NEW: HHS, CMS, DEA Implement Waivers to Expand Telehealth & Virtual Services for Medicare Beneficiaries
Policy Update – 3.17.20
On March 17, the Administration announced new flexibilities from multiple agencies intended to expand access to telehealth under COVID-19 emergency authorities. The ATA believes that telehealth is key to addressing this national emergency and we are pleased that the Administration has taken significant steps toward expanding telehealth coverage for Medicare beneficiaries.
ATA worked with members last week to provide key recommendations to the Administration on actions needed to expand telehealth, many of which were included in the announcement yesterday.
MEDICARE AND MEDICAID
The Centers for Medicare and Medicaid Services (CMS) is using Section 1135 waiver authority to waive originating site restrictions for telehealth during this emergency. The agency will reimburse for telehealth visits to Medicare patients starting March 6, whether the patient is in a health care facility or in their home. CMS specifically notes that it will exercise enforcement discretion on the 3-year pre-existing relationship rule created by Congress (see previous alert for more information).
CMS also notes that Medicaid programs have the flexibility to allow for telehealth reimbursement and do not need the federal government’s permission to do so.
- CMS Press Release: https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak
- CMS Fact Sheet: https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak
- CMS FAQs: https://edit.cms.gov/files/document/medicare-telehealth-frequently-asked-questions-faqs-31720.pdf
The Department of Health and Human Services Office for Civil Rights (HHS OCR) issued a notification of Enforcement Discretion indicating that OCR will not enforce certain HIPAA regulations during this emergency in order to ease access to telehealth services.
- HHS OCR Notice: https://www.hhs.gov/hipaa/for-professionals/special-topics/emergency-preparedness/notification-enforcement-discretion-telehealth/index.html
Ryan Haight Remote Prescribing
The Drug Enforcement Administration (DEA) answered “yes” to the question “can telemedicine now be used under the conditions outlined in the [Controlled Substances Act]?” under the public health emergency telemedicine exception to Ryan Haight. DEA-registered prescribers may issue prescriptions for controlled substances via telemedicine without a prior in-person evaluation if the prescription is for a legitimate medical purpose, real-time two-way audio-video is used, and the practitioner is acting in accordance with state law.
- DEA COVID-19 information page: https://deadiversion.usdoj.gov/coronavirus.html
Waiving Cost Sharing
The Department of Health and Human Services Office of the Inspector General (HHS OIG) has issued a notice to physicians and other practitioners that they will not be subject to administrative sanctions for reducing or waiving cost-sharing for telehealth. This applies to patients receiving care funded by federal health programs.
- HHS OIG Policy Statement: https://oig.hhs.gov/fraud/docs/alertsandbulletins/2020/policy-telehealth-2020.pdf
Please share your reactions with us on these developments. We are working to provide Congress and the agencies with recommendations on a rolling basis and need your help in identifying priorities that will have the most impact.