All of the recent focus of Telehealth reimbursement has over-looked some key components of the Waiver 1135 and what you need to know now and into the future when the PHE ends.
• Medicare has waived penalties for HIPAA violations against clinicians that “act in good faith” to provide care though telehealth communication tools that may not be fully HIPAA compliant, such as Apple FaceTime, Skype, Google Hangouts, Facebook Messenger, and WhatsApp
• Practices that do not have a HIPAA Business Associate Agreement in place with the app developer organization, which under normal circumstances would be required, will not be penalized
• Medicare practitioners are allowed to provide telehealth services to patients that reside in other states (if also permitted by state requirements)
• CMS will not conduct audits to determine if Medicare patients that receive a telehealth encounter had a previously established relationship with the provider
• The Drug Enforcement Agency will no longer require that patients submit to in-person physical exams prior to being prescribed controlled substances. Instead providers can use a real-time, two-way,audio-visual communications device prior to prescribing controlled substances.
• Many behavioral health and education services may now be furnished via telehealth using audio-only technology. On April 30, 2020 CMS added a column that identified 89 HCPCS codes as audio-only services in the CMS telehealth code list file.
• Allowing providers to have flexibility to reduce or waive cost-sharing for telehealth visits paid for by federal government healthcare programs. On March 17, 2020, OIG issued “OIG Policy Statement Regarding Physicians and Other Practitioners That Reduce or Waive Amounts Owed by Federal Health Care Program Beneficiaries for Telehealth Services During the 2019 Novel Coronavirus (COVID-19)Outbreak. But how do you start informing patients that they will now have a share of cost once the PHE is lifted? It is easier to take away then then to put back in.