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St. Louis Metropolitan Medical Society

The Greater St. Louis Medical Group Management Association is pleased to launch a partnership with the St. Louis Metropolitan Medical Society (SLMMS).  This partnership will feature the sharing of information in publications and on our websites.  

Thanks to Kevin Peek, Sandberg Phoenix & von Gontard P.C. for sharing the following article.

Take Two and (Video) Call Me in the Morning
Recent legislation supports Missouri's telehealth system

Of the six million-plus individuals residing in Missouri, a little over 30 percent are scattered throughout the rural areas of the state. As less than 10 percent of licensed physicians practice outside of the state’s major populated areas, a disparity exists that results in significant difficulty in accessing health care for many rural-residing Missourians. Fortunately, practical solutions are emerging in availability.

Technological advances on mobile devices allow users to perform extraordinary tasks ranging from immediate access to breaking news to playing a video game in which livid birds are launched at emerald-colored pigs. Telehealth utilizes a mobile device’s most basic technology—a phone call—in order to assist patients in areas in which access to medical care is challenging due to physical distance.

In 2016, Gov. Jay Nixon signed into law the expansion of the use of telemedicine within Missouri. “Telehealth” and “telemedicine” services consist of the delivery of health care services by means of advanced telecommunication technology from the origin site (patient location) and the distant site (physician location). This technology and type of service facilitates the assessment, diagnosis, consultation, treatment, education, care management and self-management of a patient’s health care from a distance. The 2016 legislation expanded the use of telemedicine across all health care providers.

In order to participate in telehealth through Missouri’s Medicaid program (MO HealthNet), providers have to be enrolled in MO HealthNet and approved by the Missouri Telehealth Network. The 2016 law expanded the list of authorized originating sites where a MO HealthNet enrollee could receive services. Prior to the legislation, a patient could only receive telehealth services if the patient was located in a clinical setting such as a hospital, clinic, nursing home or rehabilitation center. The extended list increased access points to care by minimizing barriers.

Fortunately, with the passage of House Bill 1617, the lists limiting the locations of a “distant site” and “origin site” were eliminated as of Aug. 28, 2018, allowing for services to be rendered even more broadly. According to the new legislation, the Department of Social Services must reimburse providers for services provided through telehealth if such providers can ensure services are rendered meeting the standard of care that would otherwise be expected should such services be provided in person (RSMO § 208.670). The locations of the physician and the patient are no longer a specific consideration, though it is safe to say that a physician is unlikely to be acting within the standard of care if the patient is knowingly hiking through the local landfill during a telehealth appointment.

Further, reimbursement for telehealth services must be made in the same way as reimbursement for in-person contact. However, consideration shall also be made for reimbursement to the originating site.

Though many feel that telehealth does not provide the same personal experience provided with a face-to-face doctor visit, it is certainly a viable alternative to going without medical assistance or traveling a significant distance to a physician when a video call could allow the same service. Further, it is a step toward a more cost-effective means of providing the same care as an in-person visit.

Kevin K. Peek is an associate in the St. Louis office of Sandberg Phoenix & von Gontard P.C. and focuses his practice on cases involving medical malpractice defense and the defense of providers in correctional health care. Sandberg Phoenix & von Gontard P.C. is a member of Greater St. Louis MGMA. He can be reached at

The following articles also appeared in the St. Louis Metropolitan Medical Society's newsletter:

Leaders - Born or Made? by Julie Guethler, Transform Healthcare Strategies

Health Care Innovation in St. Louis by Melony Tanko, Kypher and Michael Tan, Kypher Intern

Navigating MIPS in 2018 by Derrick Weisbrod, Greater St. Louis MGMA Director at Large

Surviving the Stress: Malpractice Risk Reduction by Diane Robben, Greater St. Louis MGMA VP Business Partners

View from the Inside by Kathleen McCarry, Greater St. Louis MGMA VP Advocacy

Filling the Gap: How Physicians and Aspiring Medical Students Learn from Each Other by Julie Guethler, Greater St. Louis MGMA Past President

What the "Soft Market" Means for Physicians by Monte Shields, The Keane Insurance Group

A Tale of Two Practices by Julie Guethler, MGMA of Greater St. Louis President

Physicians Beware of Referrals for Home Care and Potential Fraud Charges by Diane Robben, JD, MGMA of Greater St. Louis VP Business Partners and Denise Bloch, JD

MGMA of Greater St. Louis: Committed to Developing Strong Practice Managers by John Marshall, MGMA of Greater St. Louis Director at Large

Finding Good Employees by Chris Keefe, CPA, CMPE, MGMA of Greater St. Louis President-Elect

Workplace Wellness: Start Small to Improve the Health of Your Employees  by Chris Keefe, MGMA of Greater St. Louis President-Elect

Carrots and Sticks in Coding: Why Good Documentation Matters by Kathleen McCarry, MGMA of Greater St. Louis VP Advocacy

 Introduction to MGMA: Can Your Practice Afford to be "Left in the Cold?"  by Jim Kidd, MGMA of Greater St. Louis President





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Greater St. Louis MGMA
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