Telehealth Rules Relaxed During Pandemic

Understanding What is Currently Permitted and Reimbursed

Although telehealth has been part of the healthcare landscape for years, the recent COVID-19 global pandemic has catapulted it into the limelight. Before 2020, strict rules and regulations limited the use of telehealth technologies, and Medicare, Medicaid, and many insurance companies would not reimburse for the majority of telehealth services.

When the pandemic rapidly spread around the world, healthcare providers had to find safer ways to care for not only those potentially infected with COVID-19 but also other patients. As a result, the federal government allowed more flexibility in telehealth and the Centers for Medicare & Medicaid Services (CMS) witnessed a weekly jump from 14,000 to nearly 1.7 million virtual visits during the last week of April 2020. Later that summer, President Trump signed an executive order to expand access even further.

Increased Channels to Telehealth Services

Nearly everyone is familiar with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that was created to safeguard sensitive patient data. Prior to COVID-19, healthcare facilities were required to use only HIPAA-compliant telehealth systems.

The U.S. Department of Health and Human Services relaxed these rules during the pandemic, saying that “a covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients.”

This permission allows healthcare providers to use a wide variety of means to communicate with and serve patients including phone consults, text messaging, smartphone applications, and video conferencing devices.

HHS has stated that “covered health care providers will not be subject to penalties for violations of the HIPAA Privacy, Security, and Breach Notification Rules that occur in the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”

State Licensing Changes

During this period, many state governments have also relaxed state-level rules and licensing requirements in order to improve patient care during this unusual time.  More than 41 states and U.S. territories have approved waivers that provide more flexibility during the pandemic.

The American Medical Association has encouraged state governments to align themselves, at minimum, with the current Medicare telemedicine guidelines. In addition, the AMA strongly suggests that states follow other state telehealth best practices including:

• Protect continuity of patient care by eliminating separate telemedicine insurance networks
• Ensure wide coverage and reimbursement for all medically needed services that can be successfully provided via telehealth visits
• Treat telemedicine services equal to in-person visits and reimbursed at the same rate
• Allow coverage and payment for all telehealth modalities, including voice only
• Waive requirements that an existing patient-physician relationship must exist prior to telehealth visits
• Guarantee patients have access to telehealth services from their selected provider, if available
• Allow physicians to provide telehealth services without requiring a telemedicine contract
• Provide coverage and payment of COVID-19 telehealth visits with zero cost sharing
• Suspend any restrictions on telemedicine, including service type and geographic limitations
• Permit telehealth visits across state lines

More Services Reimbursed

One of the most significant changes instituted during the national emergency relates to Medicare reimbursements. According to a document published by the American Medical Association, Medicare will now reimburse for telehealth visits at the same rate as in-person visits around the country. Hundreds of telehealth services are now eligible for Medicare reimbursement.

In addition, under the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), waivers have been issued that allow a broader number of practitioners to provide telehealth services. Physical therapists and occupational therapists as well as speech language pathologists and others, who were previously unable to bill for Medicare telehealth services, can now do so.

Many private insurers have followed suit. Some insurance companies are now waiving member cost-sharing requirements for telehealth visits and behavioral health treatment while others have supported the expansion of telemedicine services through providing equipment that can be used remotely by patients.

Telehealth and Malpractice Insurance

If you have or are planning to expand your telehealth services, contact your professional liability provider to ensure that any and all telehealth services and electronic communications are covered. They should provide you with the same level of coverage as for an in-person visit. NOW Insurance covers telehealth implementation for all our customers. Our organization can quickly provide affordable and simple insurance to healthcare practitioners and allied health workers. We also offer general liability for private practices, clinics, hospitals and other medical facilities. Request an immediate quote from our quick and easy online application.

Since telehealth relies much more on internet and cloud-based communication methods, healthcare practitioners and practices may be more vulnerable to cyber-attacks and data breaches. Consider investing in cyber liability insurance as an extra layer of protection against such an incident.