Earlier this month, the Congressional Telehealth Caucus introduced the Protecting Access to Post-COVID-19 Telehealth Act of 2020 (“Act”). This bipartisan bill will continue the current, temporary expanded use of telehealth beyond the COVID-19 pandemic by eliminating limitations that restrict its use for Medicare beneficiaries. In particular, the Act will (i) eliminate most geographic and originating site restrictions on the use of telehealth in Medicare and establish a patient’s home as an eligible distant site, which allows patients to receive care from home and providers to be reimbursed for delivering the same, (ii) prevent a sudden loss of telehealth services for Medicare beneficiaries by authorizing the Centers for Medicare and Medicaid Services (CMS) to continue reimbursement for telehealth for 90 days beyond the end of the public health emergency, (iii) make permanent the disaster waiver authority, enabling the Department of Health and Human Services to expand telehealth in Medicare during all future emergencies and disasters, and (iv) require a study on the use of telehealth during COVID-19, including its costs, uptake rates, measurable health outcomes, and racial and geographic disparities.
In late June, more than 300 healthcare and technology organizations submitted a joint letter to congress asking for permanent change to telehealth regulations. The Act addresses nearly all of the industry stake holders’ priorities, including the ability to provide reimbursable telehealth care to CMS beneficiaries while they are located in their homes. If enacted, this component of the Act would alleviate the most prevalent challenge telehealth providers face when seeking to provide Medicare beneficiaries with access to care—the location of patient at the time of the encounter.
Following this trend of telehealth expansion, it is expected that the annual proposed Medicare Physician Fee Schedule will follow suit. The Physician Fee Schedule has not yet been published but is typically released each July.
In addition to federal support, state representatives have also continued to advocate for telehealth expansion. Earlier this month, Colorado Governor, Jared Polis, signed SB20-212, a bill that expands telehealth access. It prohibits health insurance carriers from: (i) imposing limitations or requirements on HIPAA-compliant technologies; (ii) requiring a previously established patient-provider relationship in order to receive medically necessary telehealth services; and (iii) imposing additional certification, location, or training requirements. Furthermore, the state’s Medicaid program will no longer require previous in-person contact as a condition for reimbursement of health care or mental health care delivered through telemedicine.
In Idaho, Governor Brad Little signed Executive Order NO. 2020-13, which seeks to make permanent certain COVID-19 related waivers for telehealth. As a result of the public health emergency, more than 150 state rules were temporarily waived. The Executive Order prompts state agencies to evaluate whether these waived regulations are unnecessary or counterproductive outside of the declared emergency, with the intention of simplifying and eliminating rules and regulations that interfere with efficient access to virtual healthcare. Idaho waivers include reimbursement of telehealth services delivered telephonically without real-time video, expanding previous limitations on originating or distant sites, and coverage for telehealth visits provided by in-network providers. Idaho state agencies are required to submit final rule changes to the state legislature by January 2021.
How Frier Levitt Can Help
We expect access to telehealth to continue to expand, alongside coverage for the same. Through this dynamic period of development, stakeholders must continue to abide by applicable laws and regulations that are changing regularly. For a review of your current practices or assistance creating a compliant telehealth business model, contact Frier Levitt.