Coronavirus $8.3 Billion Spending Bill Waives HHH Constraints on Telehealth Use
Congress recently passed a spending bill to provide $8.3 billion to combat the spread of the coronavirus (COVID-19). The bill allows the Department of Health and Human Services (HHS) to lift restrictions that have been in place regarding telehealth services under Medicare Part B, but still kept some limitations.
Specifics of the bill include:
- Waiving the “original site’ requirement allowing telehealth to be used and reimbursed in nonrural areas, patients’ homes, and other nontraditional sites.
- Allowing telephones to be used to provide telehealth services provided the telephones have 2-way, real-time interactive audio, and video capabilities.
The following circumstances are applicable to the waivers:
- Continue throughout the declared public health emergency for the 2019 novel coronavirus issued by the Secretary of Health and Human Services on January 31, 2020, and including any renewals.
- Require that the distant site practitioner—or a practitioner within his or her same practice—has a pre-existing relationship with the patient within the last three years and that the relationship is documented by Medicare reimbursements.
Notably, because the entire country is under the public health emergency, waivers apply to anywhere in the U.S. for any Medicare-reimbursable telehealth service—not just for treatment of the coronavirus. Also, although the originating-site requirement may be waived, a facility fee is still available only to the previously approved types of eligible originating sites (e.g., hospitals, physician offices, nursing facilities).
Additionally, it is important to be aware that the Health Insurance Portability and Accountability Act (HIPAA) is still in effect and enforcement of privacy or security standards have not been relaxed by Congress or the Office for Civil Rights (OCR).
Compliance Perspective
Failure to observe and follow the applicable limitations regarding the government’s lifting of restrictions for telehealth services or diligently follow HIPAA guidelines for protecting residents’ right to privacy may result in citations and be considered violation of state and federal regulations.
Discussion Points:
- Review policies and procedures and amend as needed to cover the use of telehealth services and the need to ensure HIPAA privacy and security provisions are not compromised.
- Train staff regarding the use of telehealth services and the importance of reporting any incident where the proper use was ignored to a supervisor or through the Hotline.
- Periodically audit to determine if telehealth services are being provided to residents and if the limitations and HIPAA privacy and security standards are being followed.
