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Telehealth

Federal updates

CARES Act - Stimulus Updates

Section 3703. Expanding Medicare Telehealth Flexibilities

This section would eliminate the requirement in Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 (Public Law 116-123) that limits the Medicare telehealth expansion authority during the COVID-19 emergency period to situations where the physician or other professional has treated the patient in the past three years. This would enable beneficiaries to access telehealth, including in their home, from a broader range of providers, reducing COVID-19 exposure.

Section 3704. Allowing Federally Qualified Health Centers and Rural Health Clinics to Furnish Telehealth in Medicare

The CARES Act provides $275 million for the Health Resources and Services Administration, including $185 million to expand telehealth services at rural critical access hospitals.

This section would allow, during the COVID-19 emergency period, Federally Qualified Health Centers and Rural Health Clinics to serve as a distant site for telehealth consultations. A distant site is where the practitioner is located during the time of the telehealth service. This section would allow FQHCs and RHCs to furnish telehealth services to beneficiaries in their home. Medicare would reimburse for these telehealth services based on payment rates similar to the national average payment rates for comparable telehealth services under the Medicare Physician Fee Schedule. It would also exclude the costs associated with these services from both the FQHC prospective payment system and the RHC all-inclusive rate calculation.

Section 3705. Expanding Medicare Telehealth for Home Dialysis Patients

This section would eliminate a requirement during the COVID-19 emergency period that a nephrologist conduct some of the required periodic evaluations of a patient on home dialysis face-to-face, allowing these vulnerable beneficiaries to get more care in the safety of their home.

Section 3706. Allowing for the Use of Telehealth during the Hospice Care Recertification Process in Medicare

Under current law, hospice physicians and nurse practitioners cannot conduct recertification encounters using telehealth. This section would allow, during the COVID-19 emergency period, qualified providers to use telehealth technologies in order to fulfill the hospice face-to-face recertification requirement.

Section 3707. Encouraging the Use of Telecommunications Systems for Home Health Services in Medicare

This section would require the Health and Human Services to issue clarifying guidance encouraging the use of telecommunications systems, including remote patient monitoring, to furnish home health services consistent with the beneficiary care plan during the COVID-19 emergency period.

CMS

The U.S. Department of Health and Human Services issued a waiver temporarily eliminating the requirement that the telehealth originating site must be a physician’s office or other authorized healthcare facility and allows Medicare to pay for telehealth services when beneficiaries are in their homes or any setting of care. Starting March 6, services delivered by telehealth to a Medicare beneficiary are reimbursable regardless of geographic restrictions or originating site limitations.

In particular, this includes services delivered to beneficiaries in non-rural areas and/or located in their own homes. CMS will not enforce the requirement that patients have a prior relationship with the telehealth provider. The telehealth visits are considered the same as in-person visits and will be paid at the same rate. Providers may also continue to provide the virtual check-in services and e-visits that they were previously able to offer.

OCR

Effective immediately, the HHS Office for Civil Rights will exercise enforcement discretion and waive penalties for Health Insurance Portability and Accountability Act violations against healthcare providers that serve patients in good faith through everyday communications technologies such as FaceTime or Skype during the COVID-19 nationwide public health emergency.

State DOH/Medicaid

Governor’s Office

DOH

New York State Medicaid will reimburse evaluation and management services delivered by telephone (in addition to telehealth) in cases where face-to-face visits may not be recommended and it is medically appropriate for the member to be evaluated and managed by telephone. Telephonic E&M services must be provided by a physician, nurse practitioner, physician assistant or licensed midwife actively enrolled in fee-for-service Medicaid or Medicaid managed care plans. The rate range represents between $80 and $100/hour (depending on length of time).

Gov. Cuomo’s Executive Order 202.5, issued March 18, authorizes the waiver of regulations to permit home health and long-term care providers to permit in-person and in-home supervision to be conducted by telephone or video.

Verbal consent is permitted during the emergency, but must be documented.

Telehealth-related updates from DOH:

Billing and insurers

Commercial Insurers

The New York State Department of Financial Services and Vermont Department of Financial Regulation require private health insurers in New York and Vermont to make COVID-19 testing free for patients by waiving any out of pocket costs. COVID-19 screening and testing is free for all insurers. The member will not be responsible for any copayments, other cost share, or fees associated with:

  • An emergency room visit or visit to an in network health care provider for the purpose of getting tested for COVID-19.
  • Drive-thru specimen collection sites.

Aetna

MVP Health Care, Inc.

MVP Health Care is offering telemedicine services, its myERnow virtual emergency room and myVisitNow online doctor visits.

CDPHP

The following telemedicine services are being made available to CDPHP members at no cost share:

  • ER Anywhere: Emergency telemedicine app available to members 24/7 for consultations, triage, testing and treatment. ER Anywhere is a safe and convenient alternative to the emergency room.
    • Members can access ER Anywhere by downloading the mobile app or calling 1-866-ER-Anywhere.
  • Doctor On Demand: Telemedicine app available 24/7 for consultation, testing and treatment. Doctor On Demand is a safe and convenient alternative to urgent care. Members can access Doctor On Demand by downloading the mobile app or logging into the Doctor On Demand website.
  • CDPHP is also encouraging members to take advantage of telephonic consultations. To that end, CDPHP will be covering telephonic consults (audio and video) with participating providers for physical and mental health services.

BlueShield of Northeastern New York

Blue Shield of NENY offers telemedicine through Doctor on Demand.

Excellus BC/BS

Telehealth services are covered under all product lines. Excellus will waive the cost share for all telehealth visits (not just those related to COVID-19) for all members until the State of Emergency has been lifted.

Associations

AMA

American College of Physicians

American Academy of Family Physicians

Webinars/Conference Calls