The coronavirus (COVID-19) pandemic has quickly transformed our economy, daily lives, and overall health care system.  While this crisis has presented our world with record challenges, it has created a rapid adoption of telehealth and the need to deliver health care at a distance.  Changes are needed to reduce staff exposure to ill patients, preserve PPE, and minimize the impact of surge on health care organizations.  Telehealth services help provide necessary care to patients while minimizing the risk of contracting the virus.

As the outbreak spreads, many practices are facing a decline in patient visits, and virtual visits may give patients and practices the peace of mind from the worry of the spread of infection. Telehealth visits via phone call or video chat are two ways to reduce viral exposure, and the federal government is encouraging health care providers to adopt and use telehealth to see patients in appropriate situations. Many payers are recognizing the importance of telehealth to prevent in-person spread of the virus while still providing quality care to beneficiaries.  As a result, new revisions to regulations regarding telehealth are assisting practices by promoting the use of the services.

Technology: The federal government has provided flexibility in the video equipment that can be used and many vendors are offering free or reduced prices in support of a quick ramp-up of telehealth services. Types of products include:

• Video Only or simple phone calls: Quick to implement (Facetime/Skype/Zoom)
• Telehealth-Specific Video: Many vendors support South Carolina provider needs and we have gathered contacts for those who demonstrate ease of startup and low or no startup costs. Technology vendors found here: HIPAA Compliant Telehealth Technology
• Video Embedded into Electronic Health Record: More time consuming to implement but important to research for future efficiencies while using telehealth (since COVID is just the beginning for telehealth adoption)

HIPAA: The Federal Office of Civil Rights (OCR) has temporarily relaxed its standards during this national emergency to allow covered health care providers to use video technologies that do not fully comply with HIPAA rules. Health care providers choosing to use products such as FaceTime or Skype should inform patients that there may be privacy risks. Health care providers seeking more privacy for patients should consider products that use encryption and tools such as passcodes to restrict the session.

Reimbursement: Reimbursement of services delivered via telehealth is complex and not necessarily consistent across Medicare, Medicaid and private payers. However, CMS has continued to expand COVID-19 Telehealth reimbursement, so it is important to closely monitor these updates as payers tend to follow the same guidelines as CMS. Some of these highlighted changes are:

• Many payers are waiving the video requirement for certain evaluation and management services, enabling providers to bill Medicare for services delivered by audio-only phones.
• Rural Health and Federally Qualified Health Clinics previously were not paid to provide telehealth expertise as “distant sites”.  Now, Medicare beneficiaries located in rural and other medically undeserved areas will have access to care from home without travel.
• Physical and occupational therapy as well as speech language pathology are now eligible for telehealth reimbursement.
• Other general CMS telehealth reimbursement changes found here: Telehealth Reimbursement Policies

Implementation: “HHS Telemedicine Hack” telemedicine implementation learning course for ambulatory providers-10-week learning session on Wednesdays beginning July 22-September 23, 2020:

• 5 sessions on key topics including workflows, documentation, reimbursement
• 5 virtual “office hour” discussion panels with experts responding to questions
• Inter-session peer-to-peer learning via virtual discussion and ad hoc interest groups
• CME/CEU available and at no cost to participants
• Click to register: HHS Telemedicine Hack 10-Week Learning Course

If your practice is among those seeking to ramp up telemedicine visits for patients during the coronavirus pandemic, we can help.  Our experienced team has implemented these processes in organizations and can work with you on a seamless implementation.   Contact our Healthcare Services Team for more information or to get assistance with your telemedicine initiatives: healthcare@websterrogers.com.