CMS Rolls Out a General Provider Telehealth and Telemedicine Tool Kit

Information from CMS for medical providers on telehealth and telemedicine

Information from CMS for medical providers on telehealth and telemedicineBy: Susan St. John

CMS has rolled out a telehealth/telemedicine tool kit to assist medical professionals with health care delivery during the current COVID-19 public health emergency.

The toolkit contains information and links concerning:

 

  • 1135 Waivers – allows the Secretary of HHS to temporarily waive or modify certain Medicare, Medicaid, and Children’s Health Insurance Program (CHIP) requirements to ensure sufficient health care services and items are available to meet the needs of individuals enrolled in Social Security Act programs during the emergency and that providers who provide services in good faith can be reimbursed and exempted from sanctions (provided there is no determination of fraud and abuse). 1135 waiver or modifications include:
    • Conditions of participation and other certification requirements;
    • Program participation and similar requirements;
    • Preapproval requirements;
    • State licensing requirements where services are rendered as long as the provider has equivalent licensing in another State (for Medicare, Medicaid, CHIP reimbursement only; State licensing still controls whether a non-Federal provider may provide services in a state he/she is not licensed in);
    • EMTALA sanctions for redirection for medical screening, as long as redirection is not the result of discrimination on the basis of a patient’s source of payment or ability to pay;
    • Stark self-referral sanctions;
    • Adjustment (not waiver) to performance deadlines and timetables;
    • Limitations on payment to permit Medicare enrollees to use out of network providers in an emergency situation.

Continue reading

A Telehealth Break for Medicare Patients and Providers

new medicare laws for telehealth related to corona virus

new medicare laws for telehealth related to corona virusBy: David J. Davidson

Up until now, Medicare has been fairly structured in how telehealth services are reimbursed. Medicare would pay for telehealth services only if certain, very narrow criteria were met. These rules covered the patient, the patient’s location, the provider, the types of services rendered, the telehealth equipment used and the way the services are coded. Those rules can now be relaxed under recent federal legislation.

On March 6, 2020, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 into law. That law relaxes the current Medicare criteria, in order to expand the use of telehealth as a resource against COVID-19. Pursuant to this law, the Secretary of HHS has the authority to waive the “site” requirements for telehealth services provided to Medicare beneficiaries who are located in an identified “Emergency Area” during an “Emergency Period.” Since the whole country is currently is experiencing a public health emergency, as declared by both the President and the Secretary of HHS, the Emergency Period and Emergency Area requirements are met on a nation-wide basis.

Continue reading