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CMS Announces Relaxed Telehealth Rules to Support COVID-19 Emergency

Wednesday, March 25, 2020   (0 Comments)
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This article was written for AAOE by Marion K. Jenkins, PHD, FHIMSS, Partner at HealthSpaces


CMS Announces Relaxed Telehealth Rules to Support COVID-19 Emergency

Expands billable services, increases options for more readily available technology solutions


On March 17, 2020, CMS announced relaxed restrictions during the current COVID-19 situation on the types of telehealth encounters that can be reimbursed. This is retroactive starting March 6, 2020, and for the duration of the COVID-19 Public Health Emergency.  Services include Medicare Telehealth Services, Virtual Check-In and E-Visits.  It expands billable services, removes geographic restrictions (beyond just rural), relaxes some rules concerning HHS audits and HIPAA, which opens up many more attractive technology options to physician clinics. 


This important pivot by CMS significantly improves the ability of providers to care for their patients while lessening the risk of exposure to everyone involved.  It is very beneficial for those patients whose needs might be considered “routine” in terms of COVID-19, but still represent a critical stage in a patient’s care cycle, including check-in visits, post procedure followup, prescription refills, etc.  It is expected that commercial payers will follow CMS’ lead in expanding the billable procedures, but there is little formal information so far on this. 


Significant highlights of the new CMS rules:

      For Medicare Telehealth Visits, HHS will relax audit requirements that currently require a prior established relationship between a patient and a provider.

      The number of allowed services is significantly expanded, along with the ability for non-physician healthcare professionals to provide and bill for certain e-visits. 

      HHS will use “enforcement discretion” and waive penalties for HIPAA violations, and specifically allows the use of “everyday communications technologies” for telehealth. 


This expanded use of telehealth is already well underway, which unfortunately has caused some dedicated telehealth platforms to be overloaded as reported here


Dedicated, healthcare-centric video- and tele-conferencing solutions have always touted their  purpose-built architecture as an advantage.  However, this has proven to be a disadvantage  during this crisis because of high cost, scalability issues and slower implementation times. 


This has shined the light on the advantages of “everyday communications technologies” such as Google Meet, Zoom, Skype,  etc.  Indeed, these solutions have always had the advantage of rapid implementation, user friendliness and little or even no cost.  In addition, their massive scalability seems to readily absorb the sudden increase in users.  


It is also anticipated that once this crisis is over, there will be an ongoing and continued interest in telehealth solutions and other virtual technologies, which has long been a desire for many providers, staff and patients alike.  Going forward, this is an important consideration for the design and operation of medical facilities, as well as the benefits of developing more user- friendly automation into clinical and business office workflows.  

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