pure tone air conduction testing by an industrial audiometric technician, as defined by federal law, who is working in an industrial hearing conservation program directed by a physician or an audiologist.
(8) The performance of speech-language pathology or audiology services in this state by any person not a resident of this state who is not licensed under this article, if such services are performed for no more than five (5) days in any calendar year and in cooperation with a speech-language pathologist or audiologist licensed under this article, and if such person meets the qualifications and requirements for application for licensure described in sections 5(1) and 5(2) or 6(1) and 6(2) of this chapter. However, a person not a resident of this state who is not licensed under this article, but who is licensed under the law of another state which has established licensure requirements at least equivalent to those established by section 5 or 6 of this chapter or who is the holder of a certificate of clinical competence in speech-language pathology or audiology or its equivalent issued by a nationally recognized association for speech-language or hearing, may offer speech-language pathology or audiology services in this state for no more than thirty (30) days in any calendar year, if such services are performed in cooperation with a speech-language pathologist or audiologist licensed under this article.


ASHA Telepractice Resources During COVID-19

Telepractice resources including state-by-state tracking of laws and regulations for telepractice and temporary practice: https://www.asha.org/About/Telepractice-Resources-During-COVID-19/

To support and empower members to provide the highest quality, life changing communication, swallowing and hearing services to the people of the State of Indiana.

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