Telehealth and Restraint/Seclusion in Schools

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On March 26, 2014, the Office of Medicaid Policy and Planning (“OMPP”) published a notice of proposed reimbursement methodology for telehealth monitoring services for Home Health Agencies (“HHA”).  In this notice, OMPP proposes to add telehealth monitoring services as a covered service for HHA and to reimburse HHA for such services.  OMPP also proposes to eliminate the current limitation for requiring the hub site, which is the location of the physician or practitioner providing the consultation services, to be greater than 20 miles from the spoke site, which is the location of the patient when the service is provided. This limitation is only being removed for telemedicine services provided by Federally Qualified Health Centers (FQHCs), Rural Health Clinics (RHCs), Community Mental Health Centers (CMHCs), and Critical Access Hospitals (CAHs).  These changes are made in accordance with Indiana Code 12-15-5-11, which was added by the General Assembly in 2013, PL 204-2013.  A proposed rule for the new reimbursable service will be published at a later date, but the proposed effective date for the new reimbursable service is October 1, 2014. The Notice of Proposed Reimbursement Methodology is available here.

On March 26, 2013, the Commission on Seclusion and Restraint in Schools published various documents regarding new rules for the use of restraint and seclusion in schools.  These published documents include an: (1) Economic Impact Statement; (2) Notice of Public Hearing, set for April 21, 2014 (Indianapolis), April 23, 2014 (Evansville) and April 24, 2014 (Chesterton); and (3) Proposed Rule.  This Proposed Rule is published in accordance with Indiana Code 20-20-40, which was added by the 2013 General Assembly, PL 122-2013.   The Proposed Rule provides rules regarding the use of restraint and seclusion in public school corporations, charter schools, and accredited nonpublic schools.  Specifically, the rules apply to: (1) all public school corporations, charter schools, or accredited nonpublic schools; (2) all public school corporations, charter schools, or accredited nonpublic schools students regardless of whether student has been identified as eligible for special education services; and (3) all programs and services subject to the supervision of the state educational agency, including those programs conducted by or through the following: (A) public school corporations, (B) charter schools, (C) special education planning districts,
(D) state agencies, or (E) other public agencies. (proposed 513 IAC 1-2-1) The Proposed Rule emphasizes the elimination or minimization of the use of restraint and seclusion and  provides: (i) guidelines regarding the use of restraint and seclusion; (ii) guidelines for the prevention of the use of potentially harmful restraints/seclusions; (iii) training requirements for the use of restraints/seclusions; (iv) guidelines for adopting and distributing the school’s seclusion/restraint policy; and (v) requirements for reporting of incidents of restraint/seclusion.   The full text of the Proposed Rule regarding the use of restraints and seclusions in schools is available here


If you have any questions, please feel free to contact Leah Mannweiler at lmannweiler@kdlegal.com or Meghan McNab at mmcnab@kdlegal.com.