Representative Will and Representative Caraveo, bill sponsors, introduced House Bill 20-1092. The bill requires the Department of Health Care Policy and Financing (HCPF) to reimburse federally qualified health centers (FQHCs) for providing telemedicine and clinical pharmacy services to Medicaid clients. HCPF is required to promulgate rules to implement the bill.
Under current law, telemedicine is a service that some providers can bill to Medicaid. However, for FQHCs, HCPF defines a payable encounter as requiring an in-person face-to-face visit. The bill establishes that telemedicine service meets the definition of a face-to-face encounter for FQHCs, and that the reimbursement rate for a telemedicine service must be at least the same rate as for a comparable in-person visit.
Colorado's Medicaid program does not currently cover services provided by clinical pharmacists at FQHCs. While some FQHCs do offer clinical pharmacist services, these are typically grant funded. The bill requires costs for services provided by clinical pharmacists through an FQHC to be reimbursed by Medicaid.