Consistent with recently issued recommendations from The Centers for Disease Control (CDC) for social distancing during the COVID-19 emergency, on March 17, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that, during the on-going public health crisis, it will permit Medicare providers to bill traditional Medicare (Medicare Parts A and B) for telemedicine services provided to Medicare beneficiaries. Until now, traditional Medicare only provided telehealth coverage for Medicare beneficiaries for certain limited services and only via communication from pre-approved locations.

For so long as the new policy remains in effect, Medicare providers will be able to deliver telehealth evaluation & management, mental health counseling and preventive health screening services by phone or video devices (i.e., Skype or FaceTime), and beneficiaries will be able to receive them at any location, including their own home. Provider reimbursement will be at the same Medicare Physician Fee Schedule rate applicable to an in-person visit to a medical office.

In connection with this policy change, the federal government is waiving certain security and privacy requirements of the Health Insurance Portability and Accountability Act (HIPAA) so that anyone will be able to assist in the facilitation of technology for a telehealth visit by a Medicare beneficiary without the need of prior authorizations or device encryption. Additionally, to encourage senior use of the telehealth options and provide administrative ease, the HHS Office of Inspector General will permit providers to waive or reduce cost-sharing amounts (i.e., co-pays and deductibles) for traditional Medicare beneficiaries. The recently enacted policy changes will not, however, automatically dispense with the need to comply with other Medicare program participation requirements or local professional licensing or professional ethical requirements applicable to the delivery of telehealth services.

We encourage our clients in the health and senior housing industries to consider taking advantage of these recent policy changes as they adapt their service delivery models in light of the COVID-19 pandemic.  In addition, we encourage them to monitor other regulatory developments which may impact their ability to operate during this public health crisis and evaluate, as they re-tool for this new era, their potential eligibility to participate in government financial support programs currently under consideration by Congress.

If you would like more information on these Medicare reimbursement policy changes, or wish to receive advice on health law-related regulatory developments impacting your practice or explore potential opportunities to enhance your ability to finance the continuation of medical service delivery without compromising patient or provider safety during this challenging time, contact either Rafael A. Ruiz-Ayala, rruizayala@dugganbertsch.com or Mori A. Hall, mhall@dugganbetsch.com, of our Health Law Practice Group.