Hawaii

Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

At A Glance
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MEDICAID REIMBURSEMENT

  • Live Video: Yes
  • Store-and-Forward: Yes
  • Remote Patient Monitoring: Yes* (CMS RPM Codes)
  • Audio Only: Yes (Temporarily until 12/31/25)

PRIVATE PAYER LAW

  • Law Exists: Yes
  • Payment Parity: Yes

PROFESSIONAL REQUIREMENTS

  • Licensure Compacts: IMLC
  • Consent Requirements: No

STATE RESOURCES

  1. Medicaid Program: Hawaii Medicaid (Med-QUEST)
  2. Administrator: Hawaii Dept. of Human Services
  3. Regional Telehealth Resource Center: Pacific Basin Telehealth Resource Center
Disclaimer

PLEASE NOTE: CCHP is providing the following for informational purposes only. We are not providing legal advice or interpretation of the laws and regulations and policies. CCHP encourages you to check with the appropriate state agency for further information and direction. This information should not be construed as legal counsel. Consult with an attorney if you are seeking a legal opinion.

Last updated 06/03/2024

Definition

“Telehealth” means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities:  store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site.  Except as provided through an interactive telecommunication system, standard telephone contacts, facsimile transmissions, or e-mail text, in combination or alone, do not constitute telehealth services.

SOURCE: HI Revised Statutes § 431:10A-116.3(g); 432D-23.5(g); & 432:1-601.5(g). Amended by HB 907 (Will be repealed after December 31, 2025).  (Accessed Jun. 2024).

Applies to network adequacy:  

Telehealth means “health care services provided through telecommunications technology by a health care professional who is at a location other than where the covered person is located.”

SOURCE: HI Revised Statutes § 431:26-101. (Accessed Feb. 2024).

Last updated 06/03/2024

Parity

SERVICE PARITY

No accident and health or sickness insurance plan/health maintenance organization, mutual benefit society plan that is issued, amended, or renewed shall require in-person contact between a health care provider and a patient as a prerequisite for payment for services appropriately provided through telehealth in accordance with generally accepted health care practices and standards prevailing in the applicable professional community at the time the services were provided. Coverage may be subject to all the terms and conditions of the plan agreed upon among the enrollee or subscriber, the insurer and the health care provider.

SOURCE: HI Revised Statutes § 431:10A-116.3(b); 432D-23.5(b); & 432:1-601.5(b). Amended by HB 907 (Will be repealed December 31, 2025).(Accessed Jun. 2024).


PAYMENT PARITY

Reimbursement for services provided through telehealth via an interactive telecommunication system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and patient; provided that reimbursement for two-way, real-time audio-only communication technology for purpose of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient’s home shall be equivalent to eighty per cent of the reimbursement for the same services provided via in-person contact between a health care provider and a patient. To be reimbursed for telehealth via an interactive telecommunications system using two-way, real-time audio-only communication technology in accordance with this subsection, the health care provider shall first conduct an in-person visit or a telehealth visit that is not audio-only, within six months prior to the initial audio-only visit, or within twelve months prior to any subsequent audio-only visit. The telehealth visit required prior to the initial or subsequent audio-only visit in this subsection shall not be provided using audio-only communication. Nothing in this section shall require the heath care provider to be physically present with the patient at an originating site unless a health care provider at a distant site deem sit necessary.

SOURCE: HI Revised Statutes § 431:10A-116.3(c); 432D-23.5(c); & 432:1-601.5 (c). Amended by HB 907. (Will be repealed December 31, 2025). (Accessed Jun. 2024).

Unless otherwise provided by law, reimbursement for behavioral health services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and a patient; provided that reimbursement for two-way, real-time audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient’s home shall be equivalent to eighty percent of the reimbursement for the same services provided via in-person contact between a health care provider and a patient. To be reimbursed for telehealth via an interactive telecommunications system using two-way, real-time audio-only communication technology in accordance with this subsection, the health care provider shall first conduct an in-person visit or a telehealth visit that is not audio-only, within six months prior to the initial audio-only visit, or within twelve months prior to any subsequent audio-only visit. The telehealth visit required prior to the initial or subsequent audio-only visit in this subsection shall not be provided using audio-only communication.

SOURCE:  HI Revised Statutes 453-1.3(h).  Amended by HB 907 (Will be repealed December 31, 2025).(Accessed Jun. 2024).

Last updated 06/03/2024

Requirements

Insurance plans, health maintenance organizations and mutual benefit society plans cannot require in-person contact between a health provider and a patient as a prerequisite for payment for services appropriately provided through telehealth.

All insurers must provide to current and prospective insureds a written disclosure of covered benefits associated with telehealth services, including information on copayments, deductibles, or coinsurance requirements under a policy, contract, plan, or agreement. The information provided must be current, understandable, and available prior to the issuance of a policy, contract, plan, or agreement and upon request thereafter

SOURCE: HI Revised Statutes § 431:10A-116.3; 432D-23.5; & 432:1-601.5. Amended by HB 907 (Will be repealed December 31, 2025).  (Accessed Jun. 2024).

Network Adequacy

Health benefit plans must maintain a network sufficient in numbers and appropriate types of providers to assure that all covered benefits will be accessible without unreasonable travel or delay. Plans may use telehealth as a service delivery system option for ensuring network adequacy.

SOURCE: HI Revised Statutes § 431:26-103. (Accessed Jun. 2024).

Last updated 06/04/2024

Definitions

“Telehealth” means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities:  store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the health care provider is at a distant site. Except as provided through an interactive telecommunications system, standard telephone contacts, facsimile transmissions, or e-mail text, in combination or alone, do not constitute telehealth services.”

SOURCE: HI Revised Statutes § 346-59.1(g). (Accessed Jun. 2024).

Telehealth services is the use of communication equipment to link health care practitioners and patients in different locations. It may be used in place of a face-to-face, “hands on” encounter for consultation, office visits, individual psychotherapy and pharmacologic management. For purposes of this section, the term “patient” refers to individuals eligible for medical assistance.

SOURCE: Code of HI Rules 17-1737-51.1(a). (Accessed Jun. 2024).

Audio-visual real-time telehealth – Multimedia communications equipment that includes, at a minimum, audio and video equipment permitting two-way, real-time interactive communication between the patient and distant site physician or practitioner.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Dentistry & Federally Qualified Health Centers

“Telehealth” means the use of telecommunication services to transmit patient health information for interpretation and diagnosis while a patient is at an originating site and the health care provider is at a distant site. . It is an intended to facilitate access for patients who would otherwise not receive services due to geographic barriers. “Teledentistry” is a form of telehealth.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 37 (Apr. 2024) (Accessed Jun. 2024).

Last updated 06/03/2024

Email, Phone & Fax

Recently Passed Legislation – Effective until December 31, 2025.

Med-QUEST Division (MQD) supports the medically appropriate use of interactive telecommunications system using two-way, real-time audio-only communication technology (audio-only) to increase access to healthcare and promote continuity of care. MQD will continue to reimburse select healthcare services delivered through audio-only communication technology after the Federal PHE expires. The following guidance is in effect until December 31, 2025, which aligns with the amended Hawaii Revised Statute 346-59.1 as amended by 2023 Hawaii legislative session Act 107 (HB 907).

Hawai’i Revised Statute (HRS) 346-59.1 amended during the 2023 Hawai’i legislative session (Act 107 (HB 907)) updated definitions and reimbursements:

HRS 346-59.1 as amended specifically states: (b) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and a patient; provided that reimbursement for the diagnosis, evaluation, or treatment of a mental health disorder delivered through an interactive telecommunications system using two-way, real-time audio-only communication technology shall meet the requirements of title 42 Code of Federal Regulations section 410.78.

SOURCE:  HI Med-Quest Memo No: QI-2338, CCS-2311, FFS 23-22 (Nov 17, 2023).  (Accessed Jun. 2024).

Newly Amended Statute, Will be Repealed Dec. 31, 2025

Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and a patient; provided that reimbursement for the diagnosis, evaluation, or treatment of a mental health disorder delivered through an interactive telecommunications system using two-way, real-time audio-only communication technology shall meet the requirements of title 42 Code of Federal Regulations section 410.78.  Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary.

Except as provided through an interactive telecommunications system, standard telephone contacts, facsimile transmissions, or e-mail text, in combination or alone, do not constitute telehealth services.

SOURCE: HI Revised Statute, Sec. 346-59.1 as amended by HB 907HD 2/SD 2 (Accessed Jun. 2024).

Audio-only real-time communication technology (Audio-only) – For services furnished for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in their home, interactive telecommunications may include two-way, real-time audio-only communication technology if the distant site physician or practitioner is technically capable to use an interactive telecommunications system as defined in the previous sentence, but the patient is not capable of, or does not consent to, the use of video technology.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QIk-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

No Reimbursement for:

  • Telephone
  • Facsimile machine
  • Electronic mail

SOURCE: Code of HI Rules 17-1737.-51.1(c) p. 69 (Accessed Feb. 2024).  (NOTE:  Temporarily suspended by HI Dept of Human Services, Med-QUEST, Memo No. QIk-2338/FFS 23-22, CCS-2311.) (Accessed Jun. 2024).

Conditions for reimbursement of interactive telecommunications system using two-way, realtime audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient includes the following:

The provider must have the capacity to furnish two-way, audio-video telehealth services;

Audio-only mode must be the preference of the patient;

The patient’s medical record must document the reason for the patient’s preference for audio-only mode (examples: broadband access is unsatisfactory, audio-visual technology is not available or is available and the patient does not know how or does not wish to use the technology); and

In-person visit requirements with the provider furnishing a service by use of interactive telecommunications system using two-way, real-time audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient includes:

  • An in-person visit must occur six months prior to the initial audio-only service furnished;
  • After the initial 6 month in-person visit, a minimum of one medically necessary service must be furnished in-person within 12 months and every twelve months thereafter if services continue to be furnished by interactive telecommunications system. If no medically necessary service is required within 12 months of the previous in-person visit, the next medically necessary service must be furnished inperson. The patient’s medical record must document the reason why an in-person visit was not furnished within that particular 12-month period.
  • The provider furnishing the medically necessary service may be the same provider who furnished services through interactive telecommunications system or may be a provider of the same specialty or subspeciality in the same group practice.

Limitation: A clinical psychologist and a clinical social worker may bill and receive payment for individual psychotherapy via a telecommunications system but may not seek payment for medical evaluation and management services.

Modifier “FQ-service furnished using audio-only communication technology” must be used when billing for services furnished by real-time audio-only communication technology. U

For FQHCs:

FQHCs must ensure the provision of relevant wrap-around non-billable services. Efforts shall be made to ensure that patients receive relevant wrap around non-billable services, and this may mean delivering care to the patient’s location as one way to ensure services are received. Wrap-around non-billable services may or may not occur on the same day as services provided through telehealth modality and the eligible FQHC provider delivering services through the telehealth modality must provide clear instructions to the patient on how and when the wrap-around non-billable services will be provided. Wrap-around non-billable services must be documented in the patient’s medical record.

See Appendix B for more information including coding guidelines and codes.

SOURCE:  HI Med-Quest Memo No: QI-2338, CCS-2311, FFS 23-22 (Nov 17, 2023).  (Accessed Jun. 2024).

Direct Acting Antiviral (DAA) Medications for Treatment of Chronic Hepatitis C Infection

For on-treatment monitoring, an in-person or telehealth/phone visit may be scheduled, if needed, for patient support, assessment of symptoms, and/or new medications.

SOURCE: HI Med-Quest Memo No. QI-2227/FFS 22-08 (December 30, 2022). (Accessed Jun. 2024).

Telephone services, including consultation, medical advice, and course of treatment (including long distance calls), are not recognized as a valid medical service(s) and may not be claimed as a Medicaid service.

SOURCE: HI Med-Quest Provider Manual, Ch. 2: Provider Requirements, Revised Apr. 2010, pg. 16, (Accessed Jun. 2024).

Medical/Surgical Services

Telephone calls, including long-distance calls, are not covered and cannot be billed to the Medicaid Program or to the patient.

SOURCE: HI Med-Quest Provider Manual, Ch. 6: Medical/Surgical Services, Revised Jan. 2011, pg. 34, (Accessed Jun. 2024).

Behavioral Health Services

Telephone Consultation. Telephone services, including long distance calls, are not recognized as valid medical services and may not be billed to Medicaid as an office visit.

SOURCE: HI Med-Quest Provider Manual, Ch. 15: Behavioral Health Services, Revised Oct. 18, 2002, pg. 3, (Accessed Jun. 2024).

Last updated 06/03/2024

Live Video

POLICY

The State’s Medicaid managed care and fee-for-service programs shall not deny coverage for any service provided through telehealth that would be covered if the service were provided through in-person consultation between a patient and a health care provider.

(Repeal and reenactment on December 31, 2025) Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and a patient; provided that reimbursement for the diagnosis, evaluation, or treatment of a mental health disorder delivered through an interactive telecommunications system using two-way, real-time audio-only communication technology shall meet the requirements of title 42 Code of Federal Regulations section 410.78.  Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary.

SOURCE: HI Revised Statutes § 346-59.1 (a & b).  Amended by HB 907 HD2 SD 2 (Repeal date of December 31, 2025).  (Accessed Jun. 2024).

Reimbursement for services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via in-person contact between a health care provider and a patient; provided that reimbursement for two-way, real-time audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient’s home shall be equivalent to eighty per cent of the reimbursement for the same services provided via in-person contact between a health care provider and a patient.

To be reimbursed for telehealth via an interactive telecommunications system using two-way, real-time audio-only communication technology in accordance with this subsection, the health care provider shall first conduct an in-person visit or a telehealth visit that is not audio only, within six months prior to the initial audio-only visit, or within twelve months prior to any subsequent audio-only visit.  The telehealth visit required prior to the initial or subsequent audio-only visit in this subsection shall not be provided using audio-only communication.  Nothing in this section shall require a health care provider to be physically present with the patient at an originating site unless a health care provider at the distant site deems it necessary.

SOURCE: HI Revised Statutes § 431:10A-116.3(c).  Amended by HB 907 HD2 SD 2 (Repeal date of December 31, 2025).  (Accessed Jun 2024).

Interactive audio and video telecommunication systems must be used. Interactive telecommunications systems must be multi-media communications that, at a minimum, include audio and video equipment, permitting real-time consultation among the patient, consulting practitioner, and referring practitioner. Telephones, facsimile machines, and electronic mail systems do not meet the requirements of interactive telecommunications system. As a condition of payment the patient must be present and participating in the telehealth visit.

SOURCE: Code of HI Rules 17-1737-51.1(c). (Accessed Jun. 2024). (NOTE: Recent legislation not yet reflected in Rules)

Eligible providers are health care providers who are eligible to bill Hawai’i Medicaid; practicing within their scope; and delivering services which can be appropriately and effectively administered through telehealth.

Services provided by telehealth must be appropriate for the telehealth modality, clinically appropriate for the patient, rendered in conformance with the full description of the procedure code, and performed by a health care provider eligible to bill Hawai’i Medicaid. Services provided shall be consistent with all federal and state privacy, security, and confidentiality laws.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QIk-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

As noted in the Overview, due to the Maui fires, a public health emergency (PHE) was declared on August 8, 2023. Certain waivers were put into place for telehealth policies.  See Med-Quest Memo QI-2335A for more information.


ELIGIBLE SERVICES/SPECIALTIES

Services provided by telehealth must be appropriate for the telehealth modality, clinically appropriate for the patient, rendered in conformance with the full description of the procedure code, and performed by a health care provider eligible to bill Hawai’i Medicaid. Services provided shall be consistent with all federal and state privacy, security, and confidentiality laws.  See Attachment A in memo for list of suggested codes for live video.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Dentistry

The eligible codes for reimbursement will remain consistent with Memo QI-1702A (see Attachment A) with the addition of code D0145. All eligible codes are subject to the processing policies as defined in Chapter 14 of the Medicaid Dental Provider Manual.  See Manual also for codes.

CDT code D9999 must be used to identify the claim for PPS payment by FQHCs and RHCs.

While the reimbursement for radiographic services is traditionally based on the date that the radiograph is read by the dentist providing the diagnosis, to minimize confusion that may potentially arise with asynchronous technology, the following protocol will be used when filing claims:

  • Only one claim submission is allowed for each patient visit. All services to be claimed must be included in that single submission.
  • The service date on the claim is the date that the patient was treated at the originating site regardless of whether asynchronous or synchronous technology was used.
  • When asynchronous technology is used and the service date on the claim does not match the clinical notes (interpretation of the x-rays was done on a different day from when the patient was seen), a notation in clinical records should explain the discrepancy for auditing purposes.

The FFS reimbursement fee is based on the location of the eligible Medicaid provider at the time of service, Oahu or Neighboring Island.

Clinics that qualify for FQHC Prospective Payment System (PPS) reimbursement may submit telehealth claims using PPS reimbursement, as long as both the patient and dentist were each physically located at separate eligible FQHC/RHC sites during the encounter and the diagnosis.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 37-38 (Apr. 2024). HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Applied Behavioral Analysis & Autism Spectrum Disorder

Applied behavioral analysis services (including family adaptive behavior treatment guidance) can be provided through telehealth.  MedQuest provides some areas of consideration when approving ABA services through telehealth (see memo). Memo QI 2301/FFS 23-01 Updates policy.

SOURCE: QI-2020 (Jun. 17, 2020), HI Med-Quest memo QI-2301/FFS 23-01.(January 13, 2023) (Accessed Jun. 2024).

Federally Qualified Health Centers

Providers who are eligible to bill for Hawaii Medicaid services are also eligible providers who can bill for telehealth.  Eligible services will be consistent with Memo QI-1702A and FFS 19-01.  See memo for specific billing scenarios.  Memo QI- 2139/FFS 21-15 replaces Memo QI-1702A.  See Attachment C in QI-2338/FFS 23-22, CCS-2311.

SOURCE: Med-QUEST Memo 20-07 (Mar. 16, 2020), QI-2139 Tele-Health Law (Act 226, SLH 2016) Implementation (Replaces QI-1702A) HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Community Integration Services (CIS)-Supportive Housing Services

CIS services may be rendered via telehealth as appropriate, as long as the required face-to-face interaction requirements are met (See Section 16, Service Settings for more information). Services rendered via telehealth shall be billed with the additional and appropriate telehealth modifiers, and applicable POS codes, as outline in memorandum QI-1702A (NOTE: QI 1702A was replaced with QI-2338/FFS 23-22/CCS 2311). Services may also be rendered via an approved telehealth modality, if determined by the health plan to be appropriate and effective and agreed to by the member.

SOURCE: Med-QUEST Memo QI-2105 (April 1, 2021). (Accessed Jun. 2024).

Induced/Intentional Termination of Pregnancy (ITOP) Evaluation & Management Services

Telehealth (audio-visual modality) may be used for evaluation and management services performed prior to the date of the medical ITOP. Codes in the range of 99201-99215 with modifiers 95, GQ, or GT are allowed.

SOURCE: Med-QUEST Memo FFS 2105 (May 7, 2021). (Accessed Jun. 2024).

QUEST Integration Health Plans & Community Case Management Agencies

Assessments and re-assessments may be conducted using telehealth and telecommunications technology only if an in-person interaction is not an option and should only be used on an exception basis. In-person interactions with members using appropriate safety precautions is the current expectation. Where possible, members at greatest risk and need should be prioritized to receive in-person interactions before members at lower risk and need.

The health plan must document the reason for conducting an interaction using a technology option.

SOURCE: Memo QI-2107A (April 29, 2021). (Accessed Jun. 2024).

Chronic Hepatitis C Infection

An in-person or telehealth/phone visit may be scheduled, if needed, for patient support, assessment of symptoms, and/or new medications.

SOURCE:  HI Med-Quest Memo QI-2227/FFS 22-08 (December 30, 2022). (Accessed Jun. 2024).

Health and Functional Assessments

The assessment should include a face-to-face interview. Assessments and reassessments may be conducted by telehealth, based on member’s choice and preference. If using telehealth, it must meet privacy requirements.

SOURCE: HI Med-Quest Memo QI-2406, (Feb. 28, 2024), pg. 49, (Accessed Jun. 2024).


ELIGIBLE PROVIDERS

Eligible providers are health care providers who are eligible to bill Hawai’i Medicaid; practicing within their scope; and delivering services which can be appropriately and effectively administered through telehealth.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Dentistry

Clinics that qualify for FQHC Prospective Payment System (PPS) reimbursement may submit telehealth claims using PPS reimbursement, as long as both the patient and dentist were each physically located at separate eligible FQHC/RHC sites during the encounter and the diagnosis.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 38 (Apr. 2024) (Accessed Jun. 2024).

Federally Qualified Health Centers

Providers who are eligible to bill for Hawaii Medicaid services are also eligible to bill for telehealth. Refer to HRS §346-53.64 (5) for the list of providers who may provide PPS services. See Attachment C in QI-2338/FFS 23-22, CCS-2311.

SOURCE: Med-QUEST FFS Memo 20-03 (Mar. 16, 2020), HI Med-QUEST Medicaid Provider Manual: Federally Qualified Health Centers, Chapter 21 (21.2.1),pg. 2 , HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).


ELIGIBLE SITES

All providers prescribing controlled substances must be located in the State of Hawai’i. Until December 31, 2024, Federally Qualified Health Center (FQHC) behavioral health providers may be located at a non-HRSA approved site or satellite within the United States and the United States’ territories. If the FQHC provider is prescribing controlled substances, they must be located in the State of Hawai’i.

Originating/Spoke Site – The location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider’s office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient’s home, and other nonmedical environments such as school-based health centers, university-based health centers, or the work location of the patient. The originating site includes a patient’s residence. The U.S. Department of Health and Human Services Office for Civil Rights expects that patients should not receive telehealth services in public or semi-public settings, absent patient consent or exigent circumstances.

Distant/Hub Site – The location of the enrolled Hawai’i Medicaid provider delivering Medicaid eligible services through telehealth. The U.S. Department of Health and Human Services Office for Civil Rights expects health care providers will implement HIPAA safeguards and conduct telehealth in private settings, such as a doctor in a clinic or office connecting to a patient who is at home or at another clinic.

Non-FQHC Providers 

With one exception, the provider must be located within the United States and the United States’ territories is eligible to be a distant site for delivery and payment purposes. Exception: If prescribing controlled substances, the provider must be located in the State of Hawai’i.

FQHC Providers

With exceptions, the FQHC provider must be located at their contracted FQHC’s HRSA approved site or satellite.

Exceptions:

  • Until December 31, 2024, FQHC behavioral health providers may be located at a non-HRSA approved site or satellite within the United States and the United States’ territories.
  • If prescribing controlled substances, the provider must be located in the State of Hawai’i.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Eligible originating sites listed in the Administrative Rules:

  • The office of a physician or practitioner
  • Hospitals;
  • Critical Access Hospitals;
  • Rural Health Clinics;
  • Federally Qualified Health Centers;
  • Federal telehealth demonstration project sites.

SOURCE: Code of HI Rules 17-1737-51.1(d), p. 70  – Law passed & state plan amendment accepted prohibiting this limitation, however the prohibiting language is still present in regulation (Accessed Jun. 2024).

In statute, these locations are also included:

  • A patient’s home;
  • Other non-medical environments such as school-based health centers, university-based health centers, or the work location of a patient.

SOURCE: HI Revised Statutes § 346-59.1. (Accessed Jun. 2024).

Approved state plan amendment authorizes HI Medicaid to remove geographic and originating site requirements.

SOURCE: HI State Plan Amendment 16-0004. (Accessed Jun. 2024). 

Federally Qualified Health Centers:

The criteria for sites eligible to receive PPS payment is the same regardless whether or not tele-health is utilized. The services must be provided at an HRSA approved site or satellite. 5C (Other Activities/Locations) sites are not eligible to receive PPS reimbursement in Hawaii and therefore are not eligible to receive PPS for tele-health services.

The spoke (originating site) is the location where the patient is located whether accompanied or not by a health care provider through telehealth.  The originating site includes a patient’s residence.

SOURCE: HI Med-QUEST FFS Memo 20-03. (Accessed Jun. 2024).

Dental

The Medicaid rules for claims for teledentistry-related services will be consistent with the State’s rules on where teledentistry may be used.

The FFS reimbursement fee is based on the location of the eligible Medicaid provider at the time of service, Oahu or Neighboring Island.

Clinics that qualify for FQHC Prospective Payment System (PPS) reimbursement may submit telehealth claims using PPS reimbursement, as long as both the patient and dentist were each physically located at separate eligible FQHC/RHC sites during the encounter and the diagnosis. (Form 5b service sites registered with Med-QUEST as a Medicaid location and issued a HRSA Notice of Award identifying the specific service location address). Refer to Provider Memo QI-2338/ FFS 23-22. The first lines of these claims should be D9999 or D0140, according to PPS claim submission rules.

Claims for patients that were located at “public health settings” not federally registered as a FQHC or RHC service site are not eligible for PPS reimbursement.

All claims must indicate the treatment location in the “Remarks” section of the claim form. This is the location of the patient, including the name and address of “public health setting.” For example: Roosevelt High School, 1120 Nehoa Street, Honolulu, 96822. Claims that do not include the specific location of the patient will be denied.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 37-38 (Apr. 2024) (Accessed Jun. 2024).


GEOGRAPHIC LIMITS

All providers prescribing controlled substances must be located in the State of Hawai’i. Until December 31, 2024, Federally Qualified Health Center (FQHC) behavioral health providers may be located at a non-HRSA approved site or satellite within the United States and the United States’ territories. If the FQHC provider is prescribing controlled substances, they must be located in the State of Hawai’i.

Originating/Spoke Site – The location where the patient is located, whether accompanied or not by a health care provider, at the time services are provided by a health care provider through telehealth, including but not limited to a health care provider’s office, hospital, critical access hospital, rural health clinic, federally qualified health center, a patient’s home, and other nonmedical environments such as schoolbased health centers, university-based health centers, or the work location of the patient. The originating site includes a patient’s residence. The U.S. Department of Health and Human Services Office for Civil Rights expects that patients should not receive telehealth services in public or semi-public settings, absent patient consent or exigent circumstances.

Distant/Hub Site – The location of the enrolled Hawai’i Medicaid provider delivering Medicaid eligible services through telehealth. The U.S. Department of Health and Human Services Office for Civil Rights expects health care providers will implement HIPAA safeguards and conduct telehealth in private settings, such as a doctor in a clinic or office connecting to a patient who is at home or at another clinic.

Non-FQHC Providers 

With one exception, the provider must be located within the United States and the United States’ territories is eligible to be a distant site for delivery and payment purposes. Exception: If prescribing controlled substances, the provider must be located in the State of Hawai’i.

FQHC Providers

With exceptions, the FQHC provider must be located at their contracted FQHC’s HRSA approved site or satellite.

Exceptions:

  • Until December 31, 2024, FQHC behavioral health providers may be located at a non-HRSA approved site or satellite within the United States and the United States’ territories.
  • If prescribing controlled substances, the provider must be located in the State of Hawai’i.

SOURCE:  HI Dept of Human Services, Med-QUEST, Memo No. QI-2338/FFS 23-22, CCS-2311. (Accessed Jun. 2024).

Telehealth services may only be provided to patients if they are presented from an originating site located in either:

  • A federally designated Rural Health Professional Shortage Area;
  • A county outside of a Metropolitan Statistical Area;
  • An entity that participates in a federal telemedicine demonstration project.

SOURCE: Code of HI Rules 17-1737.-51.1. (Accessed Jun. 2024). – Law passed (HI Statute Section 346-59.1(c) & state plan amendment accepted prohibiting this limitation, however the prohibiting language is still present in regulation.)

Approved state plan amendment authorizes HI Medicaid to remove geographic and originating site requirements.

SOURCE: HI State Plan Amendment 16-0004. (Accessed Jun. 2024). 

Teledentistry

The Medicaid rules for claims for teledentistry-related services will be consistent with the State’s rules on where teledentistry may be used.

The FFS reimbursement fee is based on the location of the eligible Medicaid provider at the time of service, Oahu or Neighboring Island.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 37 (Apr. 2024) (Accessed Jun. 2024).


FACILITY/TRANSMISSION FEE

No reference found.

Last updated 06/03/2024

Miscellaneous

Health Plan Network Adequacy

Rules for classifying/counting providers:

Providers who offer telehealth-based services may be included under the following circumstances:

  • The key role of telehealth in the context of a provider network adequacy analysis is to close network gaps, as opposed to infection control or alternative options for communication, although these are key advantages in other contexts. Therefore, telehealth may be used in this report predominantly to close gaps or enhance the provider network.
  • Telehealth shall only be used to close network gaps for the provider types/types of services only for services that canbe rendered via telehealth.
  • Rules for classifying/counting providers also apply to telehealth providers with some key distinctions.
  • Telehealth may be used to close gaps on neighbor islands, or in rural areas on Oahu. Therefore, a given provider in an urban area on one island willing to provide telehealth services in an urban area on another island may be included twice even within a given provider group. However, if the provider is located on the same island, the provider may only be counted twice if they are located in an urban area, but additionally providing services via telehealth to members in a rural part of the island (and vice versa).
  • In all these instances, the statewide metrics must deduplicate providers within a single provider group.
  • For the purposes of this report, a given provider may only serve via telehealth on a single second island than the one on which they reside. In other words, a given provider may not be used to close network gaps on more than two islands for the purposes of this report even if they in theory can provide telehealth services statewide, to proxy a consideration for a given provider’s capacity. If the provider is located outside Hawaii, they may only serve a single island via telehealth.

If a provider is available to a member via telehealth, the member driving time to the provider shall be zero minutes, unless the member’s telehealth claims typically include an origination site that is non-residential. In these cases, the driving time shall be based on the distance from the member’s residence to the origination site.

SOURCE: Department of Human Services, Med-QUEST Division Health Plan Manual (Apr. 2024), p. 182-183, 187, 178.  (Accessed Jun. 2024).

SB 2624 requires the establishment of a telehealth and rural health care pilot projects.

SOURCE: SB 2624 (2022 Session). (Accessed Jun. 2024).

Last updated 06/03/2024

Out of State Providers

All providers prescribing controlled substances must be located in the State of Hawai’i

SOURCE: Med-QUEST Memo QI-2338/FFS 23-22/CCS-2311.  (Accessed Jun. 2024).

Last updated 06/03/2024

Overview

Hawaii Medicaid (Med-QUEST) reimburses for live video.  Although their statute prohibits HI Medicaid from placing any restrictions on originating sites, regulations creating restrictions on the types or originating site eligible for reimbursement and their geographic location still exist in Hawaii Rules.  HI indicated in a memo that a state plan amendment was approved that allows for the changes in Hawaii Medicaid policy based on the statutory requirements, but it did not provide any specifics on removing the originating site or geographic restrictions currently present in HI rules.  Recently passed legislation indicates that Hawaii Medicaid will cover some audio-only delivered services until December 31, 2025.

Additionally, according to Hawaii’s statutory definition of telehealth and limited documentation from Hawaii Medicaid, they appear to be reimbursing for store-and-forward and remote patient monitoring in certain circumstances. Phone calls are allowed for limited circumstances.

Note that in August 2023 a public health emergency (PHE) was declared in Hawaii for the Maui fires.  In response to the PHE, Hawaii has enacted several waivers that impact the Medicaid population and utilize telehealth.  See Hawaii Med-Quest Memo QI-2335A for more details. These waivers will last until the end of the PHE, though Medicaid does have the ability to extend them.

Last updated 06/03/2024

Remote Patient Monitoring

POLICY

Hawaii Medicaid is required to cover appropriate telehealth services (which includes store-and-forward and remote patient monitoring) equivalent to reimbursement for the same services provided in-person.

SOURCE: HI Revised Statutes § 346-59.1.  (Accessed Jun. 2024).

Several remote monitoring codes in “Attachment A” are listed as “prime candidates” for telehealth services.

SOURCE: HI Med-Quest Division Memo QI-2338/FFS23-22/CCS-2311.  (Accessed Jun. 2024).


CONDITIONS

No Reference Found


PROVIDER LIMITATIONS

No Reference Found


OTHER RESTRICTIONS

No Reference Found

Last updated 06/03/2024

Store and Forward

POLICY

Hawaii Medicaid and private payers are required to cover appropriate telehealth services (which includes store-and-forward) equivalent to reimbursement for the same services provided in-person.

SOURCE: HI Revised Statutes § 346-59.1 & 431:10A-116.3. (Accessed Jun. 2024).

Always use one of the following when billing:  95, GQ or GT).

SOURCE: HI Med-QUEST Memo No. QI-2338/FFS 23-22/CCS-2311 (Replaces QI-2306/QI-2138, QI-2007,FFS 23-04, FFS-21015, FFS20-03, CCS-2302) (Accessed Jun. 2024).

Hawaii Medicaid requires, as a condition of payment, the patient to be present and participating in the telehealth visit.

SOURCE: Code of HI Rules 17-1737.-51.1(c) p. 70 – Law passed & state plan amendment accepted prohibiting this limitation, however the prohibiting language is still present in regulation. (Accessed Jun. 2024).

Teledentistry

While the reimbursement for radiographic services is traditionally based on the date that the radiograph is read by the dentist providing the diagnosis, to minimize confusion that may potentially arise with asynchronous technology, the following protocol will be used when filing claims:

  • Only one claim submission is allowed for each patient visit. All services to be claimed must be included in that single submission.
  • The service date on the claim is the date that the patient was treated at the originating site regardless of whether asynchronous or synchronous technology was used.
  • When asynchronous technology is used and the service date on the claim does not match the clinical notes (interpretation of the x-rays was done on a different day from when the patient was seen), a notation in clinical records should explain the discrepancy for auditing purposes.

All claims for eligible telehealth services must include either code D9995 (teledentistry-synchronous) or D9996 (teledentistry-asynchronous). These codes should have a fee set to zero.  See manual for codes.

SOURCE: HI Med-QUEST Medicaid Provider Manual: Dental, pg. 37 (Apr. 2024) (Accessed Jun. 2024).


ELIGIBLE SERVICES/SPECIALTIES

Federally Qualified Health Centers

Telemedicine-based retinal imaging and interpretation is not a covered service for PPS reimbursement. A face-to-face encounter with a member by an ophthalmologist or optometrist is eligible for PPS reimbursement, regardless of whether retinal imaging or interpretation is a component of the services provided.

SOURCE: Med-QUEST Provider Manual.  Ch. 21: Federally Qualified Health Centers. Mar. 2016, p. 4.  (Accessed Jun. 2024).


GEOGRAPHIC LIMITS

No Reference Found


TRANSMISSION FEE

No Reference Found

Last updated 06/03/2024

Cross State Licensing

The board may issue a courtesy permit to an individual licensed to engage in the practice of veterinary medicine in another jurisdiction.  A courtesy permit issued pursuant to this section shall be valid for a period of thirty days and may be renewed once in any twelve-month period; provided that any courtesy permit issued and renewed pursuant to this section shall not exceed sixty total days in any twelve-month period; provided further that a courtesy permittee’s request for more than two courtesy permits within a two-year period shall constitute prima facie evidence that the courtesy permittee is engaged in the active practice of veterinary medicine in the State and a license issued under section 471-9 shall be required.

SOURCE: HI Revised Statutes Sec. 471-9.5(a) (Section effective July 1, 2024) (Accessed Jun. 2024).

A licensed out-of-state practitioner of medicine or surgery can utilize telehealth to consult with a Hawaii licensed physician or osteopathic physician as long as they don’t open an office or meet with patients in the state; the HI licensed provider retains control of the patient; and the laws and rules relating to contagious diseases are not violated.

Commissioned medical officers or psychologists employed by the US Department of Defense and credentialed by Tripler Army Medical Center are exempt from licensing requirements when providing services to neighbor island beneficiaries within a Hawaii national guard armory.

SOURCE: HI Revised Statutes Sec. 453-2(3-4). (Accessed Jun. 2024).

Licensed out-of-state radiologists located in Hawaii, may provide services via telemedicine to patients located in another state that the radiologist is licensed to practice in.

SOURCE: HI Revised Statutes § 453-2(b) (7). (Accessed Jun. 2024).

Dentistry

The board of dentistry may issue without examination to any resident or nonresident otherwise qualified to be examined a temporary license to practice dentistry in the employment of or while under contract with the State or any county, or any legally incorporated eleemosynary dispensary or infirmary, private school, or welfare center.  The temporary license shall authorize the person to whom the license is issued to practice dentistry exclusively while engaged in that employment or contracted by the department of health to conduct dental education and training, and shall be in force until the earliest of the following occurs:

     (1)  The date the person leaves the employment authorized under the temporary license;

     (2)  The three hundred ninety-sixth calendar day following the date of issuance of the temporary license;

     (3)  The date on which the results of the licensure examination taken by the person under this chapter are posted by the board; or

     (4)  The date on which the board revokes the temporary license;

provided that the board may revoke the temporary license at any time for cause.

SOURCE: HI Revised Statutes Sec. 448-12. (Accessed Jun. 2024).

Psychologist

A person not licensed in the State who wishes to engage in the practice of psychology for a period not to exceed ninety days within a calendar year shall petition the board for a temporary permit.  If the person is licensed or certified in another state deemed by the board to have standards equivalent to this chapter, the person shall be entitled to a temporary permit in the same manner and subject to the same conditions specified in section 465-8 applicable to the issuance of licenses.  The period of ninety days may be extended at the discretion of the board but not to exceed ninety days.

SOURCE: HI Revised Statutes Sec. 465-9. (Accessed Jun. 2024).

Last updated 06/03/2024

Definitions

“Telehealth” means the use of telecommunications services, as defined in section 269‑1, to encompass four modalities:  store-and-forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non‑interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of: delivering enhanced health care services and information while a patient is at an originating site and the physician is at a distant site; establishing a physician-patient relationship; evaluating a patient; or treating a patient.  Except as provided through an interactive telecommunications system, standard telephone contacts, facsimile transmissions, or e-mail text, in combination or alone, do not constitute telehealth services.

SOURCE: HI Revised Statutes Ch. 453-1.3.  Amended by HB 907 (To be repealed December 31, 2025).  (Accessed Jun. 2024).

“Telehealth” means the use of telecommunications, as that term is defined in section 269-1, to encompass four modalities:  store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non-interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, for the purpose of delivering enhanced health care services and information while a patient is at an originating site and the radiologist is at a distant site.  Standard telephone contacts, facsimile transmissions, or e-mail texts, in combination or by themselves, do not constitute a telehealth service for the purposes of this paragraph.

SOURCE: HI Revised Statutes Sec. 453-2.  HI Revised Statutes Sec. 466J-6 (8). (Accessed Jun. 2024).

Nursing

“Telehealth” means the use of telecommunications as that term is defined in section 269-1, to encompass four modalities: store and forward technologies, remote monitoring, live consultation, and mobile health; and which shall include but not be limited to real-time video conferencing-based communication, secure interactive and non-interactive web-based communication, and secure asynchronous information exchange, to transmit patient medical information, including diagnostic-quality digital images and laboratory results for medical interpretation and diagnosis, to support long-distance clinical health care while a patient is at an originating site and the nurse is at a distant site, patient and professional health-related education, public health and health administration, to the extent that it relates to nursing.

SOURCE: HI Revised Statutes Sec. 457-2(a). (Accessed Jun. 2024).

Last updated 06/03/2024

Licensure Compacts

Member of Interstate Medical Licensure Compact

STATUS:  Senate Bill 674 & Interstate Medical Licensure Compact, Compact Map, (accessed Jun. 2024).

* See Compact websites for implementation and license issuing status and other related requirements.

Last updated 06/03/2024

Miscellaneous

Unless otherwise provided by law, reimbursement for behavioral health services provided through telehealth via an interactive telecommunications system shall be equivalent to reimbursement for the same services provided via ink-person contact between a health care provider and a patient; provided that reimbursement for two-way, real-time audio-only communication technology for purposes of diagnosis, evaluation, or treatment of a mental health disorder to a patient in the patient’s home shall be equivalent to eighty percent of the reimbursement for the same services provided via in-person contact between a health care provider and a patient. To be reimbursed for telehealth via an interactive telecommunications system using two-way, real-time audio-only communication technology in accordance with this subsection, the health care provider shall first conduct an in-person visit or a telehealth visit that is not audio-only, within six months prior to the initial audio-only visit, or within twelve months prior to any subsequent audio-only visit. The telehealth visit required prior to the initial or subsequent audio-only visit in this subsection shall not be provided using audio-only communication.

SOURCE:  HI Revised Statutes 453-1.3(h).  Amended by HB 907 (To be repealed December 31, 2025).(Accessed Jun. 2024).

Malpractice Insurance

Professional liability insurance for health care providers must provide malpractice coverage for telehealth equivalent to coverage for the same services provided via face-to-face contact.

SOURCE: HI Revised Statutes §671-7 (a). (Accessed Jun. 2024).

Network Adequacy

Health benefit plans must maintain a network sufficient in numbers and appropriate types of providers to assure that all covered benefits will be accessible without unreasonable travel or delay. Plans may use telehealth as a service delivery system option for ensuring network adequacy.

SOURCE: HI Revised Statutes § 431:26-103. (Accessed Jun. 2024).

Veterinary Telemedicine

(a)  A veterinarian shall only practice veterinary telemedicine within the context of the veterinarian-client-patient relationship between medically necessary examinations of an animal patient or medically appropriate and timely visits to the premises where the animal patient is kept.

(b)  Only a veterinarian licensed in the State shall provide veterinary telemedicine to an animal patient located in the State.

(c)  When practicing veterinary telemedicine, a veterinarian shall:

  • Conduct all necessary animal patient evaluations consistently with currently acceptable standards of care;
  • Take appropriate precautions to safeguard the confidentiality of a client’s or animal patient’s records;
  • Ensure that the client is aware of the veterinarian’s identity, location, license number, and licensure status; and
  • Maintain appropriate medical records with sufficient information for continued care that are readily available upon request by the client.

     (d)  Prescribing medications via veterinary telemedicine shall require a veterinarian-client-patient relationship and shall be at the professional discretion of the veterinarian.  The indication, appropriateness, and safety considerations for each prescription issued in association with veterinary telemedicine services shall be evaluated by the veterinarian in accordance with all jurisdictional and federal laws and standards of care.

     (e)  A veterinarian may provide veterinary teleadvice or veterinary teletriage without the prior establishment of a veterinarian-client-patient relationship.  An expert with a poison control agency who is not a veterinarian may provide veterinary teletriage.

     (f)  A veterinarian may provide veterinary telesupervision for tasks that do not require direct supervision as specified by rules adopted by the board.

     (g)  Veterinary telemedicine shall constitute the practice of veterinary medicine in the State when the individual practicing veterinary telemedicine or the animal patient are in the State.  The board shall have jurisdiction over an individual practicing veterinary telemedicine within the State regardless of where the veterinarian’s physical offices are located.

SOURCE:  HI Revised Statutes Sec. 471-2.5.  (Accessed Jun. 2024).

Last updated 06/03/2024

Online Prescribing

Medicaid

All providers prescribing controlled substances must be located in the State of Hawai’i.

Until December 31, 2024, Federally Qualified Health Center (FQHC) behavioral health providers may be located at a non-HRSA approved site or satellite within the United States and the United States’ territories. If the FQHC provider is prescribing controlled substances, they must be located in the State of Hawai’i.

SOURCE:  HI Med-QUEST Memo QI-2338/FFS 23-22/CCS-2311. (Accessed Jun. 2024).

Prescribing providers must have a provider-patient relationship prior to prescribing. This includes:

  • A face-to-face history and appropriate physical exam to make a diagnosis and therapeutic plan;
  • Discussion of diagnosis or treatment with the patient; including the benefits of other treatment options; and
  • Ensure the availability of appropriate follow-up care.

SOURCE: HI Revised Statutes § 329-1. (Accessed Jun. 2024)

Treatment recommendations made via telehealth, including issuing a prescription via electronic means, shall be held to the same standards of practice as traditional settings that do not include a in-person visit but in which prescribing is appropriate, including on-call telephone encounters and encounters for which a follow-up visit is arranged.

Issuing a prescription based solely on an online questionnaire is not treatment for the purposes of this section and does not constitute an acceptable standard of care.

A physician-patient relationship may be established via a telehealth interaction; provided that the physician has a license to practice medicine in the State.  Once a physician-patient relationship is established, a patient or physician licensed in this State may use telehealth for any authorized purpose, including consultation with a medical provider licensed in another state, authorized by this section or as otherwise provided by law.

For the purposes of prescribing opiates or medical cannabis, a physician-patient relationship shall only be established after an in-person consultation between the prescribing physician and the patient.

SOURCE: HI Revised Statutes § 453-1.3.  Amended by HB 907 (To be repealed December 31, 2025). (Accessed Jun. 2024).

For purposes of prescribing medical cannabis, a bona fide physician-patient relationship may be established via telehealth, and a nurse-patient relationship can be established via telehealth; provided that treatment recommendations that certify a patient for the medical use of cannabis via telehealth shall be allowed only after an initial in-person consultation between the certifying physician or advanced practice registered nurse and the patient.

SOURCE: HI Revised Statutes § 329-126. (Accessed Jun. 2024).

Last updated 06/03/2024

Professional Boards Standards

No Reference Found