On March 6,2020, Congress signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, which provides emergency relief to the nation during the current COVID-19 health emergency. In order to protect Americans and get ahead of the spread of the virus, the bill allows for expanded use of telemedicine services. The bill also includes waivers to certain Medicare restrictions to protect vulnerable seniors, allowing everyone to receive telehealth care covered by Medicare throughout this crisis.
What Is Telehealth?
Telehealth refers to the exchange of medical information using some form of real-time video chat. It can be useful in many situations, especially when patients cannot get to their doctor’s office. Health insurance companies and Medicare do normally cover some telehealth services, including doctor’s visits and consultations, but only in limited circumstances. Prior to the waiver signed in March, patients generally needed to live in a rural area to have their telehealth care covered. They also needed to be at one of the following locations:
- A doctor’s office
- A hospital
- A critical access hospital (CAH)
- A rural health clinic
- A federally qualified health center
- A hospital-based dialysis facility
- A skilled nursing facility
- A community mental health center
These restrictions obviously meant that patients would often have to leave their homes in order to access telehealth services, which is not ideal during a pandemic.
Changes to Telehealth Services
Not only will insurance providers now cover these visits, but there are other key changes that extend coverage during this crisis.
- The Health and Human Services (HHS) Inspector General is allowing healthcare providers to waive cost-sharing requirements for COVID-19-related telehealth visits.
- The CMS has waived reimbursement restrictions on practicing across state lines. However, doctors will still need a state licensure to deliver care in that state.
- The US Drug Enforcement Administration (DEA) has eased restrictions on the types of controlled substances providers can prescribe during a telehealth visit.
Medicare will pay for brief (5-10 minute) “virtual check-ins.” - Medicare will pay for brief (5-10 minute) “virtual check-ins” with a patient’s normal doctor, no matter where they are located. The usual copay and deductible for these check-ins will be waived.
- Providers can use popular apps for video chats, such as Apple FaceTime, Good Hangouts video, Skype, and Facebook Messenger video chat.
- The HHS Office of Civil Rights will waive penalties for HIPAA (Health Insurance Portability and Accountability Act) violations against healthcare providers who use video chatting apps with their patients “in good faith.” This means they will not be held responsible for any claims of violations of privacy.
Temporary Medicare Regulations
As discussed above, telehealth coverage is limited under normal circumstances. However, we are now in the middle of a global pandemic and it is very important that seniors stay at home and avoid contact with others. COVID-19 is highly contagious and more deadly for older adults (as well as those with compromised immune systems), so going to a doctor’s office now can present serious health risks for people over 65.
The new legislation signed in March allows the Centers for Medicare and Medicaid Services (CMS) to expand telehealth services available to Medicare beneficiaries so that they do not have to travel to their doctor’s office. According to Medicare.gov, now “doctors and other health care providers can use telehealth services to treat COVID-19 (and for other medically reasonable purposes) from offices, hospitals, and places of residence (like homes, nursing homes, and assisted living facilities.” These visits will be covered at the same rates as face-to-face visits for the time being.
Telehealth services are being extended during the current COVID-19 pandemic in order to reduce the risk of infection in doctors’ offices. These changes will allow doctors to provide care without worrying about packing their offices with vulnerable patients, and patients to stay home and receive care without worrying about an unexpected bill.