Remote Patient Monitoring Louisiana

Under the Community Choices Waiver, Louisiana Medicaid will reimburse an installation fee and a monthly maintenance fee for remote patient monitoring:

• TeleCare Activity and Sensor Monitoring,
• Health status monitoring, and
• Medication dispensing and monitoring.

Personal Emergency Response System (PERS) is also reimbursed under the Community Choices Waiver, which sends alerts when emergency services are needed by the recipient.

Activity and Sensor Monitoring

At a minimum the system must:

• Monitor the home’s points of egress
• Detect falls
• Detect movement or lack of movement
• Detect whether doors are opened or closed
• Provide a push-button emergency alert system

Health Status Monitoring

It could be beneficial for the patient with chronic conditions for monitoring weight, oxygen saturation measurements and vital signs.

Medication Dispensing and Monitoring

A remote monitoring system that is pre-programmed to dispense and monitor the recipient’s compliance with medication therapy. The provider or caregiver is notified when there are missed doses.

Standards

Providers of assistive devices and medical equipment must:

• Be a licensed home health agency or DME provider or a PERS provider
• Comply with the Louisiana Department of Health rules and regulations
• Be enrolled as a Medicaid provider to provide these services
• Be listed as a provider of choice on the Freedom of Choice form

Certain conditions apply for PERS providers. Certain standards apply for the medical equipment and supplies used (see manual).

Source: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, p. 22-24 & 80 (as revised on Jan. 1, 2019). (Accessed Sept. 2019). 

Health status monitoring: May be beneficial to individuals with congestive heart failure, diabetes or pulmonary disease. Services must be based on verified need.

Source: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, p. 24 (as revised on Jan. 1, 2019). (Accessed Sept. 2019). 

Provider Limitations

Telecare providers must meet the following requirements:

• Be UL listed/certified or have 501(k) clearance
• Be web-based
• Be compliant with the requirements of the Health Insurance Portability and Accountability Act (HIPAA)
• Have recipient-specific reporting capabilities for tracking and trending
• Have a professional call center for technical support based in the United States
• Have on-going provision of web-based data collection for each recipient, as appropriate. This includes the response to recipient self-testing, manufacturer’s specific testing, self-auditing and quality control

Source: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, p. 81 (as revised on Jan. 1, 2019). (Accessed Sept. 2019). 

Other Restrictions

Limitations

• Services must be based on verified need and have a direct or remedial benefit with specific goals and outcomes.
• The benefit must be determined by an independent assessment (done by an appropriate professional who has no fiduciary relationship with the manufacturer, supplier or vendor) on any item that costs over $500.
• All items must reduce reliance on other Medicaid state plan or waiver services
• All items must meet applicable standards of manufacture, design and installation

The items must be on the Plan of Care developed by the support coordinator and are subject to approval. A recipient is not able to receive simultaneously Telecare Activity and Sensor Monitoring services and traditional PERS services. Where applicable, recipients must use Medicaid State Plan, Medicare or other available payers first.

Source: LA Dept. of Health and Hospitals, Community Choices Waiver Provider Manual, Chapter Seven of the Medicaid Svcs. Manual, p. 33-34 (as revised on Jan. 1, 2019). (Accessed Sept. 2019).