Medicare is Expanding Telehealth Services During Coronavirus Pandemic and Office for Civil Rights (OCR) has Announced “Enforcement Discretion”

Medicare

Senior doctor with smartphone working at the office.The Centers for Medicare & Medicaid Services (CMS) has broadened access to Medicare telehealth services so that beneficiaries can receive a wider range of services from their doctors without having to travel to a healthcare facility.  Medicare covers telehealth services that include office visits, psychotherapy, and consultations provided by an eligible provider who isn’t at your location using an interactive two-way telecommunications system (like real-time audio and video).

  • For the duration of the emergency, Medicare will pay for telehealth services furnished to beneficiaries “in all areas of the country in all settings” at the same rate as regular, in-person visits.
  • HHS will not conduct audits to track whether there was a prior patient-physician relationship for claims submitted during the public health emergency.
  • Patients must initiate services, but physicians may inform their patients on the availability of telehealth services.

EXPANSION OF TELEHEALTH WITH 1135 WAIVER: Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including in patient’s places of residence starting March 6, 2020.

The general policy regarding medical licensure and telehealth is that the physician must be licensed in the state where the patient is located at the time of treatment.  The AMA telehealth guide notes that CMS has waived this requirement for Medicare patients and that states may request a waiver for Medicaid patients.

HIPAA

The OCR, the HIPAA-enforcement arm of the HHS, announced that it will exercise “enforcement discretion” and would not impose penalties for noncompliance with regulatory requirements during the “good faith provision of telehealth” services during the COVID-19 national public health emergency.

It also specifically notes that public-facing communication vehicles such as Facebook Live, Twitch and TikTok should not be used in the provision of telehealth.

These are some key take-aways but if you would like more specifics, please contact Bratton Law and speak to our registered nurse, Claire Meredino.