The U.S. Department of Health and Human Services enacted telehealth related waivers on March 17, 2020 to allow greater access to health service during the ongoing COVID-19 public health emergency. The waivers offer providers with greater options to render medical services via telehealth for the pendency of the health emergency.
Telehealth Waiver for Patients Regardless of Location or Geographic Area
Medicare generally pays for telehealth services only when it is provided by a qualified practitioner to a patient located at certain rural “originating site” locations. As of March 6, 2020, the originating site limitations have been waived. During the emergency, Medicare will pay for telehealth visits furnished to patients across the country, in both rural and urban locations, and including normal originating sites such as medical offices, hospitals, skilled nursing facilities, and in non-health facility locations such as patients’ own residences. Practitioners must use an interactive ‘real time’ audio and video telecommunications system to communicate with the patient, will be treated the same as an in-person visit for billing purposes, and paid at Medicare’s regular in-person rates.
In addition, while telehealth is limited to established patient relationships between the patient and the rendering practitioner or their group practice, CMS has indicated that they do not intend to audit patient encounters to verify compliance with this requirement during the emergency period.
Waiver of HIPAA Enforcement for Non-Secure Communications Systems
To assist providers who do not normally provide telehealth services, OCR is also waiving HIPAA restrictions on the use of unencrypted communications technology to transmit protected health information during telehealth visits. During the emergency, OCR will not impose penalties in connection with the good faith provision of telehealth services using “non-public facing audio or video communication products” including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth services. Notably, Providers should avoid using any “publicly accessible” services such as Facebook Live or Tik Tok to communicate with patients.
Waivers of Co-Pays and Deductibles for Patients
From a fraud and abuse standpoint, the US Department of Health and Human Services Office of Inspector General (“OIG”) is waiving enforcement of prohibitions on the routine waiver or reduction of patient cost-sharing amounts (deductibles and coinsurance) when receiving telehealth services during the emergency. Providers are not required to waive or reduce patient cost sharing obligations, but may do so without fear of violating the fraud and abuse laws, provided that all other payment and coverage rules are met.
If you have any questions on the above or need assistance in implementing telehealth services in your practice during the COVID-19 public health emergency please contact Frantz Ward healthcare attorneys Craig Haran
or Brad Reed.
For other issues as the epidemic evolves, please contact Brian Kelly
or Christopher Koehler,
and they will engage the appropriate members of our Coronavirus Response Team.