471 Neb. Admin. Code, ch. 47, § 004 - PROVIDER REQUIREMENTS
004.01
APPLICABLE LAWS. Providers delivering services via telehealth must follow all applicable state and federal laws and regulations governing their practice and the services they provide.
004.02
GENERAL PROVIDER REQUIREMENTS. Providers of services delivered via telehealth must comply with all applicable provider participation requirements under 471 NAC Chapters 2 and 3. In the event that provider participation requirements in 471 NAC Chapters 2 or 3 conflict with requirements outlined in this chapter, the requirements herein shall govern:
(A) Providers must ensure that services can be safely and effectively delivered using telehealth;
(B) Providers must consider a beneficiary's behavioral, physical, and cognitive abilities to participate in services provided using telehealth;
(C) The beneficiary's safety must be carefully considered for the complexity of the services provided;
(D) In situations where a caregiver or facilitator is necessary to assist with the delivery of services via telehealth their ability to assist and safety must also be considered;
(E) Beneficiaries are not required to seek services through telehealth and must be allowed to access in-person services, if the beneficiary requests; and
(F) Providers must ensure that beneficiary privacy and confidentiality is protected to the best of their ability.
004.03
TECHNOLOGY PROFICIENCY AND RESPONSIBILITY. To deliver services via telehealth, providers must be proficient in the use of applicable telehealth technologies. Providers are responsible for ensuring that the telecommunications technology requirements within this chapter are met when delivering services via telehealth.
004.04
INFORMED CONSENT. Before an initial telehealth consultation, the provider must provide the client the following written information, which must be acknowledged by the client in writing or via email:
(i) Alternative options are available, including in-person services. These alternatives are specifically listed on the client's informed consent statement. The client must be aware of their right to refuse the telehealth consultation;
(ii) All existing laws and protections for services received in-person also apply to telehealth, including:
(1) Confidentiality of information;
(2) Access to medical records and information resulting from the telehealth consultation; and
(3) Dissemination of client identifiable information, which cannot occur without written consent;
(iii) The need for the client to utilize a private location as their originating site to preserve confidentiality;
(iv) Whether the telehealth consultation will be or will not be recorded;
(v) The identification of all the parties who will be present at each telehealth consultation, and a statement indicating that the client has the right to exclude anyone from either the originating or the distant site; and
(vi) The written consent form becomes a part of the client's medical record, and a copy must be provided to the client or the client's authorized representative.
004.04(A)
VERBAL CONSENT. Clients may provide verbal rather than written consent during initial telehealth consultations. The client must confirm that they understand the information contained in the written consent form. A signed statement must be collected from the client within ten days of the service being provided and added to the client's medical record.
004.04(B)
LEGALLY AUTHORIZED REPRESENTATIVE. If the client is unable to provide consent, then it must be obtained verbally or in writing from the client's legally authorized representative.
004.04(C)
EXCEPTION FOR EMERGENCY SITUATIONS. Informed consent is not required if, because of a medical emergency, a client or their authorized representative are unable to provide written or verbal consent prior to the delivery of a service via telehealth.
004.05
PROVIDER REQUIREMENTS FOR OUT-OF-STATE SERVICES. For services delivered via telehealth to Nebraska Medicaid clients when the provider or the client, or both, is located outside of Nebraska, providers must be enrolled with Nebraska Medicaid and appropriately licensed.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
004.01 APPLICABLE LAWS. Providers delivering services via telehealth must follow all applicable state and federal laws and regulations governing their practice and the services they provide.
004.02 GENERAL PROVIDER REQUIREMENTS. Providers of services delivered via telehealth must comply with all applicable provider participation requirements under 471 NAC Chapters 2 and 3. In the event that provider participation requirements in 471 NAC Chapters 2 or 3 conflict with requirements outlined in this chapter, the requirements herein shall govern:
(A) Providers must ensure that services can be safely and effectively delivered using telehealth ;
(B) Providers must consider a beneficiary's behavioral, physical, and cognitive abilities to participate in services provided using telehealth ;
(C) The beneficiary's safety must be carefully considered for the complexity of the services provided;
(D) In situations where a caregiver or facilitator is necessary to assist with the delivery of services via telehealth their ability to assist and safety must also be considered;
(E) Beneficiaries are not required to seek services through telehealth and must be allowed to access in-person services, if the beneficiary requests; and
(F) Providers must ensure that beneficiary privacy and confidentiality is protected to the best of their ability.
004.03 TECHNOLOGY PROFICIENCY AND RESPONSIBILITY. To deliver services via telehealth , providers must be proficient in the use of applicable telehealth technologies. Providers are responsible for ensuring that the telecommunications technology requirements within this chapter are met when delivering services via telehealth .
004.04 INFORMED CONSENT. Before an initial telehealth consultation , the provider must provide the client the following written information, which must be acknowledged by the client in writing or via email:
(i) Alternative options are available, including in-person services. These alternatives are specifically listed on the client's informed consent statement. The client must be aware of their right to refuse the telehealth consultation ;
(ii) All existing laws and protections for services received in-person also apply to telehealth , including:
(1) Confidentiality of information;
(2) Access to medical records and information resulting from the telehealth consultation ; and
(3) Dissemination of client identifiable information, which cannot occur without written consent;
(iii) The need for the client to utilize a private location as their originating site to preserve confidentiality;
(iv) Whether the telehealth consultation will be or will not be recorded;
(v) The identification of all the parties who will be present at each telehealth consultation , and a statement indicating that the client has the right to exclude anyone from either the originating or the distant site ; and
(vi) The written consent form becomes a part of the client's medical record, and a copy must be provided to the client or the client's authorized representative.
004.04(A) VERBAL CONSENT. Clients may provide verbal rather than written consent during initial telehealth consultations. The client must confirm that they understand the information contained in the written consent form. A signed statement must be collected from the client within ten days of the service being provided and added to the client's medical record.
004.04(B) LEGALLY AUTHORIZED REPRESENTATIVE. If the client is unable to provide consent, then it must be obtained verbally or in writing from the client's legally authorized representative.
004.04(C) EXCEPTION FOR EMERGENCY SITUATIONS. Informed consent is not required if, because of a medical emergency, a client or their authorized representative are unable to provide written or verbal consent prior to the delivery of a service via telehealth .
004.05 PROVIDER REQUIREMENTS FOR OUT-OF-STATE SERVICES. For services delivered via telehealth to Nebraska Medicaid clients when the provider or the client, or both, is located outside of Nebraska, providers must be enrolled with Nebraska Medicaid and appropriately licensed.