{"id":27785,"date":"2020-06-11T18:45:52","date_gmt":"2020-06-11T18:45:52","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=27785"},"modified":"2020-06-11T18:45:52","modified_gmt":"2020-06-11T18:45:52","slug":"the-covid-19-pandemic-is-demonstrating-the-value-of-telehealth-and-medicaid-is-poised-to-capitalize","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/the-covid-19-pandemic-is-demonstrating-the-value-of-telehealth-and-medicaid-is-poised-to-capitalize\/","title":{"rendered":"The COVID-19 Pandemic is Demonstrating the Value of Telehealth and Medicaid is Poised to Capitalize"},"content":{"rendered":"\n

\u201cSocial distancing,\u201d a euphemism for an infection prevention and containment strategy, will undoubtedly live in the annals of meme history for its incredibly disrupting effects on the world.  Fortunately, advancements in technology that allow one to upload the same memes to the internet have also enabled medical providers to respond to the COVID-19 pandemic by furnishing medical care, also known as \u201ctelehealth\u201d or \u201ctelemedicine,\u201d to their patients in the comfort (and safety) of their own homes, thereby helping prevent the spread of COVID-19.<\/p>\n\n\n\n

Payers have different rules regarding coverage and payment for telehealth, including public payers like Medicare and Medicaid.  But while Medicare is limited in what they can do with telehealth on a permanent basis, Medicaid has considerably more flexibility to implement telehealth reforms that may endure past the public health emergency associated with COVID-19.  Today, we thought we would explore the extent of that flexibility for our readers as we\u2019re fairly confident that the nature of the delivery of care will change even after the conclusion of the COVID-19 pandemic.<\/p>\n\n\n\n

Background<\/strong><\/p>\n\n\n\n

The term \u201ctelehealth\u201d or \u201ctelemedicine\u201d is used widely in the Medicare program because Congress expressly allowed it to be paid in the same manner as the existing covered benefit for physician or practitioner services for Medicare beneficiaries. In Medicare, the Centers for Medicare & Medicaid Services (CMS) has defined the telecommunications technology necessary to furnish telehealth as requiring \u201ctwo-way\u201d interactive audio and visual telecommunications technology that allows real-time interaction between the provider and patient.\u00a0 Furthermore, Medicare ordinarily pays for telehealth furnished while the patient is in their home under very limited circumstances.\u00a0 In response to the COVID-19 public health emergency (PHE), however, Congress and CMS have significantly relaxed many of these requirements for the duration of the PHE.<\/p>\n\n\n\n

Medicaid, on the other hand, is not as federally restricted in its offering of telehealth.\u00a0 The Federal Medicaid statute and implementing regulations do not specifically recognize telehealth as a distinct service. Instead state Medicaid programs are generally afforded broad flexibility to cover telehealth services in the same manner in which state Medicaid programs cover face-to-face services under their existing state plan, Medicaid waiver, or state demonstration projects. States also have flexibility in setting payment rates for services provided through telehealth to Medicaid enrollees.\u00a0 And as we will see, CMS has recently clarified for states that they have greater flexibility to offer telehealth to Medicaid beneficiaries than is available to Medicare beneficiaries in the Medicare program.<\/p>\n\n\n\n

Recent CMS Guidance<\/strong><\/p>\n\n\n\n

On April 2, 2020, the Center for Medicaid and CHIP Services (CMCS) issued an informational bulletin (Guidance) clarifying that states may set payment methodologies for telehealth services that reimburse for the time spent by the provider at a distant site, the installation of equipment needed to perform the telehealth service, or the telehealth equipment itself. In the Guidance, CMS recognizes that there are generally four types of methods to furnish \u201ctelehealth\u201d:<\/p>\n\n\n\n