Telehealth benefits expanded during coronavirus crisis

The Trump administration expanded telehealth benefits coverage under Medicare in order to treat patients without traveling to a healthcare facility and risk catching or spreading the new coronavirus, COVID-19. Telehealth has been touted as a means to ensure people have access to their doctors without additional risks during the COVID-19 crisis.

Medicare is temporarily paying clinicians to provide telehealth services for beneficiaries nationwide, as of March 6. CMS is expanding the coverage benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. Previously, Medicare only covered telehealth care under certain circumstances, such as if the beneficiary lived in a rural area. In these cases, the beneficiary also typically wasn’t allowed to receive telehealth in their home, according to CMS.

“These changes allow seniors to communicate with their doctors without having to travel to a healthcare facility so that they can limit risk of exposure and spread of this virus,” CMS Administrator Seema Verma said in a statement. “Clinicians on the frontlines will now have greater flexibility to safely treat our beneficiaries.”

Medicare patients are already allowed to have “brief check-ins” with their clinicians through phone, video chat and online patient portals. With expanded coverage, beneficiaries can receive common office visits, mental health counseling and preventive health screenings. Medicare patients who may be at a higher risk of severe illness from COVID-19 can still visit with their physician without leaving home. The benefits also ensure patients can adhere to social distancing recommendations from the CDC to prevent the spread of the virus.

“Providers will be allowed to use everyday technologies to talk to telehealth patients, more telehealth services will be covered for millions more Medicare beneficiaries, and providers will be allowed to offer these telehealth benefits to Medicare beneficiaries at a lower cost than traditional services,” HHS Secretary Alex Azar said in a statement.

Clinicians can bill for these services beginning March 6, which is paid under the Physician Fee Schedule at the same rate as in-person services.

The actions were met with support from the American Medical Association.

“The use of telemedicine and remote care services are critical to the management of the COVID-19, while also ensuring uninterrupted care for 100 million Americans with chronic condition," AMA President Patrice A. Harris, MD, MA, said in a statement. "The AMA encourages any private payers that are not already covering telehealth services to remove those limitations now. The AMA stands ready to help physicians expand their use of telemedicine and continues to invest in resources that provide physicians with a proven path for integrating telemedicine and digital health technologies into patient care."

Healthcare industry group MGMA, which represents more than 15,500 organizations and 55,000 medical practice administrators, executives and leaders, also urged HHS to take action to implement new telehealth waiver authority last week.

At the same time CMS announced expanded telehealth, the agency also announced it approved Florida’s request for a Section 1135 Medicaid waiver to increase flexibilities to treat beneficiaries in dealing with the pandemic of COIVD-19. Specifically, the approval waives prior authorization requirements to remove barriers to some services, streamline provider enrollment processes, allow care in alternative settings if facilities are evacuated to an unlicensed facility, suspend some nursing home screening requirements and extend appeals deadline and state fair hearing requests, according to CMS.

“I want to thank Governor DeSantis for his leadership in Medicaid and for taking full advantage of federal flexibilities,” Verma said March 17. “CMS is committed to removing all unnecessary administrative and bureaucratic barriers that may hinder an effective response to this public health emergency, and I have directed my team to expeditiously process these requests.”

CMS expects more states to follow Florida’s actions to apply for the 1135 waiver.

"Florida is acutely focused on eliminating unnecessary barriers on our healthcare providers who are on the front lines serving our communities most impacted by COVID-19,” Florida Governor Ron DeSantis said in a statement. “President Trump recognizes this need and Administrator Seema Verma is providing Florida the critical flexibility for our state’s Medicaid program by waiving prior authorization requirements for essential healthcare services and expedited provider enrollment.”