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Telehealth Under COVID-19 is a Window to the Future

Dramatic Increase in Telehealth

The Centers for Medicare and Medicaid Services (CMS) issued sweeping interim program revisions in response to the COVID-19 public health emergency on April 6, effective back to March 1, 2020. During a public health emergency, remote communications technology can avoid exposure risks to health care providers, patients, and the community.

Link to the full interim rule in the Federal Register: Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID–19 Public Health Emergency. 

See the interim rule for changes regarding your specific discipline. It is easily searchable by keyword.

Our prior blog about Telehealth under COVID-19 addressed the initial telehealth changes announced in March.

Broad Changes

CMS has changed Medicare payment rules during the COVID-19 pandemic in recognition that some pre-existing rules inhibit the use of innovative technologies. On an interim basis, the costs of telecommunications technology may be reimbursed as allowable administrative and general (A&G) costs.

Although this is an “interim rule” we expect long-term changes ahead.

Among the changes are:

  1. Physicians and other practitioners, home health and hospice providers, inpatient rehabilitation facilities, rural health clinics (RHCs), and federally qualified health centers (FQHCs) are allowed broad flexibilities to furnish services using telehealth.
  2. Altering payment policies to provide specimen collection fees for independent laboratories collecting specimens from beneficiaries who are homebound or inpatients (not in a hospital) for COVID-19 testing.
  3. Expanding, on an interim basis, the list of destinations for which Medicare covers ambulance transports under Medicare Part B.
  4. Programmatic changes to the Medicare Diabetes Prevention Program (MDPP) and the Comprehensive Care for Joint Replacement (CJR) Model and program-specific requirements for the Quality Payment Program to avoid inadvertently creating incentives to place cost considerations above patient safety.

The Wave of the Future?

While these recent rapid changes were published under the pressure of the COVID-19 emergency, CMS stresses the importance of telemedicine more broadly in the interim rule :

“In general, technology has become an integral part of medicine across the entire spectrum of healthcare. Telemedicine, in particular has the potential to play a large role in enhancing the delivery of healthcare in the home for Medicare beneficiaries, including the provision of information, education, and services provided via telecommunications systems. One of the biggest benefits of telemedicine, separate from its potential to minimize risk to clinicians and patients during an outbreak of an infectious disease, is to increase access to healthcare to geographically disadvantaged and medically underserved populations, providing an improved quality of care. Telemedicine and remote monitoring can also be used to encourage patient involvement and autonomy, and to increase the tools available for the home health provider.” (See 85 F.R. at page 19248)

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Maggie Hales

Maggie Hales is a lawyer specializing in health information privacy and security. As CEO of ET&C Group LLC she advises health care providers and business associates in 36 states, Canada, Egypt, India and the EU, using The HIPAA E-Tool® to deliver up to date policies, forms and training on everything related to HIPAA compliance.

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