Michigan now allows Medicaid reimbursement for online speech therapy, which could help with access
Michigan schools are now eligible to receive Medicaid reimbursement for speech telepractice services, just as they do for on-site services.
According to the Michigan Department of Health and Human Services policy, live, online speech-language therapy, also known as telepractice, is simply “subject to the same provisions as therapy provided to a patient in person.”
Live, online delivery of speech-language services—also known as telemedicine or telehealth—is a mode of delivery that has been shown to produce the same or better results when compared to onsite delivery. Telepractice is recognized as effective by the American Speech Language Hearing Association, and supported by dozens of published, peer-reviewed research studies.
Next page: Reaction to Michigan’s decision
Under federal mandates of the Individuals with Disabilities Education Act (IDEA), school districts are required to provide students who have special needs with special education and related services such as speech-language therapy. In spite of this requirement, a nationwide shortage of speech-language pathologists (SLPs) and Michigan-specific challenges—including long commutes to hard-to-reach schools, difficulty attracting professionals to high-crime areas, and serving large bilingual populations—make it difficult to appropriately staff speech-language pathology programs.
Telepractice has been a viable alternative for several years, but a lack of Medicaid reimbursement effectively penalized districts that chose to use it—even when telepractice was their only practical option. Now that telepractice is Medicaid reimbursable, Michigan schools can choose telepractice as a therapy delivery method without having to forgo Medicaid funds.
“This is a huge win for Michigan schools and their students, making sure that there is equitable access to services students need,” said Clay Whitehead, co-founder and co-CEO of PresenceLearning, which offers live online speech therapy services. “Michigan made a smart move here, as the federal government has delegated the decision to approve online services as a valid means of delivery to the states. As such, Michigan was able to help a huge number of students with a simple memo. No complex plan review was required. We look forward to seeing other states follow Michigan’s lead.”
In April of 2015, the Centers for Medicare and Medicaid Services (CMS) issued a major clarification of federal policy regarding telemedicine reimbursement, declaring that states are no longer required to submit a separate Service Provider Agreement (SPA) for coverage of telemedicine services—if they reimburse for telemedicine services the same way they submit for face-to-face services. Currently ten states, including Michigan, have declared that districts may submit claims for reimbursement for live, online speech-language therapy services.
Material from a press release was used in this report.