{"id":26695,"date":"2020-03-19T18:01:06","date_gmt":"2020-03-19T18:01:06","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=26695"},"modified":"2020-03-19T18:01:06","modified_gmt":"2020-03-19T18:01:06","slug":"cms-takes-significant-action-to-spur-use-of-telehealth-services-for-duration-of-covid-19-emergency","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/cms-takes-significant-action-to-spur-use-of-telehealth-services-for-duration-of-covid-19-emergency\/","title":{"rendered":"CMS Takes Significant Action to Spur Use of Telehealth Services for Duration of COVID-19 Emergency"},"content":{"rendered":"\n

On March 13, 2020, President Donald Trump issued a proclamation<\/a> declaring a national emergency concerning the novel coronavirus disease (the \u201cEmergency Declaration\u201d).  The president framed the emergency declaration as empowering the Secretary of Health and Human Services (\u201cHHS\u201d) to waive \u201claws to enable telehealth,\u201d which gave providers hope that the administration would remove some of the primary regulatory barriers to the broad implementation of telehealth services. In the days since the declaration, the administration has taken increasingly significant steps to do just that.<\/p>\n\n\n\n

The Emergency Declaration authorized the Secretary of HHS to exercise his waiver authority under Section 1135 of the Social Security Act (42 U.S.C. \u00a7 1320b\u20135). Section 1135 empowers the Secretary to waive or modify only certain provisions under Medicare, Medicaid, the Children\u2019s Health Insurance Program (\u201cCHIP\u201d), and the Health Insurance Portability and Accountability Act (\u201cHIPAA\u201d) during a national emergency.  Congress broadened these waiver authorities in the emergency supplemental appropriations bill<\/a>, signed into law on March 6, which gave the Secretary additional authority under Section 1135 to loosen Medicare\u2019s telehealth billing standards. It also specifically allowed the Secretary to waive the requirement that the beneficiary live in a rural area and receive the services at an approved remote site, such as a rural hospital.<\/p>\n\n\n\n

Since the emergency declaration, CMS has taken three separate actions to spur the implementation of telehealth during this crisis.<\/p>\n\n\n\n

First, on March 13, the Secretary published an initial list of waivers<\/a> available for health care providers under his 1135 authority. Of these, only one is applicable to telemedicine. HHS is waiving the Medicare billing requirement that out-of-state providers be licensed in the state where they are providing services when they are licensed in another state. Thus, providers who are licensed in State A may bill Medicare for telehealth services delivered to residents of State B, provided they are not barred from practice in State B. Note that this waiver is for the purposes of Medicare, Medicaid, and CHIP reimbursement; it does not preempt state licensing rules.<\/p>\n\n\n\n

Generally, all states require telemedicine providers to be licensed domestically prior to delivering services to patients located in their state. Twenty-nine states plus the District of Columbia have joined the Interstate Medical Licensure Compact, which enables expedited licensure for physicians to practice across state lines. Other states, such as Oregon, have a specific expedited licensure process for out-of-state providers who wish to deliver telemedicine services within their borders. Even with these expedited applications, licensure requirements still pose a significant barrier to practicing medicine across state lines, unless state licensing agencies follow suit and begin to allow waivers .<\/p>\n\n\n\n

Second, on March 17, CMS issued a waiver to allow Medicare to reimburse for telehealth services under a much broader set of circumstances. Effective March 6, 2020 and for the duration of the COVID-19 public health emergency, Medicare will:<\/p>\n\n\n\n